hospital_name last_updated_on version hospital_location hospital_address license_number|MD "To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated." TidalHealth Peninsula 12/10/2024 2.0.0 Peninsula Regional Hospital "100 E Carrolll St Salisbury, MD 21801" 22-003|MD TRUE billing_class description code|1 code|1|type code|2 code|2|type code|3 code|3|type code|4 code|4|type modifiers drug_unit_of_measurement drug_type_of_measurement setting standard_charge|gross standard_charge|discounted_cash payer_name plan_name standard_charge|negotiated_dollar standard_charge|negotiated_percentage standard_charge|negotiated_algorithm estimated_amount standard_charge|methodology standard_charge|min standard_charge|max additional_generic_notes additional_generic_notes_with_LPP facility HC DAILY CARE PX-120000000 CDM 120 RC inpatient 1896 1858.08 All Payors / Plans All Payors / Plans 1896 other 1896 1896 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DAILY CARE L2 PX-120000002 CDM 120 RC inpatient 1896 1858.08 All Payors / Plans All Payors / Plans 1896 other 1896 1896 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DAILY CARE OB PX-122000000 CDM 122 RC inpatient 1704 1669.92 All Payors / Plans All Payors / Plans 1704 other 1704 1704 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DAILY CARE-LABOR AND DELIVERY PX-122000001 CDM 122 RC inpatient 1704 1669.92 All Payors / Plans All Payors / Plans 1704 other 1704 1704 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DAILY CARE PEDIATRICS PX-123000000 CDM 123 RC inpatient 2837 2780.26 All Payors / Plans All Payors / Plans 2837 other 2837 2837 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DAILY CARE-PED NURSERY PX-123000001 CDM 123 RC inpatient 2837 2780.26 All Payors / Plans All Payors / Plans 2837 other 2837 2837 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DAILY CARE S3A PX-124000000 CDM 124 RC inpatient 2088 2046.24 All Payors / Plans All Payors / Plans 2088 other 2088 2088 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DAILY CARE S3 C&A PX-124000001 CDM 124 RC inpatient 2095 2053.1 All Payors / Plans All Payors / Plans 2095 other 2095 2095 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DAILY CARE-NURSERY A PX-170000000 CDM 170 RC inpatient 1215 1190.7 All Payors / Plans All Payors / Plans 1215 other 1215 1215 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DAILY CARE-NURSERY B PX-170000001 CDM 170 RC inpatient 1215 1190.7 All Payors / Plans All Payors / Plans 1215 other 1215 1215 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DAILY CARE ICU LAYFIELD PX-200000000 CDM 200 RC inpatient 3846 3769.08 All Payors / Plans All Payors / Plans 3846 other 3846 3846 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DAILY CARE-CT INTENSIVE CARE UNIT PX-200000001 CDM 200 RC inpatient 3846 3769.08 All Payors / Plans All Payors / Plans 3846 other 3846 3846 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DAILY CARE CICU PX-200000002 CDM 200 RC inpatient 3846 3769.08 All Payors / Plans All Payors / Plans 3846 other 3846 3846 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ADMISSION CHARGE PX-221000000 CDM 221 RC inpatient 409 400.82 All Payors / Plans All Payors / Plans 409 other 409 409 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFUSION HYDRATION 0-1 HR PX-260963600 CDM 96360 CPT 260 RC inpatient 264 258.72 All Payors / Plans All Payors / Plans 264 other 264 264 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFUSION HYDRATION EACH ADD HR PX-260963610 CDM 96361 CPT 260 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFUSION THERAPY NON CHEMO 0-1HR PX-260963650 CDM 96365 CPT 260 RC inpatient 594 582.12 All Payors / Plans All Payors / Plans 594 other 594 594 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFUSION NON CHEMO EACH ADD HR PX-260963660 CDM 96366 CPT 260 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFUS NON CHEMO SEQUENTIAL 0-1HR PX-260963670 CDM 96367 CPT 260 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFUSION THERPAY CONCURRENT PX-260963680 CDM 96368 CPT 260 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INJ. NON CHEMO INTRAMUSCULAR/SUB PX-260963720 CDM 96372 CPT 260 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INJ. NON CHEMO IV PUSH INITIAL PX-260963740 CDM 96374 CPT 260 RC inpatient 330 323.4 All Payors / Plans All Payors / Plans 330 other 330 330 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INJ NON CHEMO IV PUSH SEQUENTIAL PX-260963750 CDM 96375 CPT 260 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC THERAPEUTIC,PROPHYLATIC,DIAG INJ EA ADD'L PUSH NEW DRUG" PX-260963760 CDM 96376 CPT 260 RC inpatient 33 32.34 All Payors / Plans All Payors / Plans 33 other 33 33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR INTRATHECAL INJ OF CHEMO PX-260964500 CDM 96450 CPT 260 RC inpatient 1138.5 1115.73 All Payors / Plans All Payors / Plans 1138.5 other 1138.5 1138.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IRRIGATION IMPLANTED VENOUS ACCES PX-260965230 CDM 96523 CPT 260 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APHERESIS SUPPLIES PX-27000000 CDM 270 RC inpatient 811.78 795.54 All Payors / Plans All Payors / Plans 811.78 other 811.78 811.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IODINE RADIOELEMENT BRACHYTHERAPY PX-270000015 CDM Q3001 CPT 270 RC inpatient 70 68.6 All Payors / Plans All Payors / Plans 70 other 70 70 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PALADIUM RADIOELEMENT BRACHYTHER PX-270000016 CDM Q3001 CPT 270 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIALYSIS SUPPLIES PX-270001000 CDM 270 RC inpatient 102 99.96 All Payors / Plans All Payors / Plans 102 other 102 102 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERITONEAL DIALYSIS SUPPLY PX-270001050 CDM 270 RC inpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIOPATCH W/SORBA DRESSING KIT PX-270002000 CDM 270 RC inpatient 34.47 33.78 All Payors / Plans All Payors / Plans 34.47 other 34.47 34.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EPIDURAL CUSTOM ANESTHESIA TRAY PX-270009010 CDM 270 RC inpatient 54.2 53.12 All Payors / Plans All Payors / Plans 54.2 other 54.2 54.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONTIN EPIDURAL ANESTH TRAY PX-270009011 CDM 270 RC inpatient 23.92 23.44 All Payors / Plans All Payors / Plans 23.92 other 23.92 23.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CUSTOM SPINAL ANESTH TRAY PX-270009012 CDM 270 RC inpatient 41.98 41.14 All Payors / Plans All Payors / Plans 41.98 other 41.98 41.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRAY BLUE RHINE PERCU TRACH PX-270009013 CDM 270 RC inpatient 352.2 345.16 All Payors / Plans All Payors / Plans 352.2 other 352.2 352.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLEXSEAL FMS KIT PX-270009014 CDM 270 RC inpatient 318 311.64 All Payors / Plans All Payors / Plans 318 other 318 318 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLEXISEAL REPLACEMENT BAGS PX-270009015 CDM 270 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UNIVERSAL KNEE DRESSING PX-270009016 CDM 270 RC inpatient 18.25 17.89 All Payors / Plans All Payors / Plans 18.25 other 18.25 18.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ELASTOPLAST 2 PX-270009017 CDM 270 RC inpatient 3.84 3.76 All Payors / Plans All Payors / Plans 3.84 other 3.84 3.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OXYCEL PX-270009018 CDM 270 RC inpatient 74.22 72.74 All Payors / Plans All Payors / Plans 74.22 other 74.22 74.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESSING RESTORE PX-270009019 CDM 270 RC inpatient 4.68 4.59 All Payors / Plans All Payors / Plans 4.68 other 4.68 4.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESSING TEGADERM 3M X 15CM PX-270009020 CDM 270 RC inpatient 4.14 4.06 All Payors / Plans All Payors / Plans 4.14 other 4.14 4.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESSING PX-270009021 CDM 270 RC inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DRESS-GUAZE,PLAIN/IODAFORM" PX-270009022 CDM 270 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SURGICEL-2 & 4 INCH PX-270009023 CDM 270 RC inpatient 21 20.58 All Payors / Plans All Payors / Plans 21 other 21 21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DECUBITUS CARE SUPPLIES PX-270009024 CDM 270 RC inpatient 9.06 8.88 All Payors / Plans All Payors / Plans 9.06 other 9.06 9.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PACK MAX BARRIER PROTECTION PX-270009025 CDM 270 RC inpatient 28.72 28.15 All Payors / Plans All Payors / Plans 28.72 other 28.72 28.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PACK SUPPLEMENTAL PICC LINE PX-270009026 CDM 270 RC inpatient 16.25 15.93 All Payors / Plans All Payors / Plans 16.25 other 16.25 16.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTRODUCER CATHETER PX-270009027 CDM 270 RC inpatient 17.28 16.93 All Payors / Plans All Payors / Plans 17.28 other 17.28 17.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TENCKHOFT ADULT CATHETER PX-270009028 CDM 270 RC inpatient 49.8 48.8 All Payors / Plans All Payors / Plans 49.8 other 49.8 49.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COUDE FOLEY CATHETER PX-270009029 CDM 270 RC inpatient 13.54 13.27 All Payors / Plans All Payors / Plans 13.54 other 13.54 13.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CATHETER KIT, MULTI-LUMEN" PX-270009030 CDM 270 RC inpatient 94.98 93.08 All Payors / Plans All Payors / Plans 94.98 other 94.98 94.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SUCTION DRAIN PX-270009031 CDM 270 RC inpatient 9.91 9.71 All Payors / Plans All Payors / Plans 9.91 other 9.91 9.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AUTOFUSION HEMOVAC PX-270009032 CDM 270 RC inpatient 130.45 127.84 All Payors / Plans All Payors / Plans 130.45 other 130.45 130.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEMOVAC PX-270009033 CDM 270 RC inpatient 18.83 18.45 All Payors / Plans All Payors / Plans 18.83 other 18.83 18.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HUMIDIFER PX-270009034 CDM 270 RC inpatient 19.54 19.15 All Payors / Plans All Payors / Plans 19.54 other 19.54 19.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LAVACATOR PX-270009035 CDM 270 RC inpatient 11.11 10.89 All Payors / Plans All Payors / Plans 11.11 other 11.11 11.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BURN CARE PACK PX-270009036 CDM 270 RC inpatient 7.44 7.29 All Payors / Plans All Payors / Plans 7.44 other 7.44 7.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SUMP PUMP PX-270009037 CDM 270 RC inpatient 77.22 75.68 All Payors / Plans All Payors / Plans 77.22 other 77.22 77.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SUCTION RESERVOIR PX-270009038 CDM 270 RC inpatient 8.35 8.18 All Payors / Plans All Payors / Plans 8.35 other 8.35 8.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RECTAL TUBE PX-270009047 CDM 270 RC inpatient 5.96 5.84 All Payors / Plans All Payors / Plans 5.96 other 5.96 5.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KEOFEED STOMACH TUBE PX-270009048 CDM 270 RC inpatient 21 20.58 All Payors / Plans All Payors / Plans 21 other 21 21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BREAST PUMP KIT DOUBLE PX-270009049 CDM 270 RC inpatient 29.76 29.16 All Payors / Plans All Payors / Plans 29.76 other 29.76 29.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENTERIC FEEDING BAG PX-270009050 CDM 270 RC inpatient 3.9 3.82 All Payors / Plans All Payors / Plans 3.9 other 3.9 3.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRANSFUSION FILTER PX-270009051 CDM 270 RC inpatient 10.25 10.05 All Payors / Plans All Payors / Plans 10.25 other 10.25 10.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE MARROW TRAY PX-270009052 CDM 270 RC inpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SUTURE TRAY PX-270009053 CDM 270 RC inpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERCUTANEOUS TRACH TRAY PX-270009054 CDM 270 RC inpatient 396 388.08 All Payors / Plans All Payors / Plans 396 other 396 396 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIOPSY NEEDLE PX-270009055 CDM 270 RC inpatient 18.56 18.19 All Payors / Plans All Payors / Plans 18.56 other 18.56 18.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ULTRASONIC TIPS (EYES) PX-270009056 CDM 270 RC inpatient 72 70.56 All Payors / Plans All Payors / Plans 72 other 72 72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SAGE ORAL CARE KITS PX-270009057 CDM 270 RC inpatient 21.4 20.97 All Payors / Plans All Payors / Plans 21.4 other 21.4 21.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SAGE PREVLON BOOT PX-270009058 CDM 270 RC inpatient 11.23 11.01 All Payors / Plans All Payors / Plans 11.23 other 11.23 11.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEROYAL 24 WEDGE M60-032 PX-270009059 CDM 270 RC inpatient 11.52 11.29 All Payors / Plans All Payors / Plans 11.52 other 11.52 11.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEROYAL 24 BARIA WDG M60-033 PX-270009060 CDM 270 RC inpatient 27.97 27.41 All Payors / Plans All Payors / Plans 27.97 other 27.97 27.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENTERAL RADIOPAQUE FEED TUBE PX-270009061 CDM 270 RC inpatient 17.92 17.56 All Payors / Plans All Payors / Plans 17.92 other 17.92 17.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BARD FECAL BAG PX-270009062 CDM 270 RC inpatient 13.46 13.19 All Payors / Plans All Payors / Plans 13.46 other 13.46 13.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MINI CHEST DRAIN PX-270009063 CDM 270 RC inpatient 72.22 70.78 All Payors / Plans All Payors / Plans 72.22 other 72.22 72.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEELZUP DISP HEEL PROTECTOR PX-270009064 CDM 270 RC inpatient 46.8 45.86 All Payors / Plans All Payors / Plans 46.8 other 46.8 46.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEELZUP BAR DISP HEEL PROTECT PX-270009065 CDM 270 RC inpatient 59.4 58.21 All Payors / Plans All Payors / Plans 59.4 other 59.4 59.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RESQPOD CIRCULAT ENHANCER PX-270009066 CDM 270 RC inpatient 112.02 109.78 All Payors / Plans All Payors / Plans 112.02 other 112.02 112.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MORPHEUS CT PICC LINE KIT PX-270009067 CDM 270 RC inpatient 180 176.4 All Payors / Plans All Payors / Plans 180 other 180 180 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC METANEB CIRCUIT KIT PX-270009068 CDM 270 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARAPAC CIRCUIT KIT PX-270009069 CDM 270 RC inpatient 29.4 28.81 All Payors / Plans All Payors / Plans 29.4 other 29.4 29.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VENT CIRCUIT PX-270009070 CDM 270 RC inpatient 27.74 27.19 All Payors / Plans All Payors / Plans 27.74 other 27.74 27.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPTIFLOW NASAL INTERFACE PX-270009071 CDM 270 RC inpatient 26.4 25.87 All Payors / Plans All Payors / Plans 26.4 other 26.4 26.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FRESENIUS DIA STAY SAFE EXT 18 PX-270009072 CDM 270 RC inpatient 22.8 22.34 All Payors / Plans All Payors / Plans 22.8 other 22.8 22.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FRESENIUS DIALYSIS ADAPTER PX-270009073 CDM 270 RC inpatient 14.4 14.11 All Payors / Plans All Payors / Plans 14.4 other 14.4 14.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RESCUSITATION BAG PX-270009074 CDM 270 RC inpatient 23.35 22.88 All Payors / Plans All Payors / Plans 23.35 other 23.35 23.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HYPOTHERMIA WARMING BLANKET PX-270009075 CDM 270 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AIR MATTRESS PX-270009076 CDM 270 RC inpatient 45.6 44.69 All Payors / Plans All Payors / Plans 45.6 other 45.6 45.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STER IRRIG H20 3000 ML PX-270009077 CDM 270 RC inpatient 5.06 4.96 All Payors / Plans All Payors / Plans 5.06 other 5.06 5.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SCLEROTHERAPY NEEDLES PX-270009081 CDM 270 RC inpatient 44.4 43.51 All Payors / Plans All Payors / Plans 44.4 other 44.4 44.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OCCLUSION BALLOONS PX-270009082 CDM 270 RC inpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STENT KITS PX-270009083 CDM 270 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TROCAR REDUCERS PX-270009084 CDM 270 RC inpatient 10.54 10.33 All Payors / Plans All Payors / Plans 10.54 other 10.54 10.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INT.EXT STAPLE SUTURE DEV PX-270009085 CDM 270 RC inpatient 68.68 67.31 All Payors / Plans All Payors / Plans 68.68 other 68.68 68.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INT/EXTER STAPLE/SUTURE DEV. PX-270009086 CDM 270 RC inpatient 134.98 132.28 All Payors / Plans All Payors / Plans 134.98 other 134.98 134.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLEX TORCAR SET PX-270009087 CDM 270 RC inpatient 182.05 178.41 All Payors / Plans All Payors / Plans 182.05 other 182.05 182.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INT EXT STAPLE/SUTURE DEV PX-270009088 CDM 270 RC inpatient 132.68 130.03 All Payors / Plans All Payors / Plans 132.68 other 132.68 132.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INT/EXT STAPLE/ SUTURE DEV PX-270009089 CDM 270 RC inpatient 299.84 293.84 All Payors / Plans All Payors / Plans 299.84 other 299.84 299.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INT/ EXT STAPLE/SUTURE DEVICE PX-270009090 CDM 270 RC inpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HICKMAN INFUS-A-PORT PX-270009091 CDM 270 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROLENE MESH--LARGE (9 X 14) PX-270009092 CDM 270 RC inpatient 114.9 112.6 All Payors / Plans All Payors / Plans 114.9 other 114.9 114.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MARLEX MESH 3X6 PX-270009093 CDM 270 RC inpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HICKMAN DUAL LUMEN CATHETER PX-270009094 CDM 270 RC inpatient 199.49 195.5 All Payors / Plans All Payors / Plans 199.49 other 199.49 199.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRONCHIAL CYTOLOGY BRUSHES PX-270009095 CDM 270 RC inpatient 8.64 8.47 All Payors / Plans All Payors / Plans 8.64 other 8.64 8.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LITHOTRIPTER (ENDO) PX-270009096 CDM 270 RC inpatient 390 382.2 All Payors / Plans All Payors / Plans 390 other 390 390 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLO TIP CATHETER PX-270009097 CDM 270 RC inpatient 45.6 44.69 All Payors / Plans All Payors / Plans 45.6 other 45.6 45.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVACUATOR BOTTLES PX-270009098 CDM 270 RC inpatient 7.37 7.22 All Payors / Plans All Payors / Plans 7.37 other 7.37 7.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ULTRATOME LX PX-270009099 CDM 270 RC inpatient 204 199.92 All Payors / Plans All Payors / Plans 204 other 204 204 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRANSBRONCHIAL/ASPIR NEEDLE PX-270009100 CDM 270 RC inpatient 58.2 57.04 All Payors / Plans All Payors / Plans 58.2 other 58.2 58.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ZEBRA GUIDEWIRE PX-270009102 CDM 270 RC inpatient 129.6 127.01 All Payors / Plans All Payors / Plans 129.6 other 129.6 129.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PEG REPLACEMENT TUBE PX-270009103 CDM 270 RC inpatient 82.8 81.14 All Payors / Plans All Payors / Plans 82.8 other 82.8 82.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BICAP PROBES PX-270009104 CDM 270 RC inpatient 209.24 205.06 All Payors / Plans All Payors / Plans 209.24 other 209.24 209.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DISPOSABLE SNARE/RETRIEVAL PX-270009105 CDM 270 RC inpatient 27.6 27.05 All Payors / Plans All Payors / Plans 27.6 other 27.6 27.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CATHETER/GUIDEWIRE (OR) PX-270009106 CDM 270 RC inpatient 17.27 16.92 All Payors / Plans All Payors / Plans 17.27 other 17.27 17.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MIAMI J COLLAR PX-270009108 CDM 270 RC inpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CERVICAL COLLAR PX-270009109 CDM 270 RC inpatient 4.09 4.01 All Payors / Plans All Payors / Plans 4.09 other 4.09 4.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CERVICAL COLLAR 2 PX-270009110 CDM 270 RC inpatient 12.6 12.35 All Payors / Plans All Payors / Plans 12.6 other 12.6 12.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WRIST SPLINT PX-270009117 CDM 270 RC inpatient 8.82 8.64 All Payors / Plans All Payors / Plans 8.82 other 8.82 8.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KNEE PACK PX-270009119 CDM 270 RC inpatient 210.29 206.08 All Payors / Plans All Payors / Plans 210.29 other 210.29 210.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HIP PACK PX-270009120 CDM 270 RC inpatient 273.78 268.3 All Payors / Plans All Payors / Plans 273.78 other 273.78 273.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLOBAL SHOULDER PACK PX-270009121 CDM 270 RC inpatient 78.82 77.24 All Payors / Plans All Payors / Plans 78.82 other 78.82 78.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SHOULDER TRACTION KIT PX-270009122 CDM 270 RC inpatient 35.4 34.69 All Payors / Plans All Payors / Plans 35.4 other 35.4 35.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KNEE WRAP W/4 COLD PACKS PX-270009123 CDM 270 RC inpatient 26.81 26.27 All Payors / Plans All Payors / Plans 26.81 other 26.81 26.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SHOULDER WRAP W/4 COLD PKS PX-270009124 CDM 270 RC inpatient 30.17 29.57 All Payors / Plans All Payors / Plans 30.17 other 30.17 30.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COLOSTOMY SUPPLIES PX-270009125 CDM 270 RC inpatient 2.92 2.86 All Payors / Plans All Payors / Plans 2.92 other 2.92 2.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLEURAVAC PX-270009126 CDM 270 RC inpatient 133.63 130.96 All Payors / Plans All Payors / Plans 133.63 other 133.63 133.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD REC. SYSTEM PX-270009127 CDM 270 RC inpatient 34.01 33.33 All Payors / Plans All Payors / Plans 34.01 other 34.01 34.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VENA CAVA FILTER SYSTEM PX-270009128 CDM 270 RC inpatient 1174.8 1151.3 All Payors / Plans All Payors / Plans 1174.8 other 1174.8 1174.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SWAN GANTZ PX-270009129 CDM 270 RC inpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SWAN GANTZ-CCO PX-270009130 CDM 270 RC inpatient 148.18 145.22 All Payors / Plans All Payors / Plans 148.18 other 148.18 148.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARSONNET PROBE PX-270009131 CDM 270 RC inpatient 83.69 82.02 All Payors / Plans All Payors / Plans 83.69 other 83.69 83.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC EXTERNAL DRAIN UNIT, 8300" PX-270009132 CDM 270 RC inpatient 153.6 150.53 All Payors / Plans All Payors / Plans 153.6 other 153.6 153.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PORTEX TRACH TUBE PX-270009133 CDM 270 RC inpatient 36.61 35.88 All Payors / Plans All Payors / Plans 36.61 other 36.61 36.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRACEOSTOMY SUPPLIES PX-270009134 CDM 270 RC inpatient 4.63 4.54 All Payors / Plans All Payors / Plans 4.63 other 4.63 4.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TROCAR CATHETER PX-270009135 CDM 270 RC inpatient 17.16 16.82 All Payors / Plans All Payors / Plans 17.16 other 17.16 17.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THORACIC CATHETER PX-270009136 CDM 270 RC inpatient 6.47 6.34 All Payors / Plans All Payors / Plans 6.47 other 6.47 6.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IN LINE SUCTION KIT PX-270009137 CDM 270 RC inpatient 16.62 16.29 All Payors / Plans All Payors / Plans 16.62 other 16.62 16.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SUCTION KIT - DIRECTIONAL TIP PX-270009138 CDM 270 RC inpatient 17.1 16.76 All Payors / Plans All Payors / Plans 17.1 other 17.1 17.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DUAL PRESSURE TRANSDUCER PX-270009139 CDM 270 RC inpatient 27 26.46 All Payors / Plans All Payors / Plans 27 other 27 27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRANSDUCER SET PX-270009140 CDM 270 RC inpatient 13.5 13.23 All Payors / Plans All Payors / Plans 13.5 other 13.5 13.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEIMLICH VALVE PX-270009141 CDM 270 RC inpatient 13.5 13.23 All Payors / Plans All Payors / Plans 13.5 other 13.5 13.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMBOLECTOMY CATHETER PX-270009142 CDM 270 RC inpatient 45.85 44.93 All Payors / Plans All Payors / Plans 45.85 other 45.85 45.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRUITT INHARD SHUNT PX-270009143 CDM 270 RC inpatient 126 123.48 All Payors / Plans All Payors / Plans 126 other 126 126 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEDIASTINAL CATHETER PX-270009144 CDM 270 RC inpatient 14.3 14.01 All Payors / Plans All Payors / Plans 14.3 other 14.3 14.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARGON PAC TRAY PX-270009145 CDM 270 RC inpatient 31.44 30.81 All Payors / Plans All Payors / Plans 31.44 other 31.44 31.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SOFT TISSUE PATCH CV PX-270009146 CDM 270 RC inpatient 144 141.12 All Payors / Plans All Payors / Plans 144 other 144 144 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDOCATCH II PX-270009147 CDM 270 RC inpatient 80.4 78.79 All Payors / Plans All Payors / Plans 80.4 other 80.4 80.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VEIN DISTENTION SYSTEM PX-270009148 CDM 270 RC inpatient 47.84 46.88 All Payors / Plans All Payors / Plans 47.84 other 47.84 47.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CAMINO TRAUMA CATHETER PX-270009149 CDM 270 RC inpatient 96 94.08 All Payors / Plans All Payors / Plans 96 other 96 96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CAMINO VENT DRAIN SYSTEM PX-270009150 CDM 270 RC inpatient 123.6 121.13 All Payors / Plans All Payors / Plans 123.6 other 123.6 123.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URETERAL KITS PX-270009151 CDM 270 RC inpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URETERAL CATHETER PX-270009152 CDM 270 RC inpatient 150 147 All Payors / Plans All Payors / Plans 150 other 150 150 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BILIARY DILATION CATHETER PX-270009153 CDM 270 RC inpatient 63.6 62.33 All Payors / Plans All Payors / Plans 63.6 other 63.6 63.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OXI SENSOR PX-270009154 CDM 270 RC inpatient 10.8 10.58 All Payors / Plans All Payors / Plans 10.8 other 10.8 10.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPRESSION FOOT COVER PX-270009155 CDM 270 RC inpatient 88.8 87.02 All Payors / Plans All Payors / Plans 88.8 other 88.8 88.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRACH TUBE PX-270009156 CDM 270 RC inpatient 50.7 49.69 All Payors / Plans All Payors / Plans 50.7 other 50.7 50.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MITT RESTRAINTS PX-270009157 CDM 270 RC inpatient 13.2 12.94 All Payors / Plans All Payors / Plans 13.2 other 13.2 13.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ABDOMINAL BINDER PX-270009158 CDM 270 RC inpatient 18.59 18.22 All Payors / Plans All Payors / Plans 18.59 other 18.59 18.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESSING PACK PX-270009159 CDM 270 RC inpatient 7.04 6.9 All Payors / Plans All Payors / Plans 7.04 other 7.04 7.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EAR SYRINGE PX-270009160 CDM 270 RC inpatient 5.88 5.76 All Payors / Plans All Payors / Plans 5.88 other 5.88 5.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STERILE SURGICAL SUPPLIES PX-270009161 CDM 270 RC inpatient 64.69 63.4 All Payors / Plans All Payors / Plans 64.69 other 64.69 64.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ABDOMINAL ANEURYSM PACK PX-270009162 CDM 270 RC inpatient 199.13 195.15 All Payors / Plans All Payors / Plans 199.13 other 199.13 199.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FEM-POP PACK PX-270009163 CDM 270 RC inpatient 81.9 80.26 All Payors / Plans All Payors / Plans 81.9 other 81.9 81.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NEURO PACK PX-270009164 CDM 270 RC inpatient 171.24 167.82 All Payors / Plans All Payors / Plans 171.24 other 171.24 171.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NEURO SUPPLEMENTARY PACK PX-270009165 CDM 270 RC inpatient 58.63 57.46 All Payors / Plans All Payors / Plans 58.63 other 58.63 58.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CAROTID PACK PX-270009166 CDM 270 RC inpatient 138.77 135.99 All Payors / Plans All Payors / Plans 138.77 other 138.77 138.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARTHROSCOPY PACK PX-270009167 CDM 270 RC inpatient 64.49 63.2 All Payors / Plans All Payors / Plans 64.49 other 64.49 64.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENT PACK PX-270009168 CDM 270 RC inpatient 31.84 31.2 All Payors / Plans All Payors / Plans 31.84 other 31.84 31.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MINOR EYE PACK ALCON PX-270009169 CDM 270 RC inpatient 49.56 48.57 All Payors / Plans All Payors / Plans 49.56 other 49.56 49.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYSTO PACK PX-270009170 CDM 270 RC inpatient 11.39 11.16 All Payors / Plans All Payors / Plans 11.39 other 11.39 11.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LAP/ABD PACK PX-270009171 CDM 270 RC inpatient 29.86 29.26 All Payors / Plans All Payors / Plans 29.86 other 29.86 29.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LOWER EXTREMITY PACK PX-270009172 CDM 270 RC inpatient 31.14 30.52 All Payors / Plans All Payors / Plans 31.14 other 31.14 31.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UPPER EXTREMITY PACK PX-270009173 CDM 270 RC inpatient 24.95 24.45 All Payors / Plans All Payors / Plans 24.95 other 24.95 24.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN CUSTOM PACK PX-270009174 CDM 270 RC inpatient 334.07 327.39 All Payors / Plans All Payors / Plans 334.07 other 334.07 334.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERITONEAL CLOSURE DEVICE PX-270009175 CDM 270 RC inpatient 23.52 23.05 All Payors / Plans All Payors / Plans 23.52 other 23.52 23.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SUCTION CANNISTER/TUBING PX-270009176 CDM 270 RC inpatient 3 2.94 All Payors / Plans All Payors / Plans 3 other 3 3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SUCTION SUPPLIES (U) PX-270009177 CDM 270 RC inpatient 3.83 3.75 All Payors / Plans All Payors / Plans 3.83 other 3.83 3.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPINAL SURGERY KIT PX-270009178 CDM 270 RC inpatient 44.05 43.17 All Payors / Plans All Payors / Plans 44.05 other 44.05 44.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VESSEL OCCULUDERS PX-270009179 CDM 270 RC inpatient 52.8 51.74 All Payors / Plans All Payors / Plans 52.8 other 52.8 52.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARTERIAL/VENOUS SET PX-270009180 CDM 270 RC inpatient 13.32 13.05 All Payors / Plans All Payors / Plans 13.32 other 13.32 13.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC 9% SODIUM CHLOR. SLUSH PX-270009181 CDM 270 RC inpatient 30 29.4 All Payors / Plans All Payors / Plans 30 other 30 30 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC REPLACEMT CAMION COLLECT BAG PX-270009182 CDM 270 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DURA PREP LARGE PX-270009183 CDM 270 RC inpatient 5.76 5.64 All Payors / Plans All Payors / Plans 5.76 other 5.76 5.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DURA PREP SMALL PX-270009184 CDM 270 RC inpatient 2.96 2.9 All Payors / Plans All Payors / Plans 2.96 other 2.96 2.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COBAN DRESSING PX-270009185 CDM 270 RC inpatient 3.4 3.33 All Payors / Plans All Payors / Plans 3.4 other 3.4 3.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITRECTOMY/RETINAL PACK PX-270009186 CDM 270 RC inpatient 328.8 322.22 All Payors / Plans All Payors / Plans 328.8 other 328.8 328.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITRECTOMY/RETINAL TUBING SET PX-270009187 CDM 270 RC inpatient 48 47.04 All Payors / Plans All Payors / Plans 48 other 48 48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDO SPOT MARKER PX-270009188 CDM 270 RC inpatient 22.8 22.34 All Payors / Plans All Payors / Plans 22.8 other 22.8 22.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDO BAR BALLOON PX-270009189 CDM 270 RC inpatient 106.8 104.66 All Payors / Plans All Payors / Plans 106.8 other 106.8 106.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDO CRE BALLOON PX-270009190 CDM 270 RC inpatient 252 246.96 All Payors / Plans All Payors / Plans 252 other 252 252 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SHOULDER REHAB KIT PX-270009191 CDM 270 RC inpatient 58.8 57.62 All Payors / Plans All Payors / Plans 58.8 other 58.8 58.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C SECTION TRACE PACK PX-270009192 CDM 270 RC inpatient 103.81 101.73 All Payors / Plans All Payors / Plans 103.81 other 103.81 103.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LAP-CHOLE TRACE PACK PX-270009193 CDM 270 RC inpatient 190.84 187.02 All Payors / Plans All Payors / Plans 190.84 other 190.84 190.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CAB TRACE PACK PX-270009194 CDM 270 RC inpatient 341.96 335.12 All Payors / Plans All Payors / Plans 341.96 other 341.96 341.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRISM MIXING BOWLS PX-270009196 CDM 270 RC inpatient 96.55 94.62 All Payors / Plans All Payors / Plans 96.55 other 96.55 96.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VERROUS NEEDLE PX-270009197 CDM 270 RC inpatient 43.52 42.65 All Payors / Plans All Payors / Plans 43.52 other 43.52 43.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN TROCARS PX-270009198 CDM 270 RC inpatient 74.4 72.91 All Payors / Plans All Payors / Plans 74.4 other 74.4 74.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ORIGIN TACKER SYSTEM PX-270009199 CDM 270 RC inpatient 312 305.76 All Payors / Plans All Payors / Plans 312 other 312 312 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ORIGIN TROCAR PX-270009200 CDM 270 RC inpatient 162 158.76 All Payors / Plans All Payors / Plans 162 other 162 162 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD CULTURE KIT PX-270009201 CDM 270 RC inpatient 9.9 9.7 All Payors / Plans All Payors / Plans 9.9 other 9.9 9.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POSEY BED CORDS PX-270009202 CDM 270 RC inpatient 4.62 4.53 All Payors / Plans All Payors / Plans 4.62 other 4.62 4.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LEVEL I TUBING PX-270009203 CDM 270 RC inpatient 77.7 76.15 All Payors / Plans All Payors / Plans 77.7 other 77.7 77.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RESTRAINT FREE SPLINT LG PX-270009204 CDM 270 RC inpatient 13.63 13.36 All Payors / Plans All Payors / Plans 13.63 other 13.63 13.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CATH TRAY PLUS CDC VARIOUS SZ PX-270009212 CDM 270 RC inpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HOYER PATIENT SLING SL-UD513 PX-270009213 CDM 270 RC inpatient 30.48 29.87 All Payors / Plans All Payors / Plans 30.48 other 30.48 30.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SNSR FLO TRAC PX-270009214 CDM 270 RC inpatient 210 205.8 All Payors / Plans All Payors / Plans 210 other 210 210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SHEATH PINNACLE PX-270009215 CDM 270 RC inpatient 9.54 9.35 All Payors / Plans All Payors / Plans 9.54 other 9.54 9.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRIPLE LUMEN KIT PX-270009216 CDM 270 RC inpatient 135.64 132.93 All Payors / Plans All Payors / Plans 135.64 other 135.64 135.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GI CYTOLOGY BRUSHES PX-270009217 CDM 270 RC inpatient 10.5 10.29 All Payors / Plans All Payors / Plans 10.5 other 10.5 10.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COLOSTOMY BAG PX-270009218 CDM 270 RC inpatient 2.2 2.16 All Payors / Plans All Payors / Plans 2.2 other 2.2 2.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PNEUMOSTAT CHEST DRAIN VAL PX-270009219 CDM 270 RC inpatient 37.73 36.98 All Payors / Plans All Payors / Plans 37.73 other 37.73 37.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TITANIUM LIAGATING CLIPS PX-270009220 CDM 270 RC inpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BASIC PACK PX-270009222 CDM 270 RC inpatient 7.56 7.41 All Payors / Plans All Payors / Plans 7.56 other 7.56 7.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THORACENTESIS TRAY PX-270009223 CDM 270 RC inpatient 30.34 29.73 All Payors / Plans All Payors / Plans 30.34 other 30.34 30.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STAPLER LINEAR PX-270009225 CDM 270 RC inpatient 208.98 204.8 All Payors / Plans All Payors / Plans 208.98 other 208.98 208.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STAPLER/RELOAD DEV 2 PX-270009226 CDM 270 RC inpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MINOR ALCON EYE PACK PX-270009227 CDM 270 RC inpatient 240 235.2 All Payors / Plans All Payors / Plans 240 other 240 240 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PADS CLO-SUR #MCP44 PX-270009230 CDM 270 RC inpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CL CLOSURE DEVICE FEMOSTOT PX-270009231 CDM 270 RC inpatient 89.4 87.61 All Payors / Plans All Payors / Plans 89.4 other 89.4 89.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CIRCUMCISION TRAY PX-270009250 CDM 270 RC inpatient 63 61.74 All Payors / Plans All Payors / Plans 63 other 63 63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE MARROW DISPOSABLE PX-270009255 CDM 270 RC inpatient 103.75 101.68 All Payors / Plans All Payors / Plans 103.75 other 103.75 103.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INSTRUMENT TRAY PX-270009300 CDM 270 RC inpatient 58 56.84 All Payors / Plans All Payors / Plans 58 other 58 58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GREEN LIGHT LASER PROCEDURE PX-270010033 CDM 270 RC inpatient 1380 1352.4 All Payors / Plans All Payors / Plans 1380 other 1380 1380 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DAVINCI PACK PX-270010034 CDM 270 RC inpatient 280.8 275.18 All Payors / Plans All Payors / Plans 280.8 other 280.8 280.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APLIGAF-PER 44 SQ CM PX-270041010 CDM Q4101 CPT 270 RC inpatient 1554 1522.92 All Payors / Plans All Payors / Plans 1554 other 1554 1554 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OASIS WOUND MATRIX PX-270041020 CDM Q4102 CPT 270 RC inpatient 113.64 111.37 All Payors / Plans All Payors / Plans 113.64 other 113.64 113.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OASIS WOUND MATRIX 3 X 7 CM PX-270041021 CDM Q4102 CPT 270 RC inpatient 189.4 185.61 All Payors / Plans All Payors / Plans 189.4 other 189.4 189.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DERMAGRAFT PX-270041060 CDM Q4106 CPT 270 RC inpatient 1500 1470 All Payors / Plans All Payors / Plans 1500 other 1500 1500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THERASKIN 2X3 PX-270041210 CDM Q4121 CPT 270 RC inpatient 1530 1499.4 All Payors / Plans All Payors / Plans 1530 other 1530 1530 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THERASKIN 1X2 PX-270041211 CDM Q4121 CPT 270 RC inpatient 1170 1146.6 All Payors / Plans All Payors / Plans 1170 other 1170 1170 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THERASKIN 1X1 PX-270041212 CDM Q4121 CPT 270 RC inpatient 1050 1029 All Payors / Plans All Payors / Plans 1050 other 1050 1050 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THERASKIN 3X6 PX-270041213 CDM Q4121 CPT 270 RC inpatient 3594 3522.12 All Payors / Plans All Payors / Plans 3594 other 3594 3594 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALGIDEX AG 4X4 1/2 IN X 5 YARDS PX-270041311 CDM 270 RC inpatient 8.54 8.37 All Payors / Plans All Payors / Plans 8.54 other 8.54 8.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALGIDEX AG 4X8 1/4 IN X 5 YARDS PX-270041312 CDM 270 RC inpatient 17.18 16.84 All Payors / Plans All Payors / Plans 17.18 other 17.18 17.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MULTIDEX GEL 1/4 OZ PX-270041313 CDM 270 RC inpatient 5.6 5.49 All Payors / Plans All Payors / Plans 5.6 other 5.6 5.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MULTIDEX POWDER 6 GRAM PX-270041314 CDM 270 RC inpatient 6.38 6.25 All Payors / Plans All Payors / Plans 6.38 other 6.38 6.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX TRANSFER 6X8 PX-270041315 CDM 270 RC inpatient 8.74 8.57 All Payors / Plans All Payors / Plans 8.74 other 8.74 8.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX TRANSFER 8X20 PX-270041316 CDM 270 RC inpatient 23.8 23.32 All Payors / Plans All Payors / Plans 23.8 other 23.8 23.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SECURA ANTIFUNGAL CREAM 2OZ TUBE PX-270041317 CDM 270 RC inpatient 4.22 4.14 All Payors / Plans All Payors / Plans 4.22 other 4.22 4.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COVERSITE 4X4 PLUS PX-270041318 CDM 270 RC inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IODOFLEX 5 GRAM PX-270041319 CDM 270 RC inpatient 5.72 5.61 All Payors / Plans All Payors / Plans 5.72 other 5.72 5.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROFORE WRAPS PX-270041320 CDM 270 RC inpatient 13.52 13.25 All Payors / Plans All Payors / Plans 13.52 other 13.52 13.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPITEL ONE 4X7 PX-270041321 CDM 270 RC inpatient 11.89 11.65 All Payors / Plans All Payors / Plans 11.89 other 11.89 11.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VISCOPASTE PX-270041322 CDM 270 RC inpatient 6.77 6.63 All Payors / Plans All Payors / Plans 6.77 other 6.77 6.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COVERSITE PLUS 6X6 PX-270041323 CDM 270 RC inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARGLASE POWDER PX-270041324 CDM 270 RC inpatient 66.77 65.43 All Payors / Plans All Payors / Plans 66.77 other 66.77 66.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CALAZYME PASTE PX-270041325 CDM 270 RC inpatient 5.2 5.1 All Payors / Plans All Payors / Plans 5.2 other 5.2 5.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MED E-KAST KIT PX-270041326 CDM 270 RC inpatient 96 94.08 All Payors / Plans All Payors / Plans 96 other 96 96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEDIHONEY CALC ALG 4X5 PX-270041327 CDM 270 RC inpatient 10.19 9.99 All Payors / Plans All Payors / Plans 10.19 other 10.19 10.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEDIHONEY HCS NON-AD 4.3X4.3 PX-270041328 CDM 270 RC inpatient 10.52 10.31 All Payors / Plans All Payors / Plans 10.52 other 10.52 10.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEDIHONEY GEL 0.5OZ PX-270041329 CDM 270 RC inpatient 4.94 4.84 All Payors / Plans All Payors / Plans 4.94 other 4.94 4.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HYDROFERA BLUE BACTERIO DRESS 4X4 PX-270041330 CDM 270 RC inpatient 7.62 7.47 All Payors / Plans All Payors / Plans 7.62 other 7.62 7.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDOFORM 2X2 FENESTRATED COLLAGEN PX-270041333 CDM 270 RC inpatient 12.97 12.71 All Payors / Plans All Payors / Plans 12.97 other 12.97 12.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST 3 INCH NO BOOT PX-270041334 CDM 270 RC inpatient 122.96 120.5 All Payors / Plans All Payors / Plans 122.96 other 122.96 122.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST 3 IN W/1 BOOT REGULAR PX-270041335 CDM 270 RC inpatient 136.2 133.48 All Payors / Plans All Payors / Plans 136.2 other 136.2 136.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST 3 IN REPLACE NO BOOT PX-270041336 CDM 270 RC inpatient 71.25 69.83 All Payors / Plans All Payors / Plans 71.25 other 71.25 71.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST 4 INCH NO BOOT PX-270041337 CDM 270 RC inpatient 122.96 120.5 All Payors / Plans All Payors / Plans 122.96 other 122.96 122.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST 4 INCH W/XL BOOT PX-270041338 CDM 270 RC inpatient 136.2 133.48 All Payors / Plans All Payors / Plans 136.2 other 136.2 136.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST BOOT REPLACE REGULAR PX-270041339 CDM 270 RC inpatient 80.78 79.16 All Payors / Plans All Payors / Plans 80.78 other 80.78 80.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST BOOT REPLACE LARGE PX-270041340 CDM 270 RC inpatient 96.23 94.31 All Payors / Plans All Payors / Plans 96.23 other 96.23 96.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST BOOT REPLACE XLARGE PX-270041341 CDM 270 RC inpatient 100.98 98.96 All Payors / Plans All Payors / Plans 100.98 other 100.98 100.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHARCOT TCC-EZ BOOT LG 41017 PX-270041342 CDM 270 RC inpatient 223 218.54 All Payors / Plans All Payors / Plans 223 other 223 223 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHARCOT TCC-EZ BOOT XLG 41018 PX-270041343 CDM 270 RC inpatient 249.99 244.99 All Payors / Plans All Payors / Plans 249.99 other 249.99 249.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PURAPLY AM 2 X 2 PX-270041344 CDM Q4196 CPT 270 RC inpatient 710.4 696.19 All Payors / Plans All Payors / Plans 710.4 other 710.4 710.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PURAPLY AM 2 X 4 PX-270041345 CDM Q4196 CPT 270 RC inpatient 1075.2 1053.7 All Payors / Plans All Payors / Plans 1075.2 other 1075.2 1075.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PURAPLY AM 5 X 5 PX-270041346 CDM Q4196 CPT 270 RC inpatient 3360 3292.8 All Payors / Plans All Payors / Plans 3360 other 3360 3360 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PURAPLY AM 6 X 9 PX-270041347 CDM Q4196 CPT 270 RC inpatient 7257.6 7112.45 All Payors / Plans All Payors / Plans 7257.6 other 7257.6 7257.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX 14MM DISC PX-270041363 CDM Q4110 CPT 270 RC inpatient 582 570.36 All Payors / Plans All Payors / Plans 582 other 582 582 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX 18MM DISC PX-270041364 CDM Q4110 CPT 270 RC inpatient 708 693.84 All Payors / Plans All Payors / Plans 708 other 708 708 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX 2X2 PX-270041365 CDM Q4110 CPT 270 RC inpatient 837.6 820.85 All Payors / Plans All Payors / Plans 837.6 other 837.6 837.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX MESHED 3X3 PX-270041366 CDM Q4110 CPT 270 RC inpatient 900 882 All Payors / Plans All Payors / Plans 900 other 900 900 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX FENESTRATED 4X4 PX-270041367 CDM Q4110 CPT 270 RC inpatient 1140 1117.2 All Payors / Plans All Payors / Plans 1140 other 1140 1140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX MESHED 4X4 PX-270041368 CDM Q4110 CPT 270 RC inpatient 1140 1117.2 All Payors / Plans All Payors / Plans 1140 other 1140 1140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX MESHED 5X5 PX-270041369 CDM Q4110 CPT 270 RC inpatient 1380 1352.4 All Payors / Plans All Payors / Plans 1380 other 1380 1380 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX FENESTRATED 6X6 PX-270041370 CDM Q4110 CPT 270 RC inpatient 1560 1528.8 All Payors / Plans All Payors / Plans 1560 other 1560 1560 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX MESHED 6X6 PX-270041371 CDM Q4110 CPT 270 RC inpatient 1560 1528.8 All Payors / Plans All Payors / Plans 1560 other 1560 1560 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT OMNIGRAFT/STAPLER 2.5X2.5 PX-270041372 CDM Q4105 CPT 270 RC inpatient 918 899.64 All Payors / Plans All Payors / Plans 918 other 918 918 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT OMNIGRAFT/STAPLER 4X4 PX-270041373 CDM Q4105 CPT 270 RC inpatient 1350 1323 All Payors / Plans All Payors / Plans 1350 other 1350 1350 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LYOFOAM 3X3.4 PX-270041374 CDM 270 RC inpatient 2.64 2.59 All Payors / Plans All Payors / Plans 2.64 other 2.64 2.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX 4X4 FOAM PX-270041375 CDM 270 RC inpatient 3.65 3.58 All Payors / Plans All Payors / Plans 3.65 other 3.65 3.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX 6X6 PX-270041376 CDM 270 RC inpatient 7.96 7.8 All Payors / Plans All Payors / Plans 7.96 other 7.96 7.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX 3X3 BORDERED FOAM PX-270041377 CDM 270 RC inpatient 2.58 2.53 All Payors / Plans All Payors / Plans 2.58 other 2.58 2.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX 4X4 BORDERED FOAM PX-270041378 CDM 270 RC inpatient 4.68 4.59 All Payors / Plans All Payors / Plans 4.68 other 4.68 4.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX BORDERED SACRUM PX-270041379 CDM 270 RC inpatient 7.6 7.45 All Payors / Plans All Payors / Plans 7.6 other 7.6 7.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX BORDERED HEEL PX-270041380 CDM 270 RC inpatient 11.42 11.19 All Payors / Plans All Payors / Plans 11.42 other 11.42 11.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MELGISORB PLUS PX-270041381 CDM 270 RC inpatient 2.48 2.43 All Payors / Plans All Payors / Plans 2.48 other 2.48 2.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX LITE 6X6 PX-270041382 CDM 270 RC inpatient 5.57 5.46 All Payors / Plans All Payors / Plans 5.57 other 5.57 5.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEFIX 2X11 YD PX-270041383 CDM 270 RC inpatient 4.02 3.94 All Payors / Plans All Payors / Plans 4.02 other 4.02 4.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROMOGRAN/PRISMA 4.34 SQ IN PX-270041384 CDM 270 RC inpatient 9.8 9.6 All Payors / Plans All Payors / Plans 9.8 other 9.8 9.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROMOGRAN/PRISMA 19.1 SQ IN PX-270041385 CDM 270 RC inpatient 29.41 28.82 All Payors / Plans All Payors / Plans 29.41 other 29.41 29.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEDIHONEY HCS 4.3X4.3 PX-270041386 CDM 270 RC inpatient 10.62 10.41 All Payors / Plans All Payors / Plans 10.62 other 10.62 10.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARTRIDGE WOUND SNAP VAC PX-270041388 CDM 270 RC inpatient 151.2 148.18 All Payors / Plans All Payors / Plans 151.2 other 151.2 151.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESSING SNAP FOAM L 10X10 ADVANCE PX-270041389 CDM 270 RC inpatient 53.1 52.04 All Payors / Plans All Payors / Plans 53.1 other 53.1 53.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESSING SNAP L 15X15 FOAM INTERFACE PX-270041390 CDM 270 RC inpatient 56.64 55.51 All Payors / Plans All Payors / Plans 56.64 other 56.64 56.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OASIS 3.5CM X 3.0CM TRIPLE LAYER PX-270041393 CDM Q4124 CPT 270 RC inpatient 187 183.26 All Payors / Plans All Payors / Plans 187 other 187 187 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OASIS 7.0CM X 3.0CM TRIPLE LAYER PX-270041394 CDM Q4124 CPT 270 RC inpatient 337 330.26 All Payors / Plans All Payors / Plans 337 other 337 337 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GRAFIX PL PRIME 1.5X2 PX-270041395 CDM Q4133 CPT 270 RC inpatient 950 931 All Payors / Plans All Payors / Plans 950 other 950 950 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GRAFIX PL PRIME 2X3 PX-270041396 CDM Q4133 CPT 270 RC inpatient 1188 1164.24 All Payors / Plans All Payors / Plans 1188 other 1188 1188 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GRAFIX PL PRIME 3X3 PX-270041397 CDM Q4133 CPT 270 RC inpatient 1350 1323 All Payors / Plans All Payors / Plans 1350 other 1350 1350 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GRAFIX PL PRIME 3X4 PX-270041398 CDM Q4133 CPT 270 RC inpatient 1458 1428.84 All Payors / Plans All Payors / Plans 1458 other 1458 1458 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GRAFIX PL PRIME 5X5 PX-270041399 CDM Q4133 CPT 270 RC inpatient 3240 3175.2 All Payors / Plans All Payors / Plans 3240 other 3240 3240 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KERECIS GRAFT 16MM CIRCULAR PX-270041400 CDM Q4158 CPT 270 RC inpatient 622 609.56 All Payors / Plans All Payors / Plans 622 other 622 622 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KERECIS GRAFT 3X3.5 PX-270041401 CDM Q4158 CPT 270 RC inpatient 1000.8 980.78 All Payors / Plans All Payors / Plans 1000.8 other 1000.8 1000.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KERECIS GRAFT 3X7 PX-270041402 CDM Q4158 CPT 270 RC inpatient 1560 1528.8 All Payors / Plans All Payors / Plans 1560 other 1560 1560 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POLYMEM 4X4 PX-270041403 CDM 270 RC inpatient 7 6.86 All Payors / Plans All Payors / Plans 7 other 7 7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POLYMEM 4X12.5 PX-270041404 CDM 270 RC inpatient 22.1 21.66 All Payors / Plans All Payors / Plans 22.1 other 22.1 22.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPTILOCK NON-ADHESIVE 8X12 PX-270041405 CDM 270 RC inpatient 6.58 6.45 All Payors / Plans All Payors / Plans 6.58 other 6.58 6.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROFORE BANDAGE COMPRESSION PAD PX-270041406 CDM 270 RC inpatient 8.8 8.62 All Payors / Plans All Payors / Plans 8.8 other 8.8 8.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NUSHEILD PLACENTAL MEMBRANE 2.01 SQ CM ALLOGRAFT PX-270041407 CDM Q4160 CPT 270 RC inpatient 474 464.52 All Payors / Plans All Payors / Plans 474 other 474 474 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NUSHEILD L3 CM X W 2 CM ALLOGRAFT PX-270041408 CDM Q4160 CPT 270 RC inpatient 954 934.92 All Payors / Plans All Payors / Plans 954 other 954 954 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NUSHEILD PLACENTAL MEMBRANE 8 SQ CM L 4CM X W 2CM ALLOGRAFT PX-270041409 CDM Q4160 CPT 270 RC inpatient 1140 1117.2 All Payors / Plans All Payors / Plans 1140 other 1140 1140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NUSHEILD PLACENTAL MEMBRANE 12 SQ CM L 4CM X W 3CM ALLOGRAFT PX-270041410 CDM Q4160 CPT 270 RC inpatient 1650 1617 All Payors / Plans All Payors / Plans 1650 other 1650 1650 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NUSHEILD L 4 CM X W 4 CM ALLOGRAFT PX-270041411 CDM Q4160 CPT 270 RC inpatient 1710 1675.8 All Payors / Plans All Payors / Plans 1710 other 1710 1710 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NUSHEILD L 6 CM X W 4CM ALLOGRAFT PX-270041412 CDM Q4160 CPT 270 RC inpatient 2250 2205 All Payors / Plans All Payors / Plans 2250 other 2250 2250 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NUSHEILD L 6 CM X W 6 CM ALLOGRAFT PX-270041413 CDM Q4160 CPT 270 RC inpatient 2988 2928.24 All Payors / Plans All Payors / Plans 2988 other 2988 2988 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEBULIZER MEDICATION BREATH ACTUATED AEROECLIPSE HANDHELD SM PX-270800001 CDM 270 RC inpatient 1.48 1.45 All Payors / Plans All Payors / Plans 1.48 other 1.48 1.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PAIL COMMODE COVER 7QT PX-270800002 CDM 270 RC inpatient 7.66 7.51 All Payors / Plans All Payors / Plans 7.66 other 7.66 7.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PAD DEFIBRILLATOR PX-270800003 CDM 270 RC inpatient 14.25 13.97 All Payors / Plans All Payors / Plans 14.25 other 14.25 14.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PADS HANDS OFF DEFIBILATOR FOR PHILIPS PX-270800004 CDM 270 RC inpatient 19.31 18.92 All Payors / Plans All Payors / Plans 19.31 other 19.31 19.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC POSITIONER ALIGNER BODY FOAM PX-270800005 CDM 270 RC inpatient 6.98 6.84 All Payors / Plans All Payors / Plans 6.98 other 6.98 6.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC TRANSPORT TUBE VIRAL KIT UVT KIT 1ML WITH FLOKED FLEX MINI T PX-270800006 CDM 270 RC inpatient 2.57 2.52 All Payors / Plans All Payors / Plans 2.57 other 2.57 2.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC STATLOCK 2 WAY FOLEY PX-270800007 CDM 270 RC inpatient 3.52 3.45 All Payors / Plans All Payors / Plans 3.52 other 3.52 3.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC SET IV NITROGLYCERIN 60CTT 103""L PVC TUBING DUO-VENT" PX-270800008 CDM 270 RC inpatient 7.21 7.07 All Payors / Plans All Payors / Plans 7.21 other 7.21 7.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC TEGADERM I.V. ADVANCED PX-270800009 CDM 270 RC inpatient 1.27 1.24 All Payors / Plans All Payors / Plans 1.27 other 1.27 1.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PUREWICK FEMALE EXTERNAL CATHETER PX-270800012 CDM 270 RC inpatient 7.8 7.64 All Payors / Plans All Payors / Plans 7.8 other 7.8 7.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC ELECTRODE EKG RADIOLUCENT PUPPYDOG NEONATAL PEDIATRIC PX-270800016 CDM 270 RC inpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BOARD WRIST REUSABLE CHILD IV 3.5 X 9.0IN PX-270800019 CDM 270 RC inpatient 1.39 1.36 All Payors / Plans All Payors / Plans 1.39 other 1.39 1.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BAG ENEMA SLIDE CLAMP PRE LUBRICATED KIT DISPOSABLE INDIVIDU PX-270800020 CDM 270 RC inpatient 1.37 1.34 All Payors / Plans All Payors / Plans 1.37 other 1.37 1.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC RESUS MNL ADLT BVM STAT CK CO2 PX-270800021 CDM 270 RC inpatient 9.34 9.15 All Payors / Plans All Payors / Plans 9.34 other 9.34 9.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SOLUTION SCRUB POVIDONE IODINE 2OZ PX-270800022 CDM 270 RC inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER URINARY EXTERNAL EXTENDED WEAR MEDIUM 26MM PX-270800024 CDM 270 RC inpatient 1.36 1.33 All Payors / Plans All Payors / Plans 1.36 other 1.36 1.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER EXTERNAL INTERMEDIATE 32MM PX-270800025 CDM 270 RC inpatient 1.36 1.33 All Payors / Plans All Payors / Plans 1.36 other 1.36 1.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC OPTICHAMBER DIAMOND WITHOUT MASK WITH RECLOSABLE BAG PX-270800027 CDM 270 RC inpatient 5.66 5.55 All Payors / Plans All Payors / Plans 5.66 other 5.66 5.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC COLLECTOR SPECIMEN STOOL PX-270800034 CDM 270 RC inpatient 1.27 1.24 All Payors / Plans All Payors / Plans 1.27 other 1.27 1.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BAG COLLECTION URINARY LEG WITH STRAP TWIST VALVE BOTTOM MED PX-270800035 CDM 270 RC inpatient 2.09 2.05 All Payors / Plans All Payors / Plans 2.09 other 2.09 2.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC TUBE NASAL GASTRIC ARGYLE SALEM SUMP WITH IRRIGATION FUNNEL PX-270800036 CDM 270 RC inpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEB AERS THERA-MST 36-95 FIO2 40/CS PX-270800038 CDM 270 RC inpatient 5.13 5.03 All Payors / Plans All Payors / Plans 5.13 other 5.13 5.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC HUMIDIFIER PREFILLED WITH ADAPTER PLASTIC 500ML PX-270800039 CDM 270 RC inpatient 1.56 1.53 All Payors / Plans All Payors / Plans 1.56 other 1.56 1.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC KIT IV START STERILE PX-270800040 CDM 270 RC inpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SKIN PREP TRAY MISSION/STJOE 20/CS PX-270800041 CDM 270 RC inpatient 12.3 12.05 All Payors / Plans All Payors / Plans 12.3 other 12.3 12.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC KIT ARTERIAL BLOOD GAS SAMPLE LATEX FREE PX-270800042 CDM 270 RC inpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CUP COLLECTION URINE MIDSTREAM CATCH PLASTIC STRAW TUBE 5.0M PX-270800043 CDM 270 RC inpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC LINER CANISTER SUCTION THIN WALL FLEX ADVANTAGE WITH FILTER PX-270800044 CDM 270 RC inpatient 1.36 1.33 All Payors / Plans All Payors / Plans 1.36 other 1.36 1.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC MASK OXYGEN AEROSOL UNDER THE CHIN WITHOUT TUBING ELONGATED PX-270800045 CDM 270 RC inpatient 1.29 1.26 All Payors / Plans All Payors / Plans 1.29 other 1.29 1.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC MASK NON REBREATHING W SAFETY VENT PX-270800046 CDM 270 RC inpatient 1.18 1.16 All Payors / Plans All Payors / Plans 1.18 other 1.18 1.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC FASTENER NASAL GASTRIC TUBE NON LATEX ADULT PX-270800048 CDM 270 RC inpatient 1.17 1.15 All Payors / Plans All Payors / Plans 1.17 other 1.17 1.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SENSOR PULSE OXIMETER FINGER DISPOSABLE NEONATAL 18IN PX-270800049 CDM 270 RC inpatient 13.24 12.98 All Payors / Plans All Payors / Plans 13.24 other 13.24 13.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SENSOR PULSE OXIMETER WITH ADHESIVE STRAP DISPOSABLE PEDIATR PX-270800050 CDM 270 RC inpatient 10.18 9.98 All Payors / Plans All Payors / Plans 10.18 other 10.18 10.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SENSOR PULSE OXIMETER FINGER DISPOSABLE ADULT 18IN PX-270800051 CDM 270 RC inpatient 10.18 9.98 All Payors / Plans All Payors / Plans 10.18 other 10.18 10.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC METER PEAK FLOW FULL RANGE WITH ZONE MANAGEMENT SINGLE PATIE PX-270800052 CDM 270 RC inpatient 9.81 9.61 All Payors / Plans All Payors / Plans 9.81 other 9.81 9.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SPLINT ELBOW ARM WRAP FREEDOM MEDIUM PX-270800055 CDM 270 RC inpatient 20.35 19.94 All Payors / Plans All Payors / Plans 20.35 other 20.35 20.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC STRAINER URINE CALCULLI KIDNEY STONE WITH FUNNEL FILTER SCRE PX-270800056 CDM 270 RC inpatient 1.26 1.23 All Payors / Plans All Payors / Plans 1.26 other 1.26 1.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC TRAY PROCEDURE CATHETER URETHRAL STRAIGHT 15FR PX-270800057 CDM 270 RC inpatient 2.33 2.28 All Payors / Plans All Payors / Plans 2.33 other 2.33 2.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC TRAY SUTURE REMOVAL PX-270800059 CDM 270 RC inpatient 1.15 1.13 All Payors / Plans All Payors / Plans 1.15 other 1.15 1.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CONTAINER SPECIMEN MUCOUS TRAP WITH SCREW ON LID 40CC PX-270800060 CDM 270 RC inpatient 1.62 1.59 All Payors / Plans All Payors / Plans 1.62 other 1.62 1.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC TUBE RECTAL COLON PLASTIC WITH LUBRICANT ADULT 24FR X 20IN PX-270800063 CDM 270 RC inpatient 3.13 3.07 All Payors / Plans All Payors / Plans 3.13 other 3.13 3.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC VALVE NASOGASTRIC ANTI REFLUX FOR ARGYLE SALEM SUMP STERILE PX-270800067 CDM 270 RC inpatient 4.12 4.04 All Payors / Plans All Payors / Plans 4.12 other 4.12 4.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC VALVE LOPEZ ENTERAL FEEDING PX-270800068 CDM 270 RC inpatient 1.7 1.67 All Payors / Plans All Payors / Plans 1.7 other 1.7 1.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SET IV ADMINISTRATION BLOOD CONTINUOUS FLOW WITH DUO TYPE Y PX-270800070 CDM 270 RC inpatient 7.79 7.63 All Payors / Plans All Payors / Plans 7.79 other 7.79 7.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC SET SECONDARY MED 37""" PX-270800071 CDM 270 RC inpatient 1.2 1.18 All Payors / Plans All Payors / Plans 1.2 other 1.2 1.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EXTENSION IV CATHETER EXTENSION STANDARD BORE LUER LOCK SET PX-270800072 CDM 270 RC inpatient 2.14 2.1 All Payors / Plans All Payors / Plans 2.14 other 2.14 2.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC VALVE LUER ACTIVATED WITH MALE LUER LOCK ADAPTER STERILE MIC PX-270800073 CDM 270 RC inpatient 1.3 1.27 All Payors / Plans All Payors / Plans 1.3 other 1.3 1.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC SET IV PRIMARY CONTINUOUS FLO WITH DUO-VENT 105""" PX-270800074 CDM 270 RC inpatient 3.81 3.73 All Payors / Plans All Payors / Plans 3.81 other 3.81 3.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC ADAPTER LUER VENOJECT MULTI SAMPLE PX-270800075 CDM 270 RC inpatient 29.34 28.75 All Payors / Plans All Payors / Plans 29.34 other 29.34 29.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER IV VASCULAR PERIPHERAL RADIOPAQUE PROTECTIVE PLUS S PX-270800076 CDM 270 RC inpatient 90.03 88.23 All Payors / Plans All Payors / Plans 90.03 other 90.03 90.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER IV VASCULAR PERIPHERAL RADIOPAQUE PROTECTIVE PLUS 2 PX-270800077 CDM 270 RC inpatient 90.03 88.23 All Payors / Plans All Payors / Plans 90.03 other 90.03 90.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER IV VASCULAR PERIPHERAL RADIOPAQUE PROTECTIVE PLUS S PX-270800078 CDM 270 RC inpatient 90.03 88.23 All Payors / Plans All Payors / Plans 90.03 other 90.03 90.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER IV VASCULAR PERIPHERAL RADIOPAQUE PROTECTIVE PLUS S PX-270800079 CDM 270 RC inpatient 90.03 88.23 All Payors / Plans All Payors / Plans 90.03 other 90.03 90.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC ELECTRODE ECG RESTING TAB ADHESIVE VINYL QTRACE 5400 ADULT PX-270800080 CDM 270 RC inpatient 21.66 21.23 All Payors / Plans All Payors / Plans 21.66 other 21.66 21.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SYRINGE HYPODERMIC WITHOUT NEEDLE WITH LUER LOCK TIP PLASTIC PX-270800081 CDM 270 RC inpatient 12.9 12.64 All Payors / Plans All Payors / Plans 12.9 other 12.9 12.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SYRINGE BD 60ML LUER-LOK TIP GRADUATION PX-270800082 CDM 270 RC inpatient 14.11 13.83 All Payors / Plans All Payors / Plans 14.11 other 14.11 14.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC RAIL PROTECTOR SPLIT SIDE PX-270800083 CDM 270 RC inpatient 36.36 35.63 All Payors / Plans All Payors / Plans 36.36 other 36.36 36.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC RESTRAINT BELT SAFETY ROLL WITH TIE COTTON ONE SIZE 17.5 X 6 PX-270800084 CDM 270 RC inpatient 24.3 23.81 All Payors / Plans All Payors / Plans 24.3 other 24.3 24.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PROTECTOR SKIN SLEEVE ARM LATEX FREE LIGHT TONE STANDARD PX-270800085 CDM 270 RC inpatient 18.49 18.12 All Payors / Plans All Payors / Plans 18.49 other 18.49 18.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PAD BED WITH SENSOR PX-270800086 CDM 270 RC inpatient 17.1 16.76 All Payors / Plans All Payors / Plans 17.1 other 17.1 17.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC HYPERTHERMIA COOLING BLANKET 24'X60""""" PX-270800087 CDM 270 RC inpatient 20.4 19.99 All Payors / Plans All Payors / Plans 20.4 other 20.4 20.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BAG DRAINAGE URINARY UROLOGY ANTI REFLUX INFECTION CONTROL 2 PX-270800090 CDM 270 RC inpatient 4.05 3.97 All Payors / Plans All Payors / Plans 4.05 other 4.05 4.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC RESUSCITATOR BABY BLUE II WITH MASK INFANT PX-270800091 CDM 270 RC inpatient 20.31 19.9 All Payors / Plans All Payors / Plans 20.31 other 20.31 20.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BAGS PEDIATRIC BLUE PX-270800092 CDM 270 RC inpatient 20.62 20.21 All Payors / Plans All Payors / Plans 20.62 other 20.62 20.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER MULTIMED PENINSULA 5/CS PX-270800095 CDM 270 RC inpatient 78 76.44 All Payors / Plans All Payors / Plans 78 other 78 78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER KIT TRIPLE PX-270800096 CDM 270 RC inpatient 138.52 135.75 All Payors / Plans All Payors / Plans 138.52 other 138.52 138.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SYSTEM CULTURE COLLECTION TRANSPORT ANAEROBIC SPECIMEN VACUT PX-270800097 CDM 270 RC inpatient 6.44 6.31 All Payors / Plans All Payors / Plans 6.44 other 6.44 6.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BAG SPECIMEN COLLECTION URINARY STERILE NEWBORN PX-270800098 CDM 270 RC inpatient 1.6 1.57 All Payors / Plans All Payors / Plans 1.6 other 1.6 1.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BAG SPECIMEN URINARY COLLECTION WITH MICROPOROUS ADHESIVE RE PX-270800099 CDM 270 RC inpatient 1.67 1.64 All Payors / Plans All Payors / Plans 1.67 other 1.67 1.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CONTAINER FORMALIN NT PREFILLED 10% 6OZ PX-270800103 CDM 270 RC inpatient 1.36 1.33 All Payors / Plans All Payors / Plans 1.36 other 1.36 1.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC LBL ORNG MED AD 1 ROLL = 500 EA PX-270800104 CDM 270 RC inpatient 12.91 12.65 All Payors / Plans All Payors / Plans 12.91 other 12.91 12.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SENSOR PULSE OXIMETER FINGER DISPOSABLE INFANT PX-270800105 CDM 270 RC inpatient 14.74 14.45 All Payors / Plans All Payors / Plans 14.74 other 14.74 14.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC TRAY PROCEDURE LUMBAR PUNCTURE DIAMOND POINT MANOMETER 4 SPE PX-270800107 CDM 270 RC inpatient 7.94 7.78 All Payors / Plans All Payors / Plans 7.94 other 7.94 7.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC TRAY LUMBAR PUNCTURE 3 WAY STOPCOCK STERILE WITH MANOMETER P PX-270800108 CDM 270 RC inpatient 6.56 6.43 All Payors / Plans All Payors / Plans 6.56 other 6.56 6.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BAG DRAINAGE UROLOGY WITH URINE METER INFECTION CONTROL 350M PX-270800109 CDM 270 RC inpatient 8.46 8.29 All Payors / Plans All Payors / Plans 8.46 other 8.46 8.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CONTAINER IV INFUSION EMPTY VIAFLEX PLASTIC BAG 1000ML PX-270800110 CDM 270 RC inpatient 2.62 2.57 All Payors / Plans All Payors / Plans 2.62 other 2.62 2.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC FILTER BLOOD SQ40SK PX-270800111 CDM 270 RC inpatient 11.14 10.92 All Payors / Plans All Payors / Plans 11.14 other 11.14 11.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SOLUTION IV INJECTION LACTATED RINGER PLASTIC BAG 500ML PX-270800112 CDM 270 RC inpatient 1.6 1.57 All Payors / Plans All Payors / Plans 1.6 other 1.6 1.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SOLUTION IV INJECTION LACTATED RINGER PLASTIC BAG 1000ML PX-270800113 CDM 270 RC inpatient 1.92 1.88 All Payors / Plans All Payors / Plans 1.92 other 1.92 1.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BIOPATCH PX-270800114 CDM 270 RC inpatient 65.85 64.53 All Payors / Plans All Payors / Plans 65.85 other 65.85 65.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CUROS CAPS PX-270800115 CDM 270 RC inpatient 62.18 60.94 All Payors / Plans All Payors / Plans 62.18 other 62.18 62.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER IV VASCULAR PERIPHERAL RADIOPAQUE PROTECTED PLUS 14 PX-270800116 CDM 270 RC inpatient 90.23 88.43 All Payors / Plans All Payors / Plans 90.23 other 90.23 90.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER IV VASCULAR PERIPHERAL RADIOPAQUE PROTECTIVE PLUS S PX-270800117 CDM 270 RC inpatient 90.37 88.56 All Payors / Plans All Payors / Plans 90.37 other 90.37 90.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SET EXT WITH MICROCLAVE CLAMP 7 INCHES PX-270800123 CDM 270 RC inpatient 3.79 3.71 All Payors / Plans All Payors / Plans 3.79 other 3.79 3.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SET EXT WITH MICROCLAVE CLAMP 60 INCHES PX-270800124 CDM 270 RC inpatient 5.92 5.8 All Payors / Plans All Payors / Plans 5.92 other 5.92 5.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BRACE ANKLE SPLINT BILATERAL REGULAR GREEN PX-270800125 CDM 270 RC inpatient 11.58 11.35 All Payors / Plans All Payors / Plans 11.58 other 11.58 11.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CANNULA NASAL CURVED TIP INFANT 7FT PX-270800126 CDM 270 RC inpatient 2.11 2.07 All Payors / Plans All Payors / Plans 2.11 other 2.11 2.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CONNECTOR 22MM OD X 22MM OD PX-270800128 CDM 270 RC inpatient 1.59 1.56 All Payors / Plans All Payors / Plans 1.59 other 1.59 1.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC IMMOBILIZER KNEE 3PANEL ADJUSTABLE UNIVERAL COTTON FOAM BLUE PX-270800129 CDM 270 RC inpatient 16.8 16.46 All Payors / Plans All Payors / Plans 16.8 other 16.8 16.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC IMMOBILIZER SHOULDER DELUXE MEDIUM PX-270800130 CDM 270 RC inpatient 4.84 4.74 All Payors / Plans All Payors / Plans 4.84 other 4.84 4.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC IMMOBILIZER SHOULDER DELUXE LARGE PX-270800131 CDM 270 RC inpatient 4.84 4.74 All Payors / Plans All Payors / Plans 4.84 other 4.84 4.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC MEDIA BLOOD CULTURE BOTTLE AUTO PEDIATRIC PLUS MEDIUM FOR BA PX-270800132 CDM 270 RC inpatient 3.65 3.58 All Payors / Plans All Payors / Plans 3.65 other 3.65 3.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PACESETTER II CLOSED HEEL BLK PX-270800133 CDM 270 RC inpatient 28.5 27.93 All Payors / Plans All Payors / Plans 28.5 other 28.5 28.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PACESETTER II CLOSED HEEL BLK MEDIUM/LARGE PX-270800134 CDM 270 RC inpatient 28.5 27.93 All Payors / Plans All Payors / Plans 28.5 other 28.5 28.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PACESETTER II CLOSED HEEL BLK PX-270800135 CDM 270 RC inpatient 28.5 27.93 All Payors / Plans All Payors / Plans 28.5 other 28.5 28.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SPLINT CASTING FIBERGLASS SCOTCHCAST CUSTOM LENGTH ROLL 5.0I PX-270800152 CDM 270 RC inpatient 86.53 84.8 All Payors / Plans All Payors / Plans 86.53 other 86.53 86.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC DRESSING WOUND HEMOSTAT ABSORBABLE STERILE SURGICEL 2 X 3IN PX-270800153 CDM 270 RC inpatient 41.62 40.79 All Payors / Plans All Payors / Plans 41.62 other 41.62 41.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC DRESSING WOUND HEMOSTAT ABSORBABLE STERILE SURGICEL 4.0 X 8. PX-270800154 CDM 270 RC inpatient 77.05 75.51 All Payors / Plans All Payors / Plans 77.05 other 77.05 77.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SOLUTION IV INJECTION DEXTROSE 10% IN WATER 1000ML PX-270800155 CDM 270 RC inpatient 2.35 2.3 All Payors / Plans All Payors / Plans 2.35 other 2.35 2.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SOLUTION IV INJECTION DEXTROSE 5% LACTATED RINGERS VISIV PLA PX-270800156 CDM 270 RC inpatient 1.75 1.72 All Payors / Plans All Payors / Plans 1.75 other 1.75 1.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC 24G X 5/8 CATHERTER PROTECTIVE PLUS PX-270800157 CDM 270 RC inpatient 96.25 94.33 All Payors / Plans All Payors / Plans 96.25 other 96.25 96.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PADDING UNDERCAST WEBRIL NON STERILE REGULAR FINISH COTTON 2 PX-270800158 CDM 270 RC inpatient 15.26 14.95 All Payors / Plans All Payors / Plans 15.26 other 15.26 15.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PADDING UNDERCAST WEBRIL NON STERILE REGULAR FINISH COTTON 3 PX-270800159 CDM 270 RC inpatient 8.22 8.06 All Payors / Plans All Payors / Plans 8.22 other 8.22 8.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PADDING UNDERCAST WEBRIL NON STERILE REGULAR FINISH COTTON 4 PX-270800160 CDM 270 RC inpatient 10.71 10.5 All Payors / Plans All Payors / Plans 10.71 other 10.71 10.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PADDING UNDERCAST WEBRIL NON STERILE REGULAR FINISH COTTON 6 PX-270800161 CDM 270 RC inpatient 7.6 7.45 All Payors / Plans All Payors / Plans 7.6 other 7.6 7.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SPLINT FINGER PLASTALUME STRAIGHT 1.25IN PX-270800162 CDM 270 RC inpatient 7.18 7.04 All Payors / Plans All Payors / Plans 7.18 other 7.18 7.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SPLINT CASTING FIBERGLASS SCOTCHCAST CUSTOM LENGTH ROLL 3.0I PX-270800163 CDM 270 RC inpatient 62.27 61.02 All Payors / Plans All Payors / Plans 62.27 other 62.27 62.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SPLINT CASTING FIBERGLASS SCOTCHCAST CUSTOM LENGTH ROLL 4.0I PX-270800164 CDM 270 RC inpatient 71.48 70.05 All Payors / Plans All Payors / Plans 71.48 other 71.48 71.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTRAOCULAR LENS MED SURG PX-276000000 CDM 276 RC inpatient 180 176.4 All Payors / Plans All Payors / Plans 180 other 180 180 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTRAOCULAR LENS PX-276023100 CDM V2631 CPT 276 RC inpatient 150 147 All Payors / Plans All Payors / Plans 150 other 150 150 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTEROCULAR LENS ALCON PX-276027880 CDM V2788 CPT 276 RC inpatient 1074 1052.52 All Payors / Plans All Payors / Plans 1074 other 1074 1074 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CAB TEST PX-300000033 CDM 300 RC inpatient 272 266.56 All Payors / Plans All Payors / Plans 272 other 272 272 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PSA SCREEN (PSAS) PX-300001030 CDM G0103 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROSEQ PX-3000026U0 CDM 0026U CPT 300 RC inpatient 2228 2183.44 All Payors / Plans All Payors / Plans 2228 other 2228 2228 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers 0 facility "HC EXON 12-15 SEQUENCING, REFLEX" PX-300002700 CDM 0027U CPT 300 RC inpatient 465 455.7 All Payors / Plans All Payors / Plans 465 other 465 465 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC JAK2 EXON 12 & OTHER NON V617F MUTATION DETECT BLOOD (JAKXB,JACXM)" PX-300002701 CDM 0027U CPT 300 RC inpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TPMT AND NUDT15 GENOTYPE PX-300003400 CDM 0034U CPT 300 RC inpatient 557 545.86 All Payors / Plans All Payors / Plans 557 other 557 557 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IG PARAPROTEIN QUAL BLD/UR PX-3000077U0 CDM 0077U CPT 300 RC inpatient 32 31.36 All Payors / Plans All Payors / Plans 32 other 32 32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFCT DS BCT/VIR RESP 22 TARGETS ARS/COV2 PX-3000202U0 CDM 0202U CPT 300 RC inpatient 437 428.26 All Payors / Plans All Payors / Plans 437 other 437 437 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SENTOSA SQ HIV-1 GENOTYPING ASSAY PX-3000219U0 CDM 0219U CPT 300 RC inpatient 557 545.86 All Payors / Plans All Payors / Plans 557 other 557 557 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFECTIOUS DETECTION SARS-COV2,INFLUENZA A/B, RSV" PX-300024100 CDM 0241U CPT 300 RC inpatient 150 147 All Payors / Plans All Payors / Plans 150 other 150 150 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BETA AMYLOID Aβ40&Aβ42 LC-MS/MS RATIO PLASMA PX-3000346U0 CDM 0346U CPT 300 RC inpatient 267 261.66 All Payors / Plans All Payors / Plans 267 other 267 267 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NEURO ALYS β-AMYL 1-42&1-40 PX-3000358U0 CDM 0358U CPT 300 RC inpatient 834 817.32 All Payors / Plans All Payors / Plans 834 other 834 834 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEGLYCEROLIZED RBC (DRBC) PX-300090220 CDM P9022 CPT 300 RC inpatient 914 895.72 All Payors / Plans All Payors / Plans 914 other 914 914 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PF CO-OX ANALYSIS (PCABG) PX-300366001 CDM 36600 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEM8(BASIC METABOLIC) PX-300800480 CDM 80048 CPT 301 RC inpatient 32 31.36 All Payors / Plans All Payors / Plans 32 other 32 32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ELECTROLYTES (LYTE) PX-300800510 CDM 80051 CPT 301 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMP METABOLIC PANEL (CMP) PX-300800530 CDM 80053 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRENATAL PROFILE (PNP) PX-300800550 CDM 80055 CPT 300 RC inpatient 217 212.66 All Payors / Plans All Payors / Plans 217 other 217 217 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LIPID PROFILE (LIPD) PX-300800610 CDM 80061 CPT 301 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FITNESS PLUS PROFILE (FPP) PX-300800611 CDM 80061 CPT 300 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RENAL PROFILE (RENAL) PX-300800690 CDM 80069 CPT 301 RC inpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXPOSURE PROFILE (EXP) PX-300800740 CDM 80074 CPT 300 RC inpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VIRAL HEPATITIS STUDY PX-300800741 CDM 80074 CPT 300 RC inpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEPATIC PANEL (LIVR) PX-300800760 CDM 80076 CPT 301 RC inpatient 32 31.36 All Payors / Plans All Payors / Plans 32 other 32 32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRENATAL PROFILE INC HIV PX-300800810 CDM 80081 CPT 300 RC inpatient 289 283.22 All Payors / Plans All Payors / Plans 289 other 289 289 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ADALIMUMAB QN WITH REFLEX TO AB, S" PX-300801450 CDM 80145 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMIKACIN PX-300801500 CDM 80150 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CAFFEINE (CAF) PX-300801550 CDM 80155 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARBAMAZEPINE (TEG) PX-300801560 CDM 80156 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYCLOSPORIN (CYCLO) PX-300801580 CDM 80158 CPT 301 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CLOZAPINE PX-300801590 CDM 80159 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DIGOXIN, SERUM (DIG)" PX-300801620 CDM 80162 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEPAKENE (DEPK)(VA) PX-300801640 CDM 80164 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRUG SCREEN QUANT DIPROPYLACETIC ACID FREE PX-300801650 CDM 80165 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ETHXOSUX-ZARONTIN (ZAR) PX-300801680 CDM 80168 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GENTAMICIN PX-300801700 CDM 80170 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NEURONTIN,GABAPENTIN(GABA)" PX-300801710 CDM 80171 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LAMOTRIGINE (LAMO) PX-300801750 CDM 80175 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LIDOCAINE (LIDO) PX-300801760 CDM 80176 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LEVETIRACETAM (LEVE) PX-300801770 CDM 80177 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC LITHIUM,SERUM (LI)" PX-300801780 CDM 80178 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OXCARBAZEPINE PX-300801830 CDM 80183 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PHENOBARBITAL (PHEN) PX-300801840 CDM 80184 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DILANTIN (PTN) PX-300801850 CDM 80185 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FREE DILANTIN (FPTNB) PX-300801860 CDM 80186 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRIMIDONE PX-300801880 CDM 80188 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROCAINAMIDE (PRO)(PRON) PX-300801900 CDM 80190 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHG ASSAY OF PROCAINAMIDE W METABOLITES PX-300801920 CDM 80192 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC QUINIDINE (QUID) PX-300801940 CDM 80194 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RAPAMYCIN (RAPA) PX-300801950 CDM 80195 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FK506(TACROLIMUS) PX-300801970 CDM 80197 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMINOPHYLLINE (THEO)(AMFN) PX-300801980 CDM 80198 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TOBRAMYCIN PX-300802000 CDM 80200 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TOPIRAMATE (TOPI) PX-300802010 CDM 80201 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VANCOMYCIN PX-300802020 CDM 80202 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFLIXIMAB QN WITH REFLEX TO AB, S" PX-300802300 CDM 80230 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC LACOSAMIDE, S" PX-300802350 CDM 80235 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VEDOLIZUMAB QN WITH ANTIBODIES, S" PX-300802800 CDM 80280 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC THIOPURINE METABOLITES, WHOLE BLOOD" PX-300802989 CDM 80299 CPT 300 RC inpatient 372 364.56 All Payors / Plans All Payors / Plans 372 other 372 372 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NORPACE (NRPC) PX-300802990 CDM 80299 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CLOMIPRAMINE (CLOM) PX-300802991 CDM 80299 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLECAINIDE (FLEC) PX-300802992 CDM 80181 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUOXETINE (FLUOX) PX-300802993 CDM 80299 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC 5-FLUCYTOSINE, SERUM" PX-300802994 CDM 80299 CPT 300 RC inpatient 37 36.26 All Payors / Plans All Payors / Plans 37 other 37 37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMIODARONE LEVEL PX-300802995 CDM 80151 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFLIXIMAB QUANTIFIC W/ REFLEX TO ANTIBODIES TO INFLIXIMAB SERUM PX-300802996 CDM 80299 CPT 300 RC inpatient 314 307.72 All Payors / Plans All Payors / Plans 314 other 314 314 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC LACOSAMIDE, SERUM" PX-300802997 CDM 80299 CPT 300 RC inpatient 209 204.82 All Payors / Plans All Payors / Plans 209 other 209 209 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VEDOLIZUMBA QN WITH ABS, SERUM" PX-300802998 CDM 80299 CPT 300 RC inpatient 197 193.06 All Payors / Plans All Payors / Plans 197 other 197 197 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ADALIMUMAB QN W/RFLX TO AB, SERUM (ADALX)" PX-300802999 CDM 80299 CPT 300 RC inpatient 515 504.7 All Payors / Plans All Payors / Plans 515 other 515 515 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DRUG SCRN,URINE,NURSERY ONLY(OPDS" PX-300803010 CDM 80307 CPT 300 RC inpatient 206 201.88 All Payors / Plans All Payors / Plans 206 other 206 206 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DRUG SCREEN, ABBREV. (ADRUG)" PX-300803011 CDM 80307 CPT 300 RC inpatient 206 201.88 All Payors / Plans All Payors / Plans 206 other 206 206 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRUG SCREEN MECONIUM PX-300803012 CDM 80307 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INITIAL DRUG SCREEN AT PRMC PX-300803013 CDM 80307 CPT 300 RC inpatient 206 201.88 All Payors / Plans All Payors / Plans 206 other 206 206 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PAIN CLINIC DRUG SCREEN PX-300803014 CDM 80307 CPT 300 RC inpatient 160 156.8 All Payors / Plans All Payors / Plans 160 other 160 160 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRENATAL DRUG SCRN. (PNDS) PX-300803015 CDM 80307 CPT 300 RC inpatient 183 179.34 All Payors / Plans All Payors / Plans 183 other 183 183 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BENZODIAZEPINE URINE SCREEN PX-300803016 CDM 80307 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BUPRENORPHINE, URINE" PX-300803017 CDM 80307 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CANNABINOIDS SCREEN PX-300803018 CDM 80307 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COCAINE METABOLITE URINE SCREEN PX-300803019 CDM 80307 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SALICYLATE SERUM (SALI) PX-300803020 CDM 80179 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACETAMINOPHEN (ACE) PX-300803021 CDM 80143 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ABBREV DRUG SCREEN, ACETEMINOPHEN & SALICYLATE" PX-300803022 CDM 80307 CPT 300 RC inpatient 291 285.18 All Payors / Plans All Payors / Plans 291 other 291 291 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PRENATAL DRUG SCREEN & BUPRENORPHINE,URINE" PX-300803023 CDM 80307 CPT 300 RC inpatient 206 201.88 All Payors / Plans All Payors / Plans 206 other 206 206 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DRUG SCREEN URINE, NURSERY & MECONIUM" PX-300803024 CDM 80307 CPT 300 RC inpatient 320 313.6 All Payors / Plans All Payors / Plans 320 other 320 320 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ABBREV DRUG SCREEN &ACETEMOPHIN/SALICYLATE PX-300803025 CDM 80307 CPT 300 RC inpatient 249 244.02 All Payors / Plans All Payors / Plans 249 other 249 249 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD & URINE ALCOHOL PX-300803026 CDM 80320 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CONTROLLED SUBSTANCE MONITORING PANEL, URINE" PX-300803027 CDM 80307 CPT 300 RC inpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRUG SCREEN (DRUS)(DRUSU) PX-300803040 CDM 80307 CPT 300 RC inpatient 534 523.32 All Payors / Plans All Payors / Plans 534 other 534 534 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRUG SCREEN PRESCRIPTION/OTC U PX-300803041 CDM 80307 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRUG SCREEN W/ REFLEX PX-300803042 CDM 80307 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC URINE DRUG SCREEN, INSTRUMENT CHEM ANALYZER" PX-300803043 CDM 80307 CPT 300 RC inpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URINE DRUG SCREEN VISUAL OBSERVATION PX-300803050 CDM 80305 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URINE DRUG SCREEN INSTRUMENT ASSISTED DIRECT OBSERV PX-300803060 CDM 80307 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRUG SCREEEN FENTANYL PX-300803070 CDM 80307 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD ALCOHOL (ALCO) PX-300803200 CDM 80320 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VOLATILE SCREEN (MEOH) PX-300803201 CDM 80320 CPT 300 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ALCOHOL, URINE (ALCOU)" PX-300803202 CDM 80320 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ETHYLENE GLYCOL, SERUM (ETGL)" PX-300803203 CDM 80320 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DRUG SCREEN, QUANT ALCOHOL BIOMARKERS 1 OR 2" PX-300803210 CDM 80321 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMPHETAMINE CONF PX-300803240 CDM 80324 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRUG SCREEN QUANT AMPHETAMINES 3 OR 4 PX-300803250 CDM 80325 CPT 300 RC inpatient 37 36.26 All Payors / Plans All Payors / Plans 37 other 37 37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC AMPHETAMINES CONFIRMATION, FLUID (CSMP)" PX-300803260 CDM 80326 CPT 300 RC inpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ANTIDEPRESSANTS, TRICYCLIC, OTHER CYCLICALS, 1 OR 2" PX-300803350 CDM 80335 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMIPRAMINE (TOF) PX-300803351 CDM 80335 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DESIPRAMINE (DSIPB) PX-300803352 CDM 80335 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NORTRIPTYLENE (NOR)(ELV) PX-300803353 CDM 80335 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMIODARONE (AMID) PX-300803450 CDM 80151 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BARBITURATE CONFIRMATION URINE PX-300803451 CDM 80345 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CLONOPIN (CLNN) PX-300803460 CDM 80346 CPT 300 RC inpatient 48 47.04 All Payors / Plans All Payors / Plans 48 other 48 48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIAZEPAM/NORDIAZEPAM (DIAZ) PX-300803461 CDM 80346 CPT 300 RC inpatient 51 49.98 All Payors / Plans All Payors / Plans 51 other 51 51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BENZODIAZIPINE CONFIRMATION URINE PX-300803462 CDM 80346 CPT 301 RC inpatient 37 36.26 All Payors / Plans All Payors / Plans 37 other 37 37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CLONAZEPAM LEVEL PX-300803463 CDM 80346 CPT 300 RC inpatient 48 47.04 All Payors / Plans All Payors / Plans 48 other 48 48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BENZODIAZEPINES CONFIRMATION, RANDOM, URINE" PX-300803470 CDM 80347 CPT 300 RC inpatient 51 49.98 All Payors / Plans All Payors / Plans 51 other 51 51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEFINITIVE DURG BENZODIAZEPINES (CSMP) PX-300803471 CDM 80347 CPT 300 RC inpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BUPRENOR & NORBUPRENOR URINE PX-300803480 CDM 80348 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CANNABINOID (THC) CONF.,MECONIUM" PX-300803490 CDM 80349 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TETRAHYDROCANNABINOL CONF URINE PX-300803491 CDM 80349 CPT 300 RC inpatient 46 45.08 All Payors / Plans All Payors / Plans 46 other 46 46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC COCAINE CONFIRMATION, MECONIUM" PX-300803530 CDM 80353 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COCAINE CONFIRMATION URINE PX-300803531 CDM 80353 CPT 300 RC inpatient 37 36.26 All Payors / Plans All Payors / Plans 37 other 37 37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DRUG SCREENING, FENTANYL" PX-300803540 CDM 80354 CPT 300 RC inpatient 372 364.56 All Payors / Plans All Payors / Plans 372 other 372 372 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC METHADONE PX-300803580 CDM 80358 CPT 300 RC inpatient 103 100.94 All Payors / Plans All Payors / Plans 103 other 103 103 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC METHADONE CONFIRMATION URINE PX-300803581 CDM 80358 CPT 300 RC inpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC METHYLENEDIOXYAMPHETAMINES PX-300803590 CDM 80359 CPT 300 RC inpatient 20 19.6 All Payors / Plans All Payors / Plans 20 other 20 20 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC OPIATE CONFIRMATION, MECONIUM" PX-300803610 CDM 80361 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPIATE CONFIRMATION URINE PX-300803611 CDM 80361 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRUG SCREEN OPIODS AND OPIATE ANALOGS 1 OR 2 PX-300803621 CDM 80326 CPT 300 RC inpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC OPIATES, 5 OR MORE" PX-300803640 CDM 80364 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEFINITIVE DRUG OPOIDS/ANALOGS (CSMP) PX-300803641 CDM 80364 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OXYCODONE W METABOLITE PX-300803650 CDM 80365 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEXAMETHASONE LEVEL PX-300803750 CDM 80375 CPT 300 RC inpatient 200 196 All Payors / Plans All Payors / Plans 200 other 200 200 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEXAMETHSONE LEVEL(DEXA) PX-300803990 CDM 80299 CPT 300 RC inpatient 180 176.4 All Payors / Plans All Payors / Plans 180 other 180 180 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ADRENOCORTICOTROPHIC HORMONE (ACTH) STIM PANEL PX-300804000 CDM 80400 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URINE DIPSTICK TEST(URDIP) PX-300810000 CDM 81000 CPT 300 RC inpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URINE W/MICROSCOPIC (UWM) PX-300810010 CDM 81001 CPT 307 RC inpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC REFRACTOMETER SPECIFIC GRAVITY PX-300810020 CDM 81002 CPT 300 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URINALYSIS ROUTINE PX-300810030 CDM 81003 CPT 307 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC URINALYSIS, QUALIT OR SEMIQUNAT;EXCEPT IMMUNOASSAY" PX-300810050 CDM 81005 CPT 300 RC inpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URINE MICROSCOPIC PX-300810150 CDM 81015 CPT 300 RC inpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UCG SPOT TEST (UCG) PX-300810250 CDM 81025 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRCA1/BRCA2 GENE ANALYSIS PX-300811620 CDM 81162 CPT 300 RC inpatient 2428 2379.44 All Payors / Plans All Payors / Plans 2428 other 2428 2428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC APC GENE, FULL GENE ANALYSIS" PX-300812010 CDM 81201 CPT 300 RC inpatient 3313 3246.74 All Payors / Plans All Payors / Plans 3313 other 3313 3313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BCR ABL P210 MRNA QUANT PX-300812060 CDM 81206 CPT 300 RC inpatient 460 450.8 All Payors / Plans All Payors / Plans 460 other 460 460 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BCR/ABL, RNA,QUAL, DIAGNOSTIC" PX-300812061 CDM 81206 CPT 300 RC inpatient 131 128.38 All Payors / Plans All Payors / Plans 131 other 131 131 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BCR ABL P190 MRNA QUANT PX-300812070 CDM 81207 CPT 300 RC inpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BCR/ABL,RNA, QUAL MINOR QUAL, DIAGNOSTIC" PX-300812071 CDM 81207 CPT 300 RC inpatient 118 115.64 All Payors / Plans All Payors / Plans 118 other 118 118 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BCR ABL TRANSLOCATION ANALY OTH PX-300812080 CDM 81208 CPT 300 RC inpatient 560 548.8 All Payors / Plans All Payors / Plans 560 other 560 560 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BCR/ABL, RNA, OTHER, QUAL, DIAGNOSTIC" PX-300812081 CDM 81208 CPT 300 RC inpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRAF ANALYSIS PX-300812103 CDM 81210 CPT 300 RC inpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CALR MUTATION ANALYSIS, MYELOPROLIFERATIVE NEOPLASM" PX-300812190 CDM 81219 CPT 300 RC inpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CALR MUTATION ANAL, MYELOPROLIFERATIVE NEOPLASM, REFLEX" PX-300812191 CDM 81219 CPT 300 RC inpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MYELOPROLIFETATIVE NEOPLASM, CALR W REFLEX MPL" PX-300812192 CDM 81219 CPT 300 RC inpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYSTIC FIB.CARRIER AND DETECTION PX-300812200 CDM 81220 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CFTR GENE ANALYSIS DUPLICATION/DELETION VARIANTS PX-300812220 CDM 81222 CPT 300 RC inpatient 151 147.98 All Payors / Plans All Payors / Plans 151 other 151 151 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOGENOMIC CONSTITUTIONAL MICROARRAY ANAL PX-300812280 CDM 81228 CPT 300 RC inpatient 1342 1315.16 All Payors / Plans All Payors / Plans 1342 other 1342 1342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOGENOMIC CHROM MICROARRAY CONGEN PX-300812290 CDM 81229 CPT 300 RC inpatient 1642 1609.16 All Payors / Plans All Payors / Plans 1642 other 1642 1642 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHROMOSOMAL MICROARRAY,AUTOPSY, PROD CONCEPTION,STILLBIRTH" PX-300812291 CDM 81229 CPT 300 RC inpatient 1856 1818.88 All Payors / Plans All Payors / Plans 1856 other 1856 1856 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIHYDROPYRIMIDINE DEHYDROGENASE FULL GENE SEQU PX-300812320 CDM 81232 CPT 300 RC inpatient 1285 1259.3 All Payors / Plans All Payors / Plans 1285 other 1285 1285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HYPERCOAGULABILITY CONSULT.(CCHC) PX-300812400 CDM 81240 CPT 300 RC inpatient 151 147.98 All Payors / Plans All Payors / Plans 151 other 151 151 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROTHROMBIN 20210 MUTATION (PTGM) PX-300812401 CDM 81240 CPT 300 RC inpatient 148 145.04 All Payors / Plans All Payors / Plans 148 other 148 148 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FACTOR V LEIDEN (F5DNA) PX-300812410 CDM 81241 CPT 302 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FMR1(FRAGILE 1 MENTAL RETARDATION) GENE ANALYSIS,EVAL ABNORMAL ALLELES" PX-300812430 CDM 81243 CPT 300 RC inpatient 320 313.6 All Payors / Plans All Payors / Plans 320 other 320 320 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FMRI GENE ANALYSIS, CHARAC OF ALLELES" PX-300812440 CDM 81244 CPT 300 RC inpatient 160 156.8 All Payors / Plans All Payors / Plans 160 other 160 160 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEMOCHROMATOSIS HFE GENE ANALYSIS PX-300812560 CDM 81256 CPT 300 RC inpatient 200 196 All Payors / Plans All Payors / Plans 200 other 200 200 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGH@ REARRANGE ABNORMAL CLONAL POP AMPLIFIED PX-300812610 CDM 81261 CPT 300 RC inpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IGH SOMATIC HYPERMUT ANALYSIS, B-CELL CHRONIC LYMPHCYTIC LEUKEMIA" PX-300812630 CDM 81263 CPT 300 RC inpatient 697 683.06 All Payors / Plans All Payors / Plans 697 other 697 697 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGK@GENE REARRANGE DETECT ABNORMAL CLONAL POP PX-300812640 CDM 81264 CPT 300 RC inpatient 249 244.02 All Payors / Plans All Payors / Plans 249 other 249 249 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPARITIVE ANALYSIS SHORT TANDEM REPEAT PX-300812650 CDM 81265 CPT 300 RC inpatient 702 687.96 All Payors / Plans All Payors / Plans 702 other 702 702 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ADD'L COMP ANALYSIS W/STR (STR2) PX-300812660 CDM 81266 CPT 300 RC inpatient 329 322.42 All Payors / Plans All Payors / Plans 329 other 329 329 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALPHA-GLOBULIN GENE ANALYSIS PX-300812690 CDM 81269 CPT 300 RC inpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC JAK2 V617F MUTATION PX-300812700 CDM 81270 CPT 310 RC inpatient 148 145.04 All Payors / Plans All Payors / Plans 148 other 148 148 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC JAK2 V167F MUTATION DETECTION, BONE MARROW" PX-300812701 CDM 81270 CPT 300 RC inpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MYELOPROLIFERATIVE NEOPLASM,JAK2 V617F W REFLEX" PX-300812702 CDM 81270 CPT 300 RC inpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HUNTINGTON DISEASE ANALYSIS PX-300812710 CDM 81271 CPT 300 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC KIT ASP816VAL MUTATION ANALYSIS, BLOOD" PX-300812730 CDM 81273 CPT 300 RC inpatient 1277 1251.46 All Payors / Plans All Payors / Plans 1277 other 1277 1277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MGMT PROMOTER METHYLATION, TUMOR" PX-300812870 CDM 81287 CPT 300 RC inpatient 885 867.3 All Payors / Plans All Payors / Plans 885 other 885 885 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MLH1 HYPERMETHYLATION ANALYSIS PX-300812880 CDM 81288 CPT 300 RC inpatient 643 630.14 All Payors / Plans All Payors / Plans 643 other 643 643 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MTHFR MUTATION ANALYSIS, COMMON VARIANTS" PX-300812910 CDM 81291 CPT 300 RC inpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYD88 L265P GENE MUTATION ANALYSIS (MYD88) PX-300813050 CDM 81305 CPT 300 RC inpatient 820 803.6 All Payors / Plans All Payors / Plans 820 other 820 820 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PML/RARA QUANT, PCR" PX-300813150 CDM 81315 CPT 300 RC inpatient 600 588 All Payors / Plans All Payors / Plans 600 other 600 600 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SMA CARRIER BY DEL/DUP (SMNCS) PX-300813290 CDM 81329 CPT 300 RC inpatient 852 834.96 All Payors / Plans All Payors / Plans 852 other 852 852 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HLA CLASS I MOLECULAR TYPING DISEASE ASSOCIATION PX-300813720 CDM 81372 CPT 300 RC inpatient 271 265.58 All Payors / Plans All Payors / Plans 271 other 271 271 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HLA CLASS II MOLECULAR TYPING DISEASE ASSOCIATION PX-300813750 CDM 81375 CPT 300 RC inpatient 791 775.18 All Payors / Plans All Payors / Plans 791 other 791 791 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ONE LOCUS (EG, HLA-DRB1,DRB3/4/5-DQB1,DQA1,DPB1,OR DPA1)EACH" PX-300813760 CDM 81376 CPT 300 RC inpatient 217 212.66 All Payors / Plans All Payors / Plans 217 other 217 217 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CELIAC DISEASE GLUTEN-FREE CASCADE PX-300813761 CDM 81376 CPT 300 RC inpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NARCOLEPSY ASSOC ANTIGEN, HLA-DQB1 TYPE, BLOOD" PX-300813762 CDM 81376 CPT 300 RC inpatient 440 431.2 All Payors / Plans All Payors / Plans 440 other 440 440 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HLA-B 5701 GENOTYPE,ABACAVIR HYPERSENSIT, BLOOD" PX-300813810 CDM 81381 CPT 300 RC inpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROMETHEUS LACTOTYPE PX-300814000 CDM 81400 CPT 300 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROMETHEUS TPMT GENETICS PX-300814010 CDM 81401 CPT 300 RC inpatient 557 545.86 All Payors / Plans All Payors / Plans 557 other 557 557 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPINAL MUSCULAR ATROPHY CARRIER SCREEN DELETE/DUPLICAT PX-300814011 CDM 81401 CPT 300 RC inpatient 557 545.86 All Payors / Plans All Payors / Plans 557 other 557 557 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HUNTINGTON DISEASE, MOLECULAR ANALYSIS" PX-300814012 CDM 81401 CPT 300 RC inpatient 940 921.2 All Payors / Plans All Payors / Plans 940 other 940 940 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MUTYH GENE ANALYSIS, Y165C AND G382D" PX-300814013 CDM 81401 CPT 300 RC inpatient 940 921.2 All Payors / Plans All Payors / Plans 940 other 940 940 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MPL EXON 10 MUTATION DETECTION, BLOOD" PX-300814031 CDM 81339 CPT 300 RC inpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MPL EXON 10 MUTATION DETECTION, REFLEX" PX-300814032 CDM 81339 CPT 300 RC inpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MPL EXON 10 SEQUENCING, REFLEX" PX-300814033 CDM 81339 CPT 300 RC inpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VERY LONG CHAIN ACLY-COA DEHYDROGENASE DEFICIENCY PX-300814060 CDM 81406 CPT 300 RC inpatient 1714 1679.72 All Payors / Plans All Payors / Plans 1714 other 1714 1714 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MUTYH GENE, FULL GENE ANALYSIS (MYHZ)" PX-300814061 CDM 81406 CPT 300 RC inpatient 1285 1259.3 All Payors / Plans All Payors / Plans 1285 other 1285 1285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UDP-GLUCURONOSYL TRANSFERASE 1A1 FULL GENE SEQU PX-300814791 CDM 81479 CPT 300 RC inpatient 1428 1399.44 All Payors / Plans All Payors / Plans 1428 other 1428 1428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MYD88, L265P, SOMATIC GENE MUTATION, SNA ALLELE-PCR" PX-300814792 CDM 81479 CPT 300 RC inpatient 817 800.66 All Payors / Plans All Payors / Plans 817 other 817 817 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHG FETAL CONGENITAL ABNOR ASSAY TWO PROTEINS PX-300815080 CDM 81508 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AFP MATERNAL 4 MARKER PX-300815110 CDM 81511 CPT 300 RC inpatient 223 218.54 All Payors / Plans All Payors / Plans 223 other 223 223 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFECTIOUS DISEASE, BACTERIAL VAGINOSIS, QUANT REAL TIME AMP" PX-300815130 CDM 81513 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FIBRO TEST ACTI TEST, S (FIBRO)" PX-300815960 CDM 81596 CPT 300 RC inpatient 372 364.56 All Payors / Plans All Payors / Plans 372 other 372 372 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NASH FIBROSURE PX-300815990 CDM 81599 CPT 300 RC inpatient 191 187.18 All Payors / Plans All Payors / Plans 191 other 191 191 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC KETONE BODIES SERUM, QUALITATIVE" PX-300820090 CDM 82009 CPT 301 RC inpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BETA HYDROXYBUTYRATE (BHOB) PX-300820100 CDM 82010 CPT 300 RC inpatient 37 36.26 All Payors / Plans All Payors / Plans 37 other 37 37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACETYLCHOLINESTERASE PX-300820130 CDM 82013 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACTH (ACTH) PX-300820240 CDM 82024 CPT 301 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ALBUMIN;SERUM, PLASMA OR WHOLE BLOOD" PX-300820400 CDM 82040 CPT 301 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ALBUMIN, URINE/OTHER SOURCE QUANTITATIVE EA." PX-300820420 CDM 82042 CPT 301 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC URINE,MICROALBUMIN" PX-300820430 CDM 82043 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALDOLASE (ALSE) PX-300820850 CDM 82085 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALDOSTERONE PX-300820880 CDM 82088 CPT 301 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALPHA-1-ANTITRYPSIN (ALA) PX-300821030 CDM 82103 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHG ALPHA-1-ANTITRYPSIN, PHENO" PX-300821040 CDM 82104 CPT 301 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALPHA-FETOPROTEIN (AFP) SERUM PX-300821050 CDM 82105 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALPHA FETOPROTEIN PX-300821051 CDM 82105 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC AFP,AMNIOTIC FLUID (AFPAF)" PX-300821060 CDM 82106 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALUMINUM (ALMU) PX-300821080 CDM 82108 CPT 300 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC AMINOLEVULINIC ACID(ALA),RAND,UR" PX-300821350 CDM 82135 CPT 300 RC inpatient 75 73.5 All Payors / Plans All Payors / Plans 75 other 75 75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC AMINO ACIDS, 2-5 QUANTITATIVE" PX-300821360 CDM 82136 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMINO ACID SCREEN BLD. (ACCB) PX-300821390 CDM 82139 CPT 300 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMMONIA PX-300821400 CDM 82140 CPT 301 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMYLASE PX-300821500 CDM 82150 CPT 301 RC inpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANDROSTENEDIONE (ANDRS) PX-300821570 CDM 82157 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANGIOTENSIN I CONVERT ENZYME PX-300821640 CDM 82164 CPT 301 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ASSAY ANTI-MULLERIAN HORM PX-300821660 CDM 82166 CPT 301 RC inpatient 133 130.34 All Payors / Plans All Payors / Plans 133 other 133 133 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHG ASSAY OF ALPOLIPOPROTEIN PX-300821720 CDM 82172 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARSENIC (ARSU) PX-300821750 CDM 82175 CPT 300 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHG ASSAY OF ASCORBIC ACID PX-300821800 CDM 82180 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BETA 2 MICROGLOBULIN (B2M) PX-300822320 CDM 82232 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BILIRUBIN TOTAL PX-300822470 CDM 82247 CPT 301 RC inpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIRECT BILIRUBIN(DBIL) PX-300822480 CDM 82248 CPT 301 RC inpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OCCULT BLD FECES (OCB) PX-300822700 CDM 82270 CPT 300 RC inpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OCCULT BLOOD X2 PX-300822702 CDM 82270 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OCCULT BLOOD X3 PX-300822703 CDM 82270 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BLOOD, OCCULT, QUAL, FECES, SINGLE SPECIMEN" PX-300822720 CDM 82272 CPT 301 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FECAL OCCULT BLOOD IMMUNO PX-300822740 CDM 82274 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHG ASSAY OF CADMIUM PX-300823000 CDM 82300 CPT 300 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITAMIN D -25 HYDROXY PX-300823060 CDM 82306 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CALCITONIN (CALTN) PX-300823080 CDM 82308 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CALCIUM TOTAL PX-300823100 CDM 82310 CPT 301 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CALCIUM IONIZED PX-300823300 CDM 82330 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CALCIUM RANDOM URINE PX-300823400 CDM 82340 CPT 301 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STONE ANALYSIS (STONE) PX-300823650 CDM 82365 CPT 301 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CO2 (CO2) PX-300823740 CDM 82374 CPT 300 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RT CO-OX ANALYSIS PX-300823750 CDM 82375 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CEA (CEAM) PX-300823780 CDM 82378 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CARNITINE(TOTAL AND FREE) QUANT., EACH SPEC" PX-300823790 CDM 82379 CPT 300 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BETA CAROTENE PX-300823800 CDM 82380 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CATECHOLAMINES FRACT. PX-300823840 CDM 82384 CPT 300 RC inpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CERULOPLASMIN (CERMN) PX-300823900 CDM 82390 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMILUMINESCENT ASSAY PX-300823970 CDM 82397 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHLORIDE BLOOD PX-300824350 CDM 82435 CPT 300 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHLORIDE URINE PX-300824360 CDM 82436 CPT 301 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHLORIDE, OTHER SOURCE" PX-300824380 CDM 82438 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHOLESTEROL (CHOL) PX-300824650 CDM 82465 CPT 301 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHOLINESTERASE, SERUM" PX-300824800 CDM 82480 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ACETYLCHOLINESTERASE,RBC (ACHS)" PX-300824820 CDM 82482 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC URINE,CITRATE 24HR (CITU)" PX-300825070 CDM 82507 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC COLLAGEN CROSS LINKS, ANY METHOD" PX-300825230 CDM 82523 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COPPER PX-300825250 CDM 82525 CPT 301 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CORTISOL FREE PX-300825300 CDM 82530 CPT 301 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CORTISOL TOTAL PX-300825330 CDM 82533 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC COLUMN CHROMATOGRAPHY, EACH SPECIMIN" PX-300825420 CDM 82542 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPK (CPK) PX-300825500 CDM 82550 CPT 301 RC inpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPK-MB (CKMB) PX-300825530 CDM 82553 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CREATININE BLOOD PX-300825650 CDM 82565 CPT 301 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CREATININE OTHER SOURCE PX-300825700 CDM 82570 CPT 301 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CREAT CLEAR 24 HR (CRCL) PX-300825750 CDM 82575 CPT 301 RC inpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CRYOGLOBULIN (CRY) PX-300825950 CDM 82595 CPT 300 RC inpatient 40 39.2 All Payors / Plans All Payors / Plans 40 other 40 40 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC B-12 (B12) PX-300826071 CDM 82607 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYSTATIN C PX-300826100 CDM 82610 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DHEA,UNCONJUGATED (DHEA)" PX-300826260 CDM 82626 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DHEA, SULFATE (DHEAS)" PX-300826270 CDM 82627 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIBUCAINE (DIBC) PX-300826380 CDM 82638 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITAMIN D - DIHYDROXY (VITDD) PX-300826520 CDM 82652 CPT 301 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ELASTASE, PANCREATIC FECAL" PX-300826560 CDM 82656 CPT 300 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ENZYME ACTIVITY IN CELLS,NOS, NON RADIOACTIVE" PX-300826570 CDM 82657 CPT 300 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ERTHROPOIETIN (ERYTP) PX-300826680 CDM 82668 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ESTRADIOL PX-300826700 CDM 82670 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ESTROGENS FRACTIONATED PX-300826710 CDM 82671 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ESTROGENS,TL (ESTB)" PX-300826720 CDM 82672 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ESTRONE PX-300826790 CDM 82679 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ETHYLENE GLYCOL PX-300826930 CDM 82693 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FECAL FAT QUANTITATIVE PX-300827100 CDM 82710 CPT 300 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FERRITIN (FER) PX-300827280 CDM 82728 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FETAL FIBRONECTIN (FFN) PX-300827310 CDM 82731 CPT 301 RC inpatient 500 490 All Payors / Plans All Payors / Plans 500 other 500 500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FOLIC ACID (FOL) PX-300827460 CDM 82746 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOGLOBULIN IGA,IGD,IGC,IGM EACH" PX-300827840 CDM 82784 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGA (IGA) PX-300827841 CDM 82784 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG (IGG) PX-300827842 CDM 82784 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGM (IGM) PX-300827843 CDM 82784 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CELIAC DISEASE SEROLOGY CASCADE PX-300827844 CDM 82784 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGE (IGE) PX-300827850 CDM 82785 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG SUBGLASS (IGGS) PX-300827870 CDM 82787 CPT 301 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RT VENOUS BG-ANALYSIS-ONLY (ABGA) PX-300828000 CDM 82800 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RT BLOOD GAS ANALYSIS PX-300828030 CDM 82803 CPT 300 RC inpatient 88 86.24 All Payors / Plans All Payors / Plans 88 other 88 88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PF BLOOD GAS ANALYSIS PX-300828031 CDM 82803 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GASTRIN AFTER SECRETIN STIMULATION PX-300829380 CDM 82938 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GASTRIN (GASN) PX-300829410 CDM 82941 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLUCOSE FLUID PX-300829450 CDM 82945 CPT 301 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLUCOSE QUANTITATIVE BLOOD PX-300829470 CDM 82947 CPT 301 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC GLUCOSE, POST GLUC. DOSE(INCLUDES GLUC)" PX-300829500 CDM 82950 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLUC. CHALLENGE SCREEN (GLUC) PX-300829501 CDM 82950 CPT 300 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POST GLUCOSE TEST PX-300829505 CDM 82952 CPT 301 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLUCOSE TOL 5 HR (OGT5) PX-300829510 CDM 82951 CPT 300 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLUCOSE TOLERANCE TEST 3 SPECIMENS PX-300829511 CDM 82951 CPT 300 RC inpatient 88 86.24 All Payors / Plans All Payors / Plans 88 other 88 88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LACTOSE TOL. TEST (LATT) PX-300829512 CDM 82951 CPT 300 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC G6PD QUANTITATIVE (G6PDQ) PX-300829550 CDM 82955 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD GLUCOSE CHECK PX-300829620 CDM 82962 CPT 300 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GGTP (GT) PX-300829770 CDM 82977 CPT 301 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FRUCTOSAMINE, SERUM" PX-300829850 CDM 82985 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FSH (FSH) PX-300830010 CDM 83001 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LH (LH) PX-300830021 CDM 83002 CPT 301 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GROWTH HORMONE (HGH) PX-300830030 CDM 83003 CPT 300 RC inpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HAPTOGLOBIN, BLD. (HAP)" PX-300830100 CDM 83010 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC H. PYLORI UREA BREATH TEST (UBT) PX-300830130 CDM 83013 CPT 301 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEAVY METAL QUANTITATIVE EACH PX-300830180 CDM 83018 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HGB INVESTIGATION (HIN)(HELEC) PX-300830200 CDM 83020 CPT 300 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEMOGLOBIN F FETAL QUALITATIVE PX-300830330 CDM 83033 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEMOGLOBIN A1C (A1C) PX-300830360 CDM 83036 CPT 301 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLASMA HGB (PHGB) PX-300830510 CDM 83051 CPT 300 RC inpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEMOSIDERIN URINE (HSID) PX-300830700 CDM 83070 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HOMOCYSTEINE, TL PLASMA (HCP)" PX-300830900 CDM 83090 CPT 301 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC 5-HIAA (HIAA) PX-300834970 CDM 83497 CPT 301 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC 17 HYDROXY PROGESTERONE (17HPG) PX-300834980 CDM 83498 CPT 301 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOASSAY,NON INFECTIOUS DISEASE;MULTI, STEP" PX-300835160 CDM 83516 CPT 301 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-NEUTRO. CYTO. AB. (ANCAB) PX-300835161 CDM 83516 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLIADIN ANTIBODY (GLIAB) PX-300835162 CDM 83516 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARIETAL CELL ANTIBODIES (PCABS) PX-300835163 CDM 83516 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TISSUE TRANSGLUTAMINASE (TTG) PX-300835164 CDM 83516 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC GLIADIN (DEAMINATED) AB, IGA" PX-300835165 CDM 83516 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TISSUE TRANSGLUTAMINASE, IGG" PX-300835166 CDM 83516 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC GLIADIN (DEAMINATED) AB, IGG" PX-300835167 CDM 83516 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOASSAY FOR ANALYTE, MULTIPLE STEP" PX-300835168 CDM 83516 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMMUNOASSAY ANALYTE QUANTITATIVE BY RADIOIMMUNOASSAY PX-300835190 CDM 83519 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACETYCHOLINE RECEPTOR AB (ACEAB) PX-300835192 CDM 83519 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC METHOTREXATE, SERUM" PX-300835200 CDM 80204 CPT 300 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARANEOPLASTIC AUTOANTIBODY EVAL. PX-300835201 CDM 83520 CPT 300 RC inpatient 782 766.36 All Payors / Plans All Payors / Plans 782 other 782 782 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MANNOSE BINDING LECTIN(MANBL) PX-300835202 CDM 83520 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CQ ESTERASE INHIBITOR,FUNCTIONAL" PX-300835203 CDM 83520 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRYPTASE (TRYPT) PX-300835204 CDM 83520 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C-1 ESTERASE INHIBITOR (C1EST) PX-300835205 CDM 83520 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STRIATED MUSCLE AB (MUSAB) PX-300835206 CDM 83520 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLOM.BASEMENT AB (AGBM) PX-300835207 CDM 83520 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SULFATIDE AUTOANTIBODY (SLFAB) PX-300835208 CDM 83520 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFLAM BOWEL SEROLOGY PANEL SERUM PX-300835209 CDM 83520 CPT 300 RC inpatient 114.5 112.21 All Payors / Plans All Payors / Plans 114.5 other 114.5 114.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOASSAY FOR ANALYTE, QUANTITATIVE NOT SPECIFIED" PX-300835210 CDM 83520 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROMETHEUS FIBROSPECT II PX-300835211 CDM 83520 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTIMULLERIAN HORMONE (AMH) PX-300835212 CDM 83520 CPT 300 RC inpatient 134 131.32 All Payors / Plans All Payors / Plans 134 other 134 134 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INSULIN LIKE GROWTH FACTOR-BINDING PROTEIN 3 (IGFBP-3) PX-300835213 CDM 83520 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC RNA POLYMERASE III ANTIBODIES, IGG, SERUM" PX-300835214 CDM 83520 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SOLUBLE LIVER ANTIGEN (SLA) AUTOANTIBODY PX-300835215 CDM 83520 CPT 300 RC inpatient 126 123.48 All Payors / Plans All Payors / Plans 126 other 126 126 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC THYROTROPIN RECEPTOR ANTIBODY,SERUM(THYRO)" PX-300835216 CDM 83520 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC 14-3-3 PROTEIN, SPINAL FLUID" PX-300835217 CDM 83520 CPT 300 RC inpatient 138 135.24 All Payors / Plans All Payors / Plans 138 other 138 138 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PROMETHEUS IBD IMMUNOASSAY, NOT OTHERWISE SPEC(FIBDD)" PX-300835218 CDM 83520 CPT 300 RC inpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ADALIMUMAB AB, S (ADLAB)" PX-300835219 CDM 83520 CPT 300 RC inpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PANCREATIC ELASTASE, FECES" PX-300835220 CDM 83520 CPT 300 RC inpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NEURON SPECIFIC ENOLASE (NSE), SPINAL FLUID" PX-300835221 CDM 83520 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ALZHEIMER DISEASE EVAL, SPINAL FLUID" PX-300835222 CDM 83520 CPT 300 RC inpatient 571 559.58 All Payors / Plans All Payors / Plans 571 other 571 571 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PHOSPHO TAU 217 PX-300835223 CDM 83520 CPT 300 RC inpatient 525 514.5 All Payors / Plans All Payors / Plans 525 other 525 525 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INSULIN (INLN) PX-300835250 CDM 83525 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IRON,SERUM (FEE)" PX-300835400 CDM 83540 CPT 301 RC inpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IRON BINDING CAPACITY PX-300835501 CDM 83550 CPT 300 RC inpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LACTIC ACID (LACT) PX-300836050 CDM 83605 CPT 301 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LACTATE RESPIRATORY PX-300836051 CDM 83605 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LDH PX-300836150 CDM 83615 CPT 301 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FECAL LACTOFERRIN PX-300836300 CDM 83630 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LEAD PX-300836550 CDM 83655 CPT 301 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEAVY METALS (METAL) PX-300836551 CDM 83655 CPT 300 RC inpatient 372 364.56 All Payors / Plans All Payors / Plans 372 other 372 372 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC LIPASE, SERUM (LPSE)" PX-300836900 CDM 83690 CPT 301 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LIPOPROTEIN A (LPA) PX-300836950 CDM 83695 CPT 300 RC inpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VAP PX-300837010 CDM 83701 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHG LIPOPROTEIN, BLOOD,BY NMR SPECT" PX-300837040 CDM 83704 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WELLNESS PROFILE (WP) PX-300837180 CDM 83718 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HDL CHOLESTEROL (HDL) PX-300837181 CDM 83718 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEART CHECK PROFILE (HCK) PX-300837182 CDM 83718 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIRECT LOW DENSITY LIPOPROTEIN PX-300837210 CDM 83721 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MAGNESIUM PX-300837350 CDM 83735 CPT 301 RC inpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MASS SPECTROMETRY & TANDEM MASS SPECTR NON DRUG ANALYTES NOT SPEC. PX-300837890 CDM 83789 CPT 300 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MERCURY (HGU) PX-300838250 CDM 83825 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC METANEPHRINES PX-300838350 CDM 83835 CPT 301 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYOGLOBIN PX-300838740 CDM 83874 CPT 301 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC B TYPE NATURIURETIC PEPTIDE PX-300838800 CDM 83880 CPT 301 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NEPHELOMETRY, EA ANALYTE NOT ELSEWHERE SPECIFIED" PX-300838830 CDM 83883 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOGLOB.TL LT.CHAINS, URINE" PX-300838831 CDM 83883 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROMETHEUS FIBROSPECT II PX-300838832 CDM 83883 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OLIGOCLONAL IMMUNE(OLIGOCLONAL BANDS) PX-300839160 CDM 83916 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CSF. NEUROLOGIGAL PROF. (SPFN) PX-300839161 CDM 83916 CPT 300 RC inpatient 405 396.9 All Payors / Plans All Payors / Plans 405 other 405 405 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ORGANIC ACID SCREEN, UR. (OASU)" PX-300839190 CDM 83919 CPT 300 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC METHYLALONIC ACID, SERUM(MMAS)" PX-300839210 CDM 83921 CPT 301 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SERUM OSMOLALITY (OSM) PX-300839300 CDM 83930 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC OSMOLALITY,URINE (UOSM)" PX-300839350 CDM 83935 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OSTEOCALCIN PX-300839370 CDM 83937 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CA OXALATE, URINE (OXU)" PX-300839450 CDM 83945 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARATHORMONE PX-300839700 CDM 83970 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PH, BODY FLUID, EXCEPT BLOOD" PX-300839860 CDM 83986 CPT 301 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PHENCYCLIDINE PX-300839920 CDM 83992 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CALPROTECTIN, FECAL" PX-300839930 CDM 83993 CPT 301 RC inpatient 300 294 All Payors / Plans All Payors / Plans 300 other 300 300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROSTATIC ACID PHOSPHATASE (PACP) PX-300840660 CDM 84066 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALK PHOSPHATASE (ALKP) PX-300840750 CDM 84075 CPT 301 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALKALINE PHOS. ISOENZYMES (APISO) PX-300840800 CDM 84080 CPT 300 RC inpatient 77 75.46 All Payors / Plans All Payors / Plans 77 other 77 77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PHOSPHORUS INORGANIC (PHOSPHATE) PX-300841000 CDM 84100 CPT 301 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PHOSPHORUS, URINE 24HR." PX-300841050 CDM 84105 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PQNU PX-300841100 CDM 84110 CPT 300 RC inpatient 37 36.26 All Payors / Plans All Payors / Plans 37 other 37 37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PORPHYRINS, URINE, QUANTIFICATION, FRACTIONATION" PX-300841200 CDM 84120 CPT 300 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POTASSIUM (K) PX-300841320 CDM 84132 CPT 301 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POTASSIUM URINE PX-300841330 CDM 84133 CPT 301 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRE-ALBUMIN PX-300841340 CDM 84134 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PREGNENOLONE PX-300841400 CDM 84140 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROGESTERONE (PROG) PX-300841440 CDM 84144 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROCALCITONIN (PCT) PX-300841450 CDM 84145 CPT 300 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROLACTIN (PROL) PX-300841460 CDM 84146 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PROLACTIN, DILUTED" PX-300841461 CDM 84146 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PSA TOTAL PX-300841530 CDM 84153 CPT 301 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FREE PSA PX-300841540 CDM 84154 CPT 301 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC A/G RATIO (AG) PX-300841550 CDM 84155 CPT 300 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROTEIN (TP) PX-300841551 CDM 84155 CPT 301 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROTEIN TOTAL URINE PX-300841560 CDM 84156 CPT 301 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROTEIN URINE (UP24) PX-300841561 CDM 84156 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUID T. PROTEIN (FPRO) PX-300841570 CDM 84157 CPT 301 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUID T. PROTEIN (FPRO) PX-300841571 CDM 84157 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERITONEAL FLD. ANALYSIS (PERTFA) PX-300841572 CDM 84157 CPT 300 RC inpatient 151 147.98 All Payors / Plans All Payors / Plans 151 other 151 151 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EFFUSION FLD. ANALYSIS (EFFA) PX-300841573 CDM 84157 CPT 300 RC inpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROTEIN E'PHORES (PE) PX-300841650 CDM 84165 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PROTEIN ELECTROPHORETIC, OTHE FLUIDS" PX-300841660 CDM 84166 CPT 301 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WESTERN BLOT W/INTERP AND REPORT;BLOOD/OTHER FLUID PX-300841820 CDM 84182 CPT 300 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PROTOPORPHYRINS,FRAC,RBC (PFE)" PX-300842020 CDM 84202 CPT 300 RC inpatient 154 150.92 All Payors / Plans All Payors / Plans 154 other 154 154 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PYRIDOXAL PHOSPHATE (VITAMIN B6) PX-300842070 CDM 84207 CPT 301 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PYRUVIC ACID (PYRV) PX-300842100 CDM 84210 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SOLUBLE TRANSFERRIN RECEPTOR PX-300842380 CDM 84238 CPT 300 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RENIN (REN) PX-300842440 CDM 84244 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RIBOFLAVIN (VITAMIN B-2) PX-300842520 CDM 84252 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SELENIUM PX-300842550 CDM 84255 CPT 300 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SEROTONIN,BLOOD (SRTNB)" PX-300842600 CDM 84260 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SEX HORMONE BINDING GLOBULIN (SHBG) PX-300842700 CDM 84270 CPT 301 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SODIUM (NA) PX-300842950 CDM 84295 CPT 301 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SODIUM URINE PX-300843000 CDM 84300 CPT 301 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SODIUM, OTHER SOURCE" PX-300843020 CDM 84302 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SOMATOMEDIN C (SOMC) PX-300843050 CDM 84305 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SPECTOPHOTOTOMETRY, ANALYTE" PX-300843110 CDM 84311 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC REFRACTOMETER SG BODY FLUID PX-300843150 CDM 84315 CPT 300 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FECAL REDUCING SUB (FRS) PX-300843760 CDM 84376 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFANT URINE RED SUB (IURS) PX-300843761 CDM 84376 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SUGARS,SINGLE QUANTITATIVE EA SPECIMIN" PX-300843780 CDM 84378 CPT 300 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SULFATE, URINE" PX-300843920 CDM 84392 CPT 300 RC inpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TESTOSERONE, FREE" PX-300844020 CDM 84402 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TESTOSTERONE (TES) PX-300844030 CDM 84403 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITAMIN B-1 (VITB1) PX-300844250 CDM 84425 CPT 301 RC inpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROGLOBULIN (TG) PX-300844320 CDM 84432 CPT 301 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NEWBORN SCREEN ONE(NBSCR1) PX-300844370 CDM 84437 CPT 300 RC inpatient 523 512.54 All Payors / Plans All Payors / Plans 523 other 523 523 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROXINE FREE PX-300844390 CDM 84439 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYR BINDING GLOB (TBG) PX-300844420 CDM 84442 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TSH PX-300844430 CDM 84443 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROID STIMULATING IG (TSIG) PX-300844450 CDM 84445 CPT 301 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITAMIN E (VITE) PX-300844460 CDM 84446 CPT 301 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AST (SGOT) PX-300844500 CDM 84450 CPT 301 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALT (SGPT) PX-300844600 CDM 84460 CPT 301 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRANSFERRIN (TRANF) PX-300844660 CDM 84466 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRIGLYCERIDES PX-300844780 CDM 84478 CPT 301 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC T3 BY RIA (T3R) PX-300844800 CDM 84480 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FREE T3 (FT3) PX-300844810 CDM 84481 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRIODOTHYRONINE T3, REVERSE" PX-300844820 CDM 84482 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TROPONIN-I(TNI) PX-300844840 CDM 84484 CPT 301 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BUN (BUN) PX-300845200 CDM 84520 CPT 301 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UREA NITROGEN RANDOM PX-300845400 CDM 84540 CPT 301 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URIC ACID (URIC) PX-300845500 CDM 84550 CPT 301 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URIC ACID OTHER SOURCE PX-300845600 CDM 84560 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VMA (VMA) PX-300845850 CDM 84585 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VAS INTS POLYPEPTIDE (VIP) PX-300845860 CDM 84586 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHG ASSAY OF VASOPRESSIN PX-300845880 CDM 84588 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITAMIN A (VITA) PX-300845900 CDM 84590 CPT 301 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VITAMIN, NOT OTHERWISE SPECIFIED" PX-300845910 CDM 84591 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC XYLOSE ABSORPTION TEST, BLOOD AND/OR URINE" PX-300846200 CDM 84620 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ZINC PX-300846300 CDM 84630 CPT 301 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ZINC, BLD. (ZN)" PX-300846301 CDM 84630 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C-PEPTIDE (CPEP) PX-300846810 CDM 84681 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC GONADOTROPIN, CHORIONIC(HCG);QUANTITATIVE" PX-300847020 CDM 84702 CPT 301 RC inpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FIRST TRIMESTER MATERNAL SCREEN PX-300847021 CDM 84702 CPT 300 RC inpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUID CHOLESTEROL (FCHOL) PX-300849991 CDM 84999 CPT 300 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STOOL OSMALITY PX-300849993 CDM 84999 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STOOL POTASSIUM PX-300849994 CDM 84999 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MANUAL DIFFERENTIAL PX-300850070 CDM 85007 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BLOOD COUNT, MANUAL EXAM W/O DIFF" PX-300850080 CDM 85008 CPT 300 RC inpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEMATOCRIT (HCT) PX-300850140 CDM 85014 CPT 305 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEMOGLOBIN (HGB) PX-300850180 CDM 85018 CPT 305 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CBC W/DIFF (CBCD) PX-300850250 CDM 85025 CPT 305 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CBC (CBC) PX-300850270 CDM 85027 CPT 305 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EOSINOPHIL COUNT (EOCT) PX-300850320 CDM 85032 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RETICULOCYTE CT (RET) PX-300850450 CDM 85045 CPT 305 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLATELET COUNT PX-300850490 CDM 85049 CPT 305 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHROMOGENIC SUBSTRATE ASSAY PX-300851300 CDM 85130 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COAG FACTOR II ASSAY (F2ASY) PX-300852100 CDM 85210 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COAG FACTOR V ASSAY (F5ASY) PX-300852200 CDM 85220 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COAG FACTOR VII ASSAY (F7ASY) PX-300852300 CDM 85230 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FACTOR VIII ANTIGEN (F8AG) PX-300852400 CDM 85240 CPT 305 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RISTOCETIN COFACTOR PX-300852450 CDM 85245 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VONWILLEBRAND FACTOR AG PX-300852460 CDM 85246 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BLEEDING DIATH PROF, LIMITED" PX-300852461 CDM 85246 CPT 300 RC inpatient 771 755.58 All Payors / Plans All Payors / Plans 771 other 771 771 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VON WILLEBRAND FACTOR PX-300852470 CDM 85247 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COAG FACTOR IX ASSAY (F9ASY) PX-300852500 CDM 85250 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COAG FACTOR X ASSAY (F10ASY) PX-300852600 CDM 85260 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COAG FACTOR XI ASSAY(F11ASY) PX-300852700 CDM 85270 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COAG FACTOR XII ASSAY (F12ASY) PX-300852800 CDM 85280 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHG ANTITHROMBIN II TEST, ACTIV" PX-300853000 CDM 85300 CPT 305 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-THROMBIN III (ANTI3) PX-300853010 CDM 85301 CPT 300 RC inpatient 48 47.04 All Payors / Plans All Payors / Plans 48 other 48 48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROTEIN C (PROTC) PX-300853020 CDM 85302 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHG CLOT INHIB PROTEIN C, ACTIV" PX-300853030 CDM 85303 CPT 305 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PROTEIN S AG, TL" PX-300853050 CDM 85305 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROTEIN S FREE PX-300853060 CDM 85306 CPT 305 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACTIVATED PROTEIN C RESISTENCE PX-300853070 CDM 85307 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FACTOR INHIBITOR TEST PX-300853350 CDM 85335 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FIBRIN(OGEN) DEGRADATION (SPLIT) PRODUCTS (FDP) (FSP) PARACOAGULATION PX-300853660 CDM 85366 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC D DIMER QUANTITATIVE PX-300853790 CDM 85379 CPT 305 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FIBRINOGEN ACTIVITY PX-300853840 CDM 85384 CPT 305 RC inpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FIBRINOGEN ANTIGEN PX-300853850 CDM 85385 CPT 300 RC inpatient 46 45.08 All Payors / Plans All Payors / Plans 46 other 46 46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPECIAL COAGULATION INTERPRETATION PX-300853900 CDM 85390 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FACTOR VIII PROFILE (F8BAT) PX-300853970 CDM 85397 CPT 300 RC inpatient 200 196 All Payors / Plans All Payors / Plans 200 other 200 200 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALPHA-2 PLASMIN INHIBITOR P PX-300854100 CDM 85410 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FIBRINOLYTIC PLASMINOGEN ACTIVATOR PX-300854150 CDM 85415 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLASMINOGEN ACTIVITY PX-300854200 CDM 85420 CPT 300 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FETALDEX SCREEN (FEDXS) PX-300854600 CDM 85460 CPT 305 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HEMOGLOBIN, FETAL, ROSETTE" PX-300854610 CDM 85461 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEPARIN ASSAY PX-300855200 CDM 85520 CPT 305 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE MARROW SMEAR PX-300855400 CDM 85540 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MURAMIDASE PX-300855490 CDM 85549 CPT 300 RC inpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLATELET FUNCTION PX-300855760 CDM 85576 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLATELET NEUTRALIZATION PX-300855970 CDM 85597 CPT 305 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PHOSPHOLIPID, HEXAGONAL" PX-300855980 CDM 85598 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROTHROMBIN TIME (PROT)(PROS) PX-300856100 CDM 85610 CPT 305 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PTMIX 1 TO 1 PX-300856110 CDM 85611 CPT 300 RC inpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RUSSELL VIPER VENOM TIME DILUTED PX-300856130 CDM 85613 CPT 305 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC REPTILASE PX-300856350 CDM 85635 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SED RATE (ESR) PX-300856510 CDM 85651 CPT 300 RC inpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SICKLE CELL PREP (SIKL) PX-300856600 CDM 85660 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC THROMBIN TIME, PLASMA" PX-300856700 CDM 85670 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PTT SCREENING PX-300857300 CDM 85730 CPT 305 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANT-PHOSPHOLIPID ABS. (APSAB) PX-300857301 CDM 85730 CPT 300 RC inpatient 88 86.24 All Payors / Plans All Payors / Plans 88 other 88 88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APTT MIX 1 TO 1 PX-300857320 CDM 85732 CPT 300 RC inpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VISCOSITY, SERUM (VSC)" PX-300858100 CDM 85810 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FEBRILE AGGLUTININS (FEB) PX-300860000 CDM 86000 CPT 300 RC inpatient 571 559.58 All Payors / Plans All Payors / Plans 571 other 571 571 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ALLERGAN SPEC IGG QUANT, EACH X8" PX-300860010 CDM 86001 CPT 302 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RAST (RST1) PX-300860030 CDM 86003 CPT 302 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RAST N E REGION (RAST) PX-300860033 CDM 86003 CPT 300 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ALLERGEN SPECIFIC IGE;QUANT OR SEMIQUANT, RECOMBINANT OR PURIFED COMPONENT, EACH" PX-300860080 CDM 86008 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLATELET ANTIBODIES PX-300860220 CDM 86022 CPT 302 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI NUCLEAR ANTIBODY PX-300860380 CDM 86038 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ASTO TITER (ASTO) PX-300860600 CDM 86060 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTISTREPTOLYSIN O SCREEN PX-300860630 CDM 86063 CPT 300 RC inpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC C-REACTIVE PROTEIN, INFLAMMATORY" PX-300861400 CDM 86140 CPT 302 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HSCRP, CARDIAC" PX-300861410 CDM 86141 CPT 302 RC inpatient 46 45.08 All Payors / Plans All Payors / Plans 46 other 46 46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BETA 2 GLYCOPROTEIN 1 ANTIBODY EACH PX-300861460 CDM 86146 CPT 306 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CARDIOLIPIN ANTIBODY, EA IG CLASS" PX-300861470 CDM 86147 CPT 302 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC COLD AGGLUTININ, TITER" PX-300861570 CDM 86157 CPT 300 RC inpatient 75 73.5 All Payors / Plans All Payors / Plans 75 other 75 75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPLEMENT;ANTIGEN EACH COMPONENT PX-300861600 CDM 86160 CPT 302 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPLEMENT C4 (C4) PX-300861601 CDM 86160 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPLEMENT C3 (C3) PX-300861602 CDM 86160 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MANNAN BINDING LECTIN COMPLEMENT PATHWAY, FUNCTIONAL, SERUM" PX-300861610 CDM 86161 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPLEMENT-TL (TCMP) PX-300861620 CDM 86162 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYCLIC CITRULLINATED PEPTIDE PX-300862000 CDM 86200 CPT 302 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-DNA ANTIBODY (ADNA) PX-300862250 CDM 86225 CPT 300 RC inpatient 88 86.24 All Payors / Plans All Payors / Plans 88 other 88 88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AB TO EXTRACTABLE NUCLEAR AG(ENA) PX-300862350 CDM 86235 CPT 300 RC inpatient 719 704.62 All Payors / Plans All Payors / Plans 719 other 719 719 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AUTOANTIBODIES TO SS-A/RO PX-300862351 CDM 86235 CPT 300 RC inpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AUTOANTIBODIES TO SS-B/LA PX-300862352 CDM 86235 CPT 300 RC inpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AUTOANTIBODIES TO SCL 70 PX-300862353 CDM 86235 CPT 300 RC inpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AUTOANTIBODIES TO SM PX-300862354 CDM 86235 CPT 300 RC inpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AUTOANTIBODIES TO U1RNP PX-300862355 CDM 86235 CPT 300 RC inpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AUTOANTIBODIES TO JO 1 PX-300862356 CDM 86235 CPT 300 RC inpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CENTROMERE ANTIBODY (CMA) PX-300862357 CDM 86235 CPT 300 RC inpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HISTONE ANTIBODY (HISTA) PX-300862358 CDM 86235 CPT 300 RC inpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NUCLEAR ANTIGEN ANTIBODY X8 PX-300862359 CDM 86235 CPT 300 RC inpatient 639 626.22 All Payors / Plans All Payors / Plans 639 other 639 639 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FLUORESCENT NONINFECTIOUS AGENT ANTIBODY, SCREEN EA" PX-300862550 CDM 86255 CPT 302 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-SMOOTH MUSCLE AB (ASMUS) PX-300862551 CDM 86255 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NMO/AQP4-IGG CBA PX-300862552 CDM 86255 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUORESCENT NONINFECTIOUS AGENT ANTIBODY;TITER EA. PX-300862560 CDM 86256 CPT 302 RC inpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PANCREATIC ELASTASE-1 PX-300862651 CDM 82656 CPT 300 RC inpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMMUNOASSAY TUMOR ANTIGEN PX-300863000 CDM 86300 CPT 302 RC inpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CA 199 (CA199) PX-300863010 CDM 86301 CPT 300 RC inpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CA 125 AG (C125) PX-300863040 CDM 86304 CPT 300 RC inpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MONO TEST (MONO) PX-300863080 CDM 86308 CPT 302 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHROMOGRANIN A PX-300863160 CDM 86316 CPT 300 RC inpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMMUNOASSAY INFECTIOUS AGENT ANTIBODY QUANTITATIVE PX-300863170 CDM 86317 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOASSAY INFECTIOUS AGENT ANTIBODY(IES), QUALIT/SEMIQUANT, SINGLE STEP COVID-19" PX-300863280 CDM 86328 CPT 300 RC inpatient 47 46.06 All Payors / Plans All Payors / Plans 47 other 47 47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMUNODIFFUSION OUCHTEROLOGY X5 PX-300863310 CDM 86331 CPT 302 RC inpatient 271 265.58 All Payors / Plans All Payors / Plans 271 other 271 271 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOFIXATION, BLOOD" PX-300863340 CDM 86334 CPT 300 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MONOCLONAL PROTEIN STUDY, BLOOD" PX-300863341 CDM 86334 CPT 300 RC inpatient 191 187.18 All Payors / Plans All Payors / Plans 191 other 191 191 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOFIXATION ELECTROPHORESIS, OTHER FLUID" PX-300863350 CDM 86335 CPT 302 RC inpatient 126 123.48 All Payors / Plans All Payors / Plans 126 other 126 126 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INSULIN ANTIBODIES (INAB) PX-300863370 CDM 86337 CPT 300 RC inpatient 106 103.88 All Payors / Plans All Payors / Plans 106 other 106 106 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTRINSIC FACTOR ANTIBODIES PX-300863400 CDM 86340 CPT 300 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ISLET CELL ANTIBODY PX-300863410 CDM 86341 CPT 302 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC B CELLS, TOTAL COUNT" PX-300863550 CDM 86355 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NATURAL KILLER CELLS, TOTAL COUNT" PX-300863570 CDM 86357 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC T CELLS, TOTAL COUNT" PX-300863590 CDM 86359 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC T CELLS, ABSOLUTE CD4 &CD8, INCLUDE RATIO" PX-300863600 CDM 86360 CPT 300 RC inpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MICROSOMAL ANTIBODIES(THYROID/KIDNEY/LIVER) EA. PX-300863760 CDM 86376 CPT 302 RC inpatient 63 61.74 All Payors / Plans All Payors / Plans 63 other 63 63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHG NEUTRALIZATION TEST, VIRAL" PX-300863820 CDM 86382 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CRYPTOCOCCAL ANTIGEN (CRAG) PX-300864030 CDM 86403 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BACTERIAL ANTIGEN DETECT (BAAG) PX-300864031 CDM 86403 CPT 300 RC inpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CRYPTOCOCCAL ANTIGEN SER. (SCRAG) PX-300864032 CDM 86403 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RA TEST (RA) PX-300864300 CDM 86430 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RHEUMATOID FACTOR; QUANTITATIVE PX-300864310 CDM 86431 CPT 302 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC M TUBERCULOSIS BY QUANTIFERON PX-300864800 CDM 86480 CPT 302 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SYPHILIS TEST, NON TREPONEMAL ANTIBODY, QUALIT(VDRL,RPR,ART)" PX-300865920 CDM 86592 CPT 302 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SYPHILLIS, NON-TREPONEMAL ANTIBODY,QUALIT, QUANTIT" PX-300865930 CDM 86593 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ASPERGILLUS, ANTIBODY" PX-300866060 CDM 86606 CPT 302 RC inpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BACTERIUM, ANTIBODY" PX-300866090 CDM 86609 CPT 300 RC inpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BARTONELLA AB PANEL PX-300866110 CDM 86611 CPT 300 RC inpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BORDATELLA PX-300866150 CDM 86615 CPT 300 RC inpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC LYME DISEASE, CONF. (LYMWB)" PX-300866170 CDM 86617 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BORRELIA BURGDORFERI(LYME DISEASE) PX-300866180 CDM 86618 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRUCELLA AGGLUTINATION PX-300866220 CDM 86622 CPT 300 RC inpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHLAMYDIA SEROLOGY PX-300866310 CDM 86631 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOMEGALOVIRUS(CMV) PX-300866440 CDM 86644 CPT 302 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TORCH TEST (TORT) PX-300866441 CDM 86644 CPT 300 RC inpatient 229 224.42 All Payors / Plans All Payors / Plans 229 other 229 229 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTIBODY CYTOMEGALOVIRUS (CMV) PX-300866450 CDM 86645 CPT 302 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENCEPHALITIS CALIFORN ANTBDY PX-300866510 CDM 86651 CPT 300 RC inpatient 133 130.34 All Payors / Plans All Payors / Plans 133 other 133 133 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARBOVIRUS PX-300866520 CDM 86652 CPT 300 RC inpatient 269 263.62 All Payors / Plans All Payors / Plans 269 other 269 269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENCEPHALTIS ST LOUIS ANTBODY PX-300866530 CDM 86653 CPT 300 RC inpatient 133 130.34 All Payors / Plans All Payors / Plans 133 other 133 133 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ENCEPHALITIS, WESTERN EQUINE" PX-300866540 CDM 86654 CPT 300 RC inpatient 134 131.32 All Payors / Plans All Payors / Plans 134 other 134 134 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EB VIRUS SEROLOGY (EBVS) PX-300866630 CDM 86663 CPT 302 RC inpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTIBODY EHRLICHIA PX-300866660 CDM 86666 CPT 302 RC inpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FRANCISELLA TURLARENSIS AB PX-300866680 CDM 86668 CPT 300 RC inpatient 134 131.32 All Payors / Plans All Payors / Plans 134 other 134 134 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHG FUNGUS, ANTIBODY" PX-300866710 CDM 86671 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HELICOBACTER PYLORI PX-300866770 CDM 86677 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC H PYLORI AB, IGG, IGM, IGA" PX-300866771 CDM 86677 CPT 300 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HTLV I/II AB (HTLV12) PX-300866870 CDM 86790 CPT 300 RC inpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HTLV OR HIV ANTIBODY, CONFIRMATORY TEST(EG. WESTERN BLOT)" PX-300866890 CDM 86689 CPT 300 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STATE HIV CONF TEST (SHIV) PX-300866891 CDM 86689 CPT 300 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HERPES SIMPLEX, NONSPEC TYPE, ANTIBODY" PX-300866940 CDM 86694 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HERPES SEROLOGY (HESE) PX-300866941 CDM 86694 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HSV AB,IGM BY IRA(HSVIGM)" PX-300866942 CDM 86694 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TORCH PROFILE LGM 1 PX-300866943 CDM 86694 CPT 300 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HERPES SIMPLEX, TYPE 1, ANTIBODY" PX-300866950 CDM 86695 CPT 302 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HERPES SIMPLEX, TYPE 2, ANTIBODY" PX-300866960 CDM 86696 CPT 302 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HISTOPLASMA PX-300866980 CDM 86698 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-HB CORE (CORE) PX-300867040 CDM 86704 CPT 302 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-CORE IGM (COREM) PX-300867050 CDM 86705 CPT 302 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-HBSAG (HAB) PX-300867060 CDM 86706 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-HBE (EAB) PX-300867070 CDM 86707 CPT 302 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEPATITIS A ANTIBODY (HAAB) PX-300867080 CDM 86708 CPT 302 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ANTI-HAV, IGM (HAV)" PX-300867090 CDM 86709 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LEGIONAIRES SEROLOGY (LGSE) PX-300867130 CDM 86713 CPT 300 RC inpatient 56 54.88 All Payors / Plans All Payors / Plans 56 other 56 56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LEPTOSPIRA SEROLOGY (LPS) PX-300867200 CDM 86720 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MUMPS TITER (MUSE) PX-300867350 CDM 86735 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYCOPLASMA SEROLOGY (MYSE) PX-300867380 CDM 86738 CPT 302 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARVOVIRUS PX-300867470 CDM 86747 CPT 302 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ANTIBODY PROTOZOA, NOT ELSEWHERE SPECIFIED" PX-300867530 CDM 86753 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RICKETTSIA PX-300867570 CDM 86757 CPT 302 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ROCKY MTN SPOTTED FEVER (RMSF) PX-300867590 CDM 86759 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RUBELLA TEST (RUBE) PX-300867620 CDM 86762 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RUBEOLA SCREEN (RBOLA) PX-300867650 CDM 86765 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHG SALMONELLA PX-300867680 CDM 86768 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOASSAY INFECTIOUS AGENT ANTIBODY(IES), QUALIT/SEMIQUANT, MULTI-STEP COVID-19" PX-300867691 CDM 86769 CPT 300 RC inpatient 44 43.12 All Payors / Plans All Payors / Plans 44 other 44 44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TOXOPLASMA SEROLOGY (TOSE) PX-300867770 CDM 86777 CPT 302 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHG TOXOPLASMA, IGM" PX-300867780 CDM 86778 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FTA (FTA) PX-300867800 CDM 86780 CPT 300 RC inpatient 48 47.04 All Payors / Plans All Payors / Plans 48 other 48 48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VARICELLA-ZOSTER PX-300867870 CDM 86787 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VARICELLA ZOSTER IMMUNE (VZI) PX-300867871 CDM 86787 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HUMAN T-CELL LYMPHOTROPIC VIRUS I&II (HTLVI) PX-300867900 CDM 86790 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-THYROGLOBULIN AB (ATHYR) PX-300868000 CDM 86800 CPT 302 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANT-HEPATITITS C (AHCV) PX-300868030 CDM 86803 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HLA B27 (HLA) PX-300868120 CDM 86812 CPT 302 RC inpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CELIAC DISEASE COMP CASCADE PX-300868160 CDM 86816 CPT 300 RC inpatient 372 364.56 All Payors / Plans All Payors / Plans 372 other 372 372 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTIBODY SCREEN (ABST) PX-300868500 CDM 86850 CPT 300 RC inpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ANTIBODY ELUTION, RBC, EA ELUTION" PX-300868600 CDM 86860 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTIBODY IDENTIFICATION PX-300868700 CDM 86870 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIRECT COOMBS PX-300868800 CDM 86880 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTIBODY TITER (ABTI) PX-300868860 CDM 86886 CPT 302 RC inpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PATIENT BLOOD TYPE (BTY) PX-300869000 CDM 86900 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BLOOD TYPING, ABO" PX-300869001 CDM 86900 CPT 300 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RHIG STUDIES (RHG) PX-300869002 CDM 86900 CPT 300 RC inpatient 146 143.08 All Payors / Plans All Payors / Plans 146 other 146 146 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD TYPING RH (D) PX-300869010 CDM 86901 CPT 300 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTIGEN TYPING PX-300869020 CDM 86902 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AHG PHASE CROSSMATCH INCUBATION PX-300869210 CDM 86921 CPT 300 RC inpatient 3 2.94 All Payors / Plans All Payors / Plans 3 other 3 3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AHG PHASE CROSSMATCH ANTIGLOBULIN PX-300869220 CDM 86922 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CROSSMATCH (XM) PX-300869230 CDM 86923 CPT 300 RC inpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONCENTRATION(ANY TYPE)INFECTIOUS AGENTS PX-300870150 CDM 87015 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CULTURE BLOOD (BLC) PX-300870400 CDM 87040 CPT 306 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CULT LOWER G I (STLC) PX-300870450 CDM 87045 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CAMPY PLATE PX-300870460 CDM 87046 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SM CULT RESPIR (RESC) PX-300870700 CDM 87070 CPT 300 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SM CULT GENITAL (GESC) PX-300870701 CDM 87070 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SM CULT CSF (SFSC) PX-300870702 CDM 87070 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CULT THROAT (THRC) PX-300870703 CDM 87070 CPT 300 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CULT NASO (NASO) PX-300870704 CDM 87070 CPT 300 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SM CULT MISC (MISC) PX-300870705 CDM 87070 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BODY FLUID SMEAR AND CULTURE PX-300870706 CDM 87070 CPT 300 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC QUANT AEROBIC W ISOLATION PRESUMP ID ISOLATES SOURCE EXC UR BLD STL PX-300870710 CDM 87071 CPT 300 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRESUMPTIVE ANAEROBIC ID PX-300870750 CDM 87075 CPT 300 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CULTURE,BACTERIAL,ANAEROBIC ISOLATE, ADD, ID EA ISOLATE" PX-300870760 CDM 87076 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CULTURE,BACTERIAL,AEROBIC ISOLATE. ADD ID EA ISOLATE" PX-300870770 CDM 87077 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BACTERIAL IDENTIFICATION X 1 PX-300870771 CDM 87077 CPT 306 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GENITAL CULTURE-GC ONLY (GCCU) PX-300870810 CDM 87081 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CULT BETA STREP (BETA) PX-300870811 CDM 87081 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CLO TEST (CLO) PX-300870812 CDM 87081 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GROUP B STREP SCREEN (GBST) PX-300870813 CDM 87081 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BORDETELLA PERTUSSIS CULT (BPEC) PX-300870814 CDM 87081 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VRE SCREEN CULTURE (VRSC) PX-300870815 CDM 87081 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRSA SCREEN CULTURE(MRSAC) PX-300870816 CDM 87081 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STAPH. AUREUS SCREEN ORTHO PX-300870817 CDM 87081 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CRE SCREEN PX-300870818 CDM 87081 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CULT URINE (URNC) PX-300870860 CDM 87086 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRESUMPTIVE IDENTIFICATION X 1 PX-300870880 CDM 87088 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FUNGUS SM AND CULT (FUSC) PX-300871020 CDM 87102 CPT 300 RC inpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC YEAST IDENTIFICATION X 1 PX-300871060 CDM 87106 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CULTURE,FUNGI, DEFINITIVE ID, EA ORGANISM,MOLD" PX-300871070 CDM 87107 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYCOPLASA PX-300871090 CDM 87109 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CULTURE,TUBERCLE,AFB, ANY SOURCE W/ISOL&PRESUMP" PX-300871160 CDM 87116 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACID FAST CULT BLOOD (AFBLC) PX-300871161 CDM 87116 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CULTURE MYCOBACTERIAL, DEFINITIVE ID, EA ISOLATE" PX-300871180 CDM 87118 CPT 300 RC inpatient 217 212.66 All Payors / Plans All Payors / Plans 217 other 217 217 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SERO TYPING X 1 PX-300871470 CDM 87147 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PBP2A TEST PX-300871472 CDM 87147 CPT 306 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD CULTURE GRAM POSITIVE PX-300871490 CDM 87149 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD CULTURE GRAM NEGATIVE PX-300871491 CDM 87149 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD CULTURE GRAM NEGATIVE 6 PX-300871492 CDM 87149 CPT 300 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD CULTURE GRAM NEGATIVE 7 PX-300871493 CDM 87149 CPT 300 RC inpatient 500 490 All Payors / Plans All Payors / Plans 500 other 500 500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD CULTURE GRAM POSITIVE 11 PX-300871494 CDM 87149 CPT 300 RC inpatient 785 769.3 All Payors / Plans All Payors / Plans 785 other 785 785 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD CULTURE GRAM POSITIVE 2 PX-300871495 CDM 87149 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD CULTURE GRAM POSITIVE 1 PX-300871496 CDM 87149 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CULTURE TYPING, ID NUCLEIC ACID(DNA OR RNA)PROBE" PX-300871500 CDM 87150 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CULTURE REFER FOR ID, FUNGUS&CULTURE ID (FUNID(DSF)" PX-300871530 CDM 87153 CPT 300 RC inpatient 183 179.34 All Payors / Plans All Payors / Plans 183 other 183 183 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ORGANISM REFERRED FOR ID, AEROBIC BACTERIA" PX-300871531 CDM 87153 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ORGANISM REFERRED FOR ID, ANAEROBIC BACTERIA(ISAN,ISAE)" PX-300871532 CDM 87153 CPT 300 RC inpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CULTURE TYPING, OTHER METHODS" PX-300871580 CDM 87158 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MACROSCOPIC EXAM, ARTHROPOD" PX-300871680 CDM 87168 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MACROSCOPIC EXAM, PARASITE" PX-300871690 CDM 87169 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PINWORM PREP PX-300871720 CDM 87172 CPT 300 RC inpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TISSUE GRINDING PX-300871760 CDM 87176 CPT 300 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SENSITIVITY TESTING PX-300871860 CDM 87186 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUID WBC (FLDWBC) PX-300872050 CDM 87205 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUID RBC (FLDRBC) PX-300872051 CDM 87205 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URINE FOR EOSINOPHILS (UREOS) PX-300872052 CDM 87205 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GC SMEAR (GCSM) PX-300872053 CDM 87205 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GRAM STAIN (GRAM) PX-300872054 CDM 87205 CPT 306 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SMEAR, FLUORES AND/OR ACID FAST BACTERIA,FUNGI, PARASITES,VIRUS OR CELL TYPES" PX-300872060 CDM 87206 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MALARIA SMEAR (MAL) PX-300872070 CDM 87207 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OVA AND PARASITES COMPLEX SMEAR PX-300872090 CDM 87209 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SMEAR, WET MOUNT, SIMPLE STAIN" PX-300872100 CDM 87210 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WET MOUNT (WTMT) PX-300872101 CDM 87210 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KOH PREP PX-300872200 CDM 87220 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VIRUS ISOLATION TISSUE CULTURE INOCULATION, PRESUMP ID CYTOPATHIC EFFECT" PX-300872520 CDM 87252 CPT 300 RC inpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VIRUS ISOLATION, TISSUE CULT, ADD STUDIES OR ID, EA ISOLATE" PX-300872530 CDM 87253 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VIRUS INOCULATION, SHELL VIA, INCL ID, EA VIRUS" PX-300872540 CDM 87254 CPT 300 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GIARDIA PX-300872690 CDM 87269 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CRYPTOSPORDIUM PX-300872720 CDM 87272 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ASPERGILUS, ANTIGEN, BRONCHOALEVOLAR LAVAGE" PX-300873050 CDM 87305 CPT 302 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CL DIFFICILE LATEX TEST (CDT) PX-300873240 CDM 87324 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC H.PYLORI ANTIGEN, STOOL" PX-300873380 CDM 87338 CPT 306 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEPATITIS B SURFACE ANTIGEN PX-300873400 CDM 87340 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEP B. SURFACE AG NEUTRALIZATION PX-300873410 CDM 87341 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEPATITIS BE ANTIGEN (EAG) PX-300873500 CDM 87350 CPT 306 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HIV-Q ANTIGEN(S) W HIV-1/HIV-2 ANTIBODIES,SIMPLE" PX-300873890 CDM 87389 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RSV ANTIGEN (RSVA) PX-300874200 CDM 87420 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ROTOVIRUS (ROTO) PX-300874250 CDM 87425 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENTEROHEMORAGIC E. COLI ASSYS PX-300874270 CDM 87427 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LEGIONELLA URINARY ANTIGEN PX-300874490 CDM 87449 CPT 306 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FUNGITELL, BAL" PX-300874491 CDM 87449 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IADNA ANAPLASMA PHAGOCYTOPHILUM AMPLIFIED PRB TQ PX-300874680 CDM 87468 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BORRELIA BURGDORFERI, AMPLIFIED PROBE TECHNIQUE" PX-300874760 CDM 87476 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CANDIDA SPECIES AMPLIFIED PROBE PX-300874810 CDM 87481 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA) PX-300874830 CDM 87483 CPT 300 RC inpatient 1148 1125.04 All Payors / Plans All Payors / Plans 1148 other 1148 1148 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IADNA EHRLICHIA CHAFFEENSIS AMPLIFIED PROBE TQ PX-300874840 CDM 87484 CPT 300 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHLAMYDIA PNEUMONIAE, DNA, AMP PROBE" PX-300874860 CDM 87486 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE" PX-300874910 CDM 87491 CPT 306 RC inpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CMV BY RAPID PCR (CMVPCR) PX-300874960 CDM 87496 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CYTOMEGALOVIRUS, AMPLIFIED PROBE" PX-300874965 CDM 87496 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CMV, QUANT, PCR, PLASMA" PX-300874970 CDM 87497 CPT 306 RC inpatient 457 447.86 All Payors / Plans All Payors / Plans 457 other 457 457 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENTEROVIRUS BY PCR (PCRENT) PX-300874980 CDM 87498 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ENTEROVIRUS, AMPLIFIED PROBE, INCLUDE REVERSE TRANSCRIPTION" PX-300874985 CDM 87498 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ENTERIC BACTERIAL PANEL, STOOL" PX-300875060 CDM 87506 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HEPATITIS B VIRAL DNA,QNT(QHBV)" PX-300875170 CDM 87517 CPT 300 RC inpatient 457 447.86 All Payors / Plans All Payors / Plans 457 other 457 457 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HEPATITIS C, REVERSE TRANSCRIPTION & QUANTIFICATION" PX-300875220 CDM 87522 CPT 306 RC inpatient 457 447.86 All Payors / Plans All Payors / Plans 457 other 457 457 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HERPES BY PCR (HSVPCR) PX-300875290 CDM 87529 CPT 306 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HERPES SIMPLEX VIRUS, AMPLIFIED PROBE" PX-300875295 CDM 87529 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HERPES VIRUS-6, AMPLIFIED PROBE" PX-300875320 CDM 87532 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HIV-1 DNA BY PCR, PLASMA" PX-300875350 CDM 87535 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HIV RNA BY PCR (PCRHIV) PX-300875360 CDM 87536 CPT 306 RC inpatient 457 447.86 All Payors / Plans All Payors / Plans 457 other 457 457 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYCOPLASMA GENITALIUM AMPLIFIED PROBE PX-300875630 CDM 87563 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYCOPLASMA GENITALIUM PCR PX-300875631 CDM 87563 CPT 300 RC inpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MYCOPLASMA PNEUMONIAE, AMP PROBE" PX-300875810 CDM 87581 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC N. GONO, AMPLIFIED PROBE" PX-300875910 CDM 87591 CPT 300 RC inpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HUMAN PAPILLOMAVIRUS(HPV) PX-300876240 CDM 87624 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HPV GENOTYPES 16&18 PX-300876250 CDM 87625 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "RESPIRATORY VIRUS, INFLUENZA TYPE A&BM 3-5 TARGETS" PX-300876310 CDM 87631 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC RESP VIRUS,MULTIPLEX, REVERSE TRANS/AMP, 12-25 TARGETS" PX-300876330 CDM 87633 CPT 300 RC inpatient 515 504.7 All Payors / Plans All Payors / Plans 515 other 515 515 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFECTIOUS AGENT DETECTION BY NUCLEIC ACID, RESPIRATORY SYNDROME" PX-300876350 CDM U0002 CPT 300 RC inpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFECTIOUS AGENT DETECTION BY NUCLEIC ACID, HIGH THROUGHPUT TECH" PX-300876351 CDM U0003 CPT 300 RC inpatient 79 77.42 All Payors / Plans All Payors / Plans 79 other 79 79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFEC AGENT DETECTION AMPLIFIED PROBE PX-300876352 CDM U0005 CPT 300 RC inpatient 26 25.48 All Payors / Plans All Payors / Plans 26 other 26 26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SURGEY MRSA SCREEN (SXMR) PX-300876410 CDM 87641 CPT 306 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC STREPTOCOCCUS,GROUP B, AMPLIFIED PROBE" PX-300876530 CDM 87653 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRICHOMONAS VAGINALIS PX-300876610 CDM 87661 CPT 300 RC inpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFECTIOUS AGENT AMPLIFIED PROBE, EA ORGANISM" PX-300877980 CDM 87798 CPT 306 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CLOSTRIDIUM DIFFICILE PCR(CDTPCR) PX-300877981 CDM 87798 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC EHRLICHIA/ANAPLASMA PCR,B" PX-300877982 CDM 87798 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC AMPLIFIED PROBE, EA. ORGANISM" PX-300877985 CDM 87798 CPT 300 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ORTHOPOXVIRUS(MONKEYPOX) DNA, PCR" PX-300877986 CDM 87798 CPT 300 RC inpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFECTIOUS AGENT QUANTIFICATION, EA ORGANISM" PX-300877990 CDM 87799 CPT 300 RC inpatient 457 447.86 All Payors / Plans All Payors / Plans 457 other 457 457 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFECTIOUS AGENT, MULTIPLE ORGS, AMPLIFIED PROBE" PX-300878010 CDM 87801 CPT 302 RC inpatient 599 587.02 All Payors / Plans All Payors / Plans 599 other 599 599 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFLUENZA ANTIGEN (FLUAG) PX-300878040 CDM 87804 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HIV AG/AB PX-300878060 CDM 87806 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC STREPTOCOCCUS, GROUP A" PX-300878800 CDM 87880 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFECTIOUS AGENT IMMUNOASSAY NOT SPECIFIED PX-300878990 CDM 87899 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HIV-1 GENOTYPIC PR RT-RESISTANCE,P" PX-300879010 CDM 87901 CPT 300 RC inpatient 971 951.58 All Payors / Plans All Payors / Plans 971 other 971 971 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC GENOTYPE BY NUCLEIC ACID,HEPATITIS C" PX-300879020 CDM 87902 CPT 300 RC inpatient 971 951.58 All Payors / Plans All Payors / Plans 971 other 971 971 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CYTOPATH, INSITU HYBRID URINE SPEC 3-5 PROBES, EA. MANUAL" PX-300881200 CDM 88120 CPT 300 RC inpatient 571 559.58 All Payors / Plans All Payors / Plans 571 other 571 571 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FLOW CYTOMETRY, CELL SFC,CYTOPLASMIC OR NUCLEAR MARKER" PX-300881840 CDM 88184 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLOW CYTO CELL SURF 1 (BILL ONLY) PX-300881841 CDM 88184 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLOW CYTOMETRY EACH ADD'L MARKER PX-300881850 CDM 88185 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLOW CYTO CELL SURF 1 ADD BILL ON PX-300881851 CDM 88185 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLOW CYTOMETRY EACH ADD'L MARKER PX-300881855 CDM 88185 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLOW CYTO INTERP 2 TO 8 MARKERS PX-300881870 CDM 88187 CPT 300 RC inpatient 44 43.12 All Payors / Plans All Payors / Plans 44 other 44 44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLOW CYTO INTERP 9 TO 15 MARKERS PX-300881880 CDM 88188 CPT 300 RC inpatient 122 119.56 All Payors / Plans All Payors / Plans 122 other 122 122 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLOW CYTOMETRY 9 TO 15 MARKERS PX-300881888 CDM 88188 CPT 300 RC inpatient 122 119.56 All Payors / Plans All Payors / Plans 122 other 122 122 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLOW CYTO INTERP 16 OR GREAT MARK PX-300881890 CDM 88189 CPT 300 RC inpatient 147 144.06 All Payors / Plans All Payors / Plans 147 other 147 147 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TISSUE CULTURE NON-NEOPLACTIC DISORDERS,LYMPHOCYTE" PX-300882300 CDM 88230 CPT 300 RC inpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TISSUE CULTURE NON-NEOPLASTIC DISORDERS,SKIN/OTHER SOLID TISSUE BIOPSY" PX-300882330 CDM 88233 CPT 300 RC inpatient 571 559.58 All Payors / Plans All Payors / Plans 571 other 571 571 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHG TISSUE CULTURE, PLACENTA" PX-300882350 CDM 88235 CPT 300 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TISSUE CULTURE NEOPLASTIC DISORDERS;BONE MARROW, BLOOD CELLS" PX-300882370 CDM 88237 CPT 300 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHG CELL CRYOPRESERVE/STORAGE PX-300882400 CDM 88240 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC METAPHASES, 1-14 (BILL ONLY)" PX-300882623 CDM 88262 CPT 300 RC inpatient 914 895.72 All Payors / Plans All Payors / Plans 914 other 914 914 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC METAPHASES, 15-20 (BILL ONLY)" PX-300882624 CDM 88262 CPT 300 RC inpatient 914 895.72 All Payors / Plans All Payors / Plans 914 other 914 914 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHROMOSOME ANALYSIS 20-25 CELLS PX-300882640 CDM 88264 CPT 300 RC inpatient 1142 1119.16 All Payors / Plans All Payors / Plans 1142 other 1142 1142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC METAPHASES, 20-25 (BILL ONLY" PX-300882641 CDM 88264 CPT 300 RC inpatient 1142 1119.16 All Payors / Plans All Payors / Plans 1142 other 1142 1142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC METAPHASES, 1-19 (BILL ONLY)" PX-300882642 CDM 88264 CPT 300 RC inpatient 1142 1119.16 All Payors / Plans All Payors / Plans 1142 other 1142 1142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHROMOSOME ANAL,AMN FL OR CHORION VIL,15 CELLS" PX-300882670 CDM 88267 CPT 300 RC inpatient 857 839.86 All Payors / Plans All Payors / Plans 857 other 857 857 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHROMOSOME ANAL, IN SITU FOR AMN FLUID 6-12 COLONIES" PX-300882690 CDM 88269 CPT 300 RC inpatient 857 839.86 All Payors / Plans All Payors / Plans 857 other 857 857 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MOLECULAR CYTOGENETICS;DNA PROBE EACH PX-300882710 CDM 88271 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PROBE, +2 (BILL ONLY)" PX-300882711 CDM 88271 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ANEUPLOIDY DETECTION,POC,FISH" PX-300882712 CDM 88271 CPT 300 RC inpatient 800 784 All Payors / Plans All Payors / Plans 800 other 800 800 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FISH,BCR/ABL FUSION (BCRABL)" PX-300882713 CDM 88271 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INTERPHASES, 25-99 (BILL ONLY)" PX-300882740 CDM 88274 CPT 300 RC inpatient 571 559.58 All Payors / Plans All Payors / Plans 571 other 571 571 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INTERPHASES, <25 (BILL ONLY)" PX-300882741 CDM 88274 CPT 300 RC inpatient 571 559.58 All Payors / Plans All Payors / Plans 571 other 571 571 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INTERPHASES, >=100 (BILL ONLY)" PX-300882750 CDM 88275 CPT 300 RC inpatient 657 643.86 All Payors / Plans All Payors / Plans 657 other 657 657 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC KARYOTYPES, >2 (BILL ONLY)" PX-300882800 CDM 88280 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AG-NOR/CBL STAIN (BILL ONLY) PX-300882830 CDM 88283 CPT 300 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC METAPHASES ADD'L CELLS (BILL ONLY PX-300882850 CDM 88285 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOGENIC AND MOLECULAR INTERP/ REPORT PX-300882910 CDM 88291 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PEROXIDASE STAIN HEMO (POD) PX-300883190 CDM 88319 CPT 300 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CONSULT, OUTSIDE SLIDE(COSPC)" PX-300883210 CDM 88321 CPT 300 RC inpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CONSULT, W/SLIDE PREP(CSPPC)" PX-300883230 CDM 88323 CPT 300 RC inpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CONSULT, W/COMP RVW OF HIS (CRHPC)" PX-300883250 CDM 88325 CPT 300 RC inpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMMUNO SENDOUT ADDL PX-300883410 CDM 88341 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMMUNO SENDOUT PX-300883420 CDM 88342 CPT 300 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MORPHOMETRIC ANAL,IN SITU HYBRID,MANU,PER SPEC,EACH MULTI PROBE STAIN" PX-300883770 CDM 88377 CPT 300 RC inpatient 832 815.36 All Payors / Plans All Payors / Plans 832 other 832 832 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MORPHOMETRIC IN SITU MULTIPLEX PROB STAI PX-300883771 CDM 88377 CPT 300 RC inpatient 706 691.88 All Payors / Plans All Payors / Plans 706 other 706 706 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MICRODISSECTION, MANUAL" PX-300883810 CDM 88381 CPT 301 RC inpatient 106 103.88 All Payors / Plans All Payors / Plans 106 other 106 106 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MLH1 HYPERMEHTYLATION,BRAF MUTATION ANALYS, TUMOR" PX-300883811 CDM 88381 CPT 300 RC inpatient 108 105.84 All Payors / Plans All Payors / Plans 108 other 108 108 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUID CELL COUNT (FCC) PX-300890500 CDM 89050 CPT 300 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CSF, ROUTINE ANALYSIS (SPFR)" PX-300890501 CDM 89050 CPT 300 RC inpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUID CELL COUNT W/DIFFERENTIAL (FDIF) PX-300890510 CDM 89051 CPT 300 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SYNOVIAL FLD. ANALYSIS (SYNA) PX-300890511 CDM 89051 CPT 300 RC inpatient 126 123.48 All Payors / Plans All Payors / Plans 126 other 126 126 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STOOL FOR POLYS (STSM) PX-300890550 CDM 89055 CPT 300 RC inpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUID CRYSTALS (FLDC) PX-300890600 CDM 89060 CPT 300 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EOSINOPHIL SMEAR (EOSM) PX-300891900 CDM 89190 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPUTUM COLLECTED PX-300892200 CDM 89220 CPT 300 RC inpatient 37 36.26 All Payors / Plans All Payors / Plans 37 other 37 37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SWEAT CHLORIDE, CONDUCTIVITY(SWT)" PX-300892300 CDM 89230 CPT 300 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPERM COUNT (SPCT) PX-300893200 CDM 89320 CPT 300 RC inpatient 83 81.34 All Payors / Plans All Payors / Plans 83 other 83 83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPERM POST VAS (SPCK) PX-300893210 CDM 89321 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRAW AND HOLD (DH) PX-300990010 CDM 99001 CPT 300 RC inpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GASTRIC OCCULT BLOOD PX-301822711 CDM 82271 CPT 301 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHROMIUM PX-301824951 CDM 82495 CPT 301 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NEPHELOMETRY, EA ANALYTE (FLCP)" PX-301835210 CDM 83521 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NEPHELOMETRY, EA ANALYTE (MSP3)" PX-301835211 CDM 83521 CPT 301 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IRON BINDING CAPACITY, % SAT" PX-301835501 CDM 83550 CPT 301 RC inpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITAMIN K Q 36585 PX-301845971 CDM 84597 CPT 301 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HCG, QUALITATIVE" PX-301847031 CDM 84703 CPT 301 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BILICHECK TRANSCUTANEOUS - EACH TIME PX-301887201 CDM 88720 CPT 301 RC inpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PANCREATIC ELASTASE, FECES" PX-302826530 CDM 82653 CPT 300 RC inpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INTERLEUKIN-6 (IL-6), SERUM" PX-302835290 CDM 83529 CPT 302 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SMOOTH MUSCLE FLUORESCENT AB, SCREEN EA (SMA)" PX-302860150 CDM 86015 CPT 302 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ANTICYTOPLASMIC NEUT FLUORESCENT AB, SCREEN EA (ANCA)" PX-302860360 CDM 86036 CPT 302 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFLAMMATORY BOWEL DISEASE PANEL FLUORESCENT AB, SCREEN EA (IBDPT)" PX-302860361 CDM 86036 CPT 302 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACETYLCHOLN RCPTR BNDNG ANTB PX-302860410 CDM 86041 CPT 302 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACETYLCHOLN RCPTR MODLG ANTB PX-302860430 CDM 86043 CPT 302 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NMO/AQP4 FACS FLUORESCENT NONINFECTIOUS AB, SCREEN EA (NMOFS/NMOFC)" PX-302860530 CDM 86053 CPT 302 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ENDOMYSIAL FLUORESCENT AB, SCREEN EA (EMA)" PX-302862310 CDM 86231 CPT 302 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLIADIN (DEAMINATED) ANTIBODY PX-302862580 CDM 86258 CPT 302 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FLUORESCENT NONINFECTIOUS AGENT AB, SCREEN EA (FACS)" PX-302863630 CDM 86363 CPT 302 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TISSUE TRANSGLUTAMINASE (TTG) AB PX-302863640 CDM 86364 CPT 302 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MUSCLE-SPECIFIC KINASE ANTB PX-302863660 CDM 86366 CPT 302 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MITOCHONDRIAL AB, IMMUNOASSAY;MULTI, STEP (AMA)" PX-302863810 CDM 86381 CPT 302 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PPD SKIN TEST PX-302865800 CDM 86580 CPT 302 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC P/Q TYPE CALCIUM CHANNEL AB QUANT BY RADIOIMMUNOASSAY PX-302865960 CDM 86596 CPT 302 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EPSTEIN BARR NUCLEAR ANTIGEN PX-302866641 CDM 86664 CPT 302 RC inpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EPSTEIN-BARR VIRUS VCA IGG AB PX-302866651 CDM 86665 CPT 302 RC inpatient 134 131.32 All Payors / Plans All Payors / Plans 134 other 134 134 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SED RATE ERYTHROCYTE, AUTOMATED" PX-305856521 CDM 85652 CPT 305 RC inpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IAAD IA CRYPTOSPORIDIUM PX-306873280 CDM 87328 CPT 306 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC GIARDIA ANTIGEN, BRUSHING" PX-306873291 CDM 87329 CPT 306 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES PX-306875020 CDM 87502 CPT 306 RC inpatient 457 447.86 All Payors / Plans All Payors / Plans 457 other 457 457 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GARDNER VAG DNA QUANT PX-306875121 CDM 87512 CPT 306 RC inpatient 457 447.86 All Payors / Plans All Payors / Plans 457 other 457 457 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MSSA BY PCR PX-306876401 CDM 87640 CPT 306 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STREP A BY PCR PX-306876511 CDM 87651 CPT 306 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPUTUM COLLECTED PX-309892200 CDM 89220 CPT 309 RC inpatient 37 36.26 All Payors / Plans All Payors / Plans 37 other 37 37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LIVER DISEASE 10 BIOCHEMICAL ASSAYS PX-310003M00 CDM 0003M CPT 310 RC inpatient 412 403.76 All Payors / Plans All Payors / Plans 412 other 412 412 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGA IMMUNOFLUOR STAIN RENAL PX-310183461 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG IMMUNOFLUOR STAIN RENAL PX-310183462 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGM IMMUNOFLUOR STAIN RENAL PX-310183463 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LAMBDA IMMUNOFLUOR STAIN RENAL PX-310183464 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KAPPA IMMUNOFLUOR STAIN RENAL PX-310183465 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C3 IMMUNOFLUOR STAIN RENAL PX-310183467 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALBUMIN IMMUNOFLUOR STAIN RENAL PX-310183468 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FIBRINOGEN IMMUNOFLUO STAIN RENAL PX-310183469 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C1Q IMMUNOFLUOR STAIN RENAL PX-310188346 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRCA 1/2 MUTATION ANALYSIS FOR TUMORS PX-310811630 CDM 81163 CPT 310 RC inpatient 3555 3483.9 All Payors / Plans All Payors / Plans 3555 other 3555 3555 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRAF MUTATION ANALYSIS (MELANOMA) PX-310812100 CDM 81210 CPT 310 RC inpatient 372 364.56 All Payors / Plans All Payors / Plans 372 other 372 372 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRAF MUTATION ANAL (OTH SOLID TUM PX-310812101 CDM 81210 CPT 310 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BRAF, GENE ALALYSIS, V60E VARIANT" PX-310812102 CDM 81210 CPT 310 RC inpatient 183 179.34 All Payors / Plans All Payors / Plans 183 other 183 183 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EGFR GENE MUTATION ANALYSIS TUMOR PX-310812350 CDM 81235 CPT 310 RC inpatient 1571 1539.58 All Payors / Plans All Payors / Plans 1571 other 1571 1571 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GENE TARGETED SEQUENCE ANALYSIS PX-310812720 CDM 81272 CPT 310 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KRAS GENE MUTATION ANALYSIS PX-310812750 CDM 81275 CPT 310 RC inpatient 329 322.42 All Payors / Plans All Payors / Plans 329 other 329 329 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC KRAS GENE ANALYSIS, VARIANTS IN CONDONS 12 13" PX-310812751 CDM 81275 CPT 310 RC inpatient 606 593.88 All Payors / Plans All Payors / Plans 606 other 606 606 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NRAS, GENE ANALYSIS, VARIANTS IN EXON 2,3" PX-310813110 CDM 81311 CPT 310 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TPMG THIOPURINE S-METHYLTRANS GENE ANALYSIS TPNUV PX-310813350 CDM 81335 CPT 310 RC inpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UGT1A1 GENE POLYMORPHISM PX-310813500 CDM 81350 CPT 310 RC inpatient 1086 1064.28 All Payors / Plans All Payors / Plans 1086 other 1086 1086 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TP53(TUMOR PROTEIN 53), TARGETED SEQUENCE ANALYSIS" PX-310813520 CDM 81352 CPT 310 RC inpatient 1599 1567.02 All Payors / Plans All Payors / Plans 1599 other 1599 1599 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MOLECULAR PATHOLOGY PROCEDURE, LEVEL 4" PX-310814030 CDM 81403 CPT 310 RC inpatient 389 381.22 All Payors / Plans All Payors / Plans 389 other 389 389 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC Y CHROMOSOME MICRODELETION DNA ANALYSIS PX-310814034 CDM 81403 CPT 310 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MOLECULAR PATHOLOGY PROCEDURE, LEVEL 5" PX-310814040 CDM 81404 CPT 310 RC inpatient 822 805.56 All Payors / Plans All Payors / Plans 822 other 822 822 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NGS COLORECTAL CANCER PANEL PX-310814450 CDM 81445 CPT 310 RC inpatient 1000 980 All Payors / Plans All Payors / Plans 1000 other 1000 1000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TARGET GENOMIC SEQU ANALYSIS PANEL, SOLID ORGAN NEOPL 5-50 GENES" PX-310814451 CDM 81445 CPT 310 RC inpatient 1280 1254.4 All Payors / Plans All Payors / Plans 1280 other 1280 1280 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NGS MELANOMA PANEL PX-310814452 CDM 81445 CPT 310 RC inpatient 1000 980 All Payors / Plans All Payors / Plans 1000 other 1000 1000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SOLID TUMOR PANEL PX-310814453 CDM 81445 CPT 310 RC inpatient 1423 1394.54 All Payors / Plans All Payors / Plans 1423 other 1423 1423 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TGSAP SOLID ORGAN NEOPLASM 5-50 DNA/DNA & ARNA ALYS PX-310814454 CDM 81445 CPT 310 RC inpatient 1956 1916.88 All Payors / Plans All Payors / Plans 1956 other 1956 1956 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TARGET GENOMIC SEQUENCE ANALYSIS PX-310814501 CDM 81450 CPT 310 RC inpatient 2155 2111.9 All Payors / Plans All Payors / Plans 2155 other 2155 2155 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UNLISTED MOLECULAR PATH PROCEDURE PX-310814791 CDM 81479 CPT 310 RC inpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MONOCLNAL PROTEIN STUD. 24HR URIN PX-310863350 CDM 86335 CPT 310 RC inpatient 126 123.48 All Payors / Plans All Payors / Plans 126 other 126 126 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IADNA ORTHOPOXVIRUS AMPLIFIED PROBE TECHNIQUE EA PX-310875931 CDM 87593 CPT 310 RC inpatient 123 120.54 All Payors / Plans All Payors / Plans 123 other 123 123 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CYTOLOGY WASHING, SMEARS" PX-310881040 CDM 88104 CPT 310 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CYTOLOGY, CYTOSPINS" PX-310881080 CDM 88108 CPT 310 RC inpatient 200 196 All Payors / Plans All Payors / Plans 200 other 200 200 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FINE NEEDLE ASPIRATION PX-310881720 CDM 88172 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FNA, INTERPRETATION]" PX-310881730 CDM 88173 CPT 310 RC inpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FNA, EA ADDL IMMEDIATE INTERP SAME SITE" PX-310881770 CDM 88177 CPT 310 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DNA PLOIDY PX-310881820 CDM 88182 CPT 310 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FLOW CYTOMETRY, CELL CYCLE OR DNA ANALYSIS" PX-310881821 CDM 88182 CPT 310 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SURG PATH, LEVEL I" PX-310883040 CDM 88300 CPT 310 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SURG PATH, LEVEL II" PX-310883050 CDM 88302 CPT 310 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SURG PATH, LEVEL III" PX-310883051 CDM 88304 CPT 310 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SURG PATH, LEVEL IV" PX-310883052 CDM 88305 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SURG PATH PROSTATE PX-310883053 CDM 88305 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RENAL PATH LEVEL IV WET TS PX-310883054 CDM 88305 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SURG PATH, LEVEL V" PX-310883070 CDM 88307 CPT 310 RC inpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SURG PATH, LEVEL VI" PX-310883071 CDM 88309 CPT 310 RC inpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SURGICAL PATH C7 PX-310883090 CDM 88309 CPT 310 RC inpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DECAL PX-310883110 CDM 88311 CPT 310 RC inpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPECIAL STAIN I PX-310883120 CDM 88312 CPT 310 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GROCOTTS METH SILVER ST FOR FUNGI PX-310883121 CDM 88312 CPT 310 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ZIEHL NIELSEN ST FOR AF BACT PX-310883122 CDM 88312 CPT 310 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPECIAL STAIN II PX-310883130 CDM 88313 CPT 310 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERIODIC ACID-SCHIFF (PAS) ST PX-310883131 CDM 88313 CPT 310 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MASSONS TRICHROME ST FOR CONN TS PX-310883132 CDM 88313 CPT 310 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC JONES METHENAMINE SILVE ST PX-310883133 CDM 88313 CPT 310 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PUCHTLERS MOD BENNHOLDS ST PX-310883134 CDM 88313 CPT 310 RC inpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FROZEN SECTION PX-310883310 CDM 88331 CPT 310 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ADD'L FROZEN SECTION PX-310883320 CDM 88332 CPT 310 RC inpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TOUCH PREP PX-310883330 CDM 88333 CPT 310 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ADDITIONAL TOUCH PREP PX-310883340 CDM 88334 CPT 310 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMMUNOPEROXIDASE STAIN ADDL PX-310883410 CDM 88341 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG1 IMMUNOFLUO STAIN RENAL PX-310883411 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMMUNOPEROXIDASE STAIN PX-310883420 CDM 88342 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG IMMUNOSTAIN PX-310883421 CDM 88342 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOHISTOCHEMISTRY, EACH ANTIBODY" PX-310883422 CDM 88342 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMMUNOFLUORESCENCE PX-310883460 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG2 IMMUNOFLUO STAIN RENAL PX-310883461 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG3 IMMUNOFLUO STAIN RENAL PX-310883462 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG4 IMMUNOFLUO STAIN RENAL PX-310883463 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C1Q PARAFFIN IMMUNOFLUO STAIN PX-310883464 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGA PARAFFIN IMMUNOFLUO STAIN PX-310883465 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG PARAFFIN IMMUNOFLUO STAIN PX-310883466 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGM PARAFFIN IMMUNOFLUO STAIN PX-310883467 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KAPPA PARAFFIN IMMUNOFLUO STAIN PX-310883468 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LAMBDA PARAFFIN IMMUNOFLUOR STAIN PX-310883469 CDM 88346 CPT 310 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RENAL BIOPSY ELECTRON MICROSCOPY PX-310883480 CDM 88348 CPT 310 RC inpatient 1142 1119.16 All Payors / Plans All Payors / Plans 1142 other 1142 1142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EACH ADD'L SINGLE ANTIBODY STAIN PX-310883500 CDM 88350 CPT 310 RC inpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MUSCLE BIOPSY PX-310883550 CDM 88355 CPT 310 RC inpatient 1142 1119.16 All Payors / Plans All Payors / Plans 1142 other 1142 1142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NERVE BX PX-310883560 CDM 88356 CPT 310 RC inpatient 1142 1119.16 All Payors / Plans All Payors / Plans 1142 other 1142 1142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TUMOR IHC QUANT OR SEMI QUANT, EA ANTIBODY" PX-310883600 CDM 88360 CPT 312 RC inpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IHC ANTIBODY VIA IMAGE ANALYSIS PX-310883610 CDM 88361 CPT 310 RC inpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IN SITU HYBIRD (FISH) EA ADD SING PROBE PX-310883641 CDM 88364 CPT 310 RC inpatient 914 895.72 All Payors / Plans All Payors / Plans 914 other 914 914 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TISSUE IN-SITU HYBRIDIZATION PX-310883650 CDM 88365 CPT 312 RC inpatient 914 895.72 All Payors / Plans All Payors / Plans 914 other 914 914 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HER-2 FISH BY CLARIENT PX-310883740 CDM 88374 CPT 310 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC M/PHMTRC ALSY ISH QUANT/SEMIQ CPTR EA MULTIPRB PX-310883741 CDM 88374 CPT 310 RC inpatient 729 714.42 All Payors / Plans All Payors / Plans 729 other 729 729 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MICRODISSECTION MANUAL-GLOB PX-310883814 CDM 88381 CPT 310 RC inpatient 158 154.84 All Payors / Plans All Payors / Plans 158 other 158 158 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MICRODISSECTION MANUAL-INTER PX-310883815 CDM 88381 CPT 310 RC inpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOLOGY THIN PREP SCREENING PX-311001230 CDM G0123 CPT 311 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOLOGY SELECT ENHANCEMENT PX-311881120 CDM 88112 CPT 311 RC inpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOLOGY THIN PREP MANUAL PX-311881420 CDM 88142 CPT 311 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOLOGY PX-311881640 CDM 88164 CPT 311 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOLOGY AUTO THIN PREP SCREEN PX-311881750 CDM 88175 CPT 311 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CUTANEOUS IMMUNOFLUORESCE BIOPSY PX-314883460 CDM 88346 CPT 314 RC inpatient 857 839.86 All Payors / Plans All Payors / Plans 857 other 857 857 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SI JOINT INJECT W ANESTH PX-320270960 CDM 27096 CPT 320 RC inpatient 682 668.36 All Payors / Plans All Payors / Plans 682 other 682 682 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INJECT CONTRAST KNEE ARTHORGR PX-320273700 CDM 27369 CPT 320 RC inpatient 682 668.36 All Payors / Plans All Payors / Plans 682 other 682 682 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR FL NG TUBE PLACEMENT PX-320437520 CDM 43752 CPT 320 RC inpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC T-TUBE CHOLANGIOGRAM PX-320475310 CDM 47531 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR T TUBE CHOLANGIOG NEW ACCESS PX-320475320 CDM 47532 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR FL CECUM TUBE PLACEMENT PX-320494420 CDM 49442 CPT 320 RC inpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ORBIT-FOREIGN BODY PX-320700300 CDM 70030 CPT 320 RC inpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MANDIBLE PX-320701100 CDM 70110 CPT 320 RC inpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FACIAL BONES PX-320701400 CDM 70140 CPT 320 RC inpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FACIAL BONES PX-320701500 CDM 70150 CPT 320 RC inpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NOSE-NASAL BONES PX-320701600 CDM 70160 CPT 320 RC inpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ORBIT-FRACTURE PX-320702000 CDM 70200 CPT 320 RC inpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SINUSES PX-320702100 CDM 70210 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SINUSES PX-320702200 CDM 70220 CPT 320 RC inpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SELLA TURCICA PX-320702400 CDM 70240 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SKULL < 4 VIEWS PX-320702500 CDM 70250 CPT 320 RC inpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SKULL - COMPLETE MIN 4 VIEWS PX-320702600 CDM 70260 CPT 320 RC inpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR TEETH SINGLE VIEW PX-320703000 CDM 70300 CPT 320 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR TEETH PARTIAL < FULL MOUTH PX-320703100 CDM 70310 CPT 320 RC inpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR TEETH COMPLETE FULL MOUTH PX-320703200 CDM 70320 CPT 320 RC inpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TM JOINTS - UNILATERAL PX-320703280 CDM 70328 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TM JOINTS - BILATERAL PX-320703300 CDM 70330 CPT 320 RC inpatient 284 278.32 All Payors / Plans All Payors / Plans 284 other 284 284 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PANOREX PX-320703550 CDM 70355 CPT 320 RC inpatient 85 83.3 All Payors / Plans All Payors / Plans 85 other 85 85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SOFT TISSUES OF NECK PX-320703600 CDM 70360 CPT 320 RC inpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SIALIOGRAM PX-320703900 CDM 70390 CPT 320 RC inpatient 3285 3219.3 All Payors / Plans All Payors / Plans 3285 other 3285 3285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEST SINGLE AP VIEW PX-320710100 CDM 71045 CPT 320 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEST 2 VIEWS PX-320710200 CDM 71046 CPT 320 RC inpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APICAL LORDOTIC CHEST PX-320710210 CDM 71021 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEST & OBLIQUES PX-320710220 CDM 71022 CPT 324 RC inpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEST-DECUBITUS PX-320710350 CDM 71048 CPT 320 RC inpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RIBS PX-320711000 CDM 71100 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RIBS WITH CHEST PX-320711010 CDM 71101 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RIBS BILATERAL WITH CHEST PX-320711110 CDM 71111 CPT 320 RC inpatient 256 250.88 All Payors / Plans All Payors / Plans 256 other 256 256 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STERNUM PX-320711200 CDM 71120 CPT 320 RC inpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STERNO-CLAVICULAR JT PX-320711300 CDM 71130 CPT 320 RC inpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPINE 1 VIEW PX-320720200 CDM 72020 CPT 320 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR C SPINE 3 VIEWS OR LESS PX-320720400 CDM 72040 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR C SPINE 4 OR 5 VIEWS PX-320720500 CDM 72050 CPT 320 RC inpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR C-SPINE 6 OR MORE VIEWS PX-320720520 CDM 72052 CPT 320 RC inpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THORACIC SPINE 2 VIEWS PX-320720700 CDM 72070 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THORACIC SPINE 3 VIEWS PX-320720720 CDM 72072 CPT 320 RC inpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPINE-THORACOLUMBAR PX-320720800 CDM 72080 CPT 320 RC inpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SCOLIOSIS SERIES PX-320720810 CDM 72081 CPT 320 RC inpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR THOR & LUM SPINE PORT 1 VIEW PX-320720811 CDM 72081 CPT 320 RC inpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR SCOLIOSIS SERIES 2-3 VIEW PX-320720820 CDM 72082 CPT 320 RC inpatient 370 362.6 All Payors / Plans All Payors / Plans 370 other 370 370 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR PORT THOR/LUMB SPINE 2-3 VIEW PX-320720821 CDM 72082 CPT 320 RC inpatient 370 362.6 All Payors / Plans All Payors / Plans 370 other 370 370 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR SCOLIOSIS SERIES 4-5 VIEW PX-320720830 CDM 72083 CPT 320 RC inpatient 398 390.04 All Payors / Plans All Payors / Plans 398 other 398 398 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR SCOLIOSIS SERIES MIN 6 VIEW PX-320720840 CDM 72084 CPT 320 RC inpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LUMBAR SPINE 2 VIEWS PX-320721000 CDM 72100 CPT 320 RC inpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LUMBAR SPINE MIN 4 VIEWS PX-320721100 CDM 72110 CPT 320 RC inpatient 256 250.88 All Payors / Plans All Payors / Plans 256 other 256 256 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LUMBAR SPINE 6 VIEW W BEND PX-320721140 CDM 72114 CPT 320 RC inpatient 370 362.6 All Payors / Plans All Payors / Plans 370 other 370 370 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LUMB SPINE BENDING VIEWS 2 OR 3 PX-320721200 CDM 72120 CPT 320 RC inpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PELVIS PX-320721700 CDM 72170 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SACRO-ILIAC JOINTS PX-320722020 CDM 72202 CPT 320 RC inpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SACRUM AND/OR COCCYX PX-320722200 CDM 72220 CPT 320 RC inpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CERVICAL MYELOGRAM PX-320722400 CDM 62302 CPT 361 RC inpatient 3796 3720.08 All Payors / Plans All Payors / Plans 3796 other 3796 3796 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THORACIC MYELOGRAM PX-320722550 CDM 72255 CPT 320 RC inpatient 3796 3720.08 All Payors / Plans All Payors / Plans 3796 other 3796 3796 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LUMBAR MYELOGRAM PX-320722650 CDM 62304 CPT 361 RC inpatient 3358 3290.84 All Payors / Plans All Payors / Plans 3358 other 3358 3358 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MYELOGRAM, COMPLETE" PX-320722700 CDM 72270 CPT 320 RC inpatient 6497 6367.06 All Payors / Plans All Payors / Plans 6497 other 6497 6497 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR EPIDUROGRAPHY PX-320722750 CDM 72275 CPT 320 RC inpatient 365 357.7 All Payors / Plans All Payors / Plans 365 other 365 365 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CLAVICLE PX-320730000 CDM 73000 CPT 320 RC inpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SCAPULA PX-320730100 CDM 73010 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SHOULDER PX-320730300 CDM 73030 CPT 320 RC inpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SHOULDER ARTHROGRAM PX-320730400 CDM 73040 CPT 322 RC inpatient 1095 1073.1 All Payors / Plans All Payors / Plans 1095 other 1095 1095 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACROMIO-CLAV JOINTS PX-320730500 CDM 73050 CPT 320 RC inpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HUMERUS PX-320730600 CDM 73060 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ELBOW PX-320730700 CDM 73070 CPT 320 RC inpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ELBOW 3 VIEWS PX-320730800 CDM 73080 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ELBOW ARTHROGRAM PX-320730850 CDM 73085 CPT 320 RC inpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FOREARM PX-320730900 CDM 73090 CPT 320 RC inpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WRIST W 20 DEGREE ELEVATION 2 VIE PX-320731000 CDM 73100 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WRIST 3 VIEW PX-320731100 CDM 73110 CPT 320 RC inpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WRIST ARTHORGRAM PX-320731150 CDM 73115 CPT 320 RC inpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HAND PX-320731200 CDM 73120 CPT 320 RC inpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC XR HAND, 3 VIEWS" PX-320731300 CDM 73130 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FINGER PX-320731400 CDM 73140 CPT 320 RC inpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HIP FOR PROGRESS, 1 VIEW" PX-320735010 CDM 73501 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HIP FOR FX, 2 OR 3 VIEWS" PX-320735020 CDM 73502 CPT 320 RC inpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PELVIS/HIPS PX-320735230 CDM 73523 CPT 320 RC inpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR HIP ARTHROGRAM PX-320735250 CDM 73525 CPT 320 RC inpatient 1095 1073.1 All Payors / Plans All Payors / Plans 1095 other 1095 1095 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR FEMUR (1)VIEW PX-320735510 CDM 73551 CPT 320 RC inpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FEMUR PX-320735520 CDM 73552 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KNEE PX-320735600 CDM 73560 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KNEE COMPLETE PX-320735640 CDM 73564 CPT 320 RC inpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KNEES WEIGHT BEAR BOTH PX-320735650 CDM 73565 CPT 320 RC inpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARTHROGRAM KNEE PX-320735800 CDM 73580 CPT 320 RC inpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LEG PX-320735900 CDM 73590 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANKLE PX-320736000 CDM 73600 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC XR ANKLE, 3 VIEWS" PX-320736100 CDM 73610 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARTHROGRAM ANKLE PX-320736150 CDM 73615 CPT 320 RC inpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FOOT PX-320736200 CDM 73620 CPT 320 RC inpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR FOOT 3 VIEWS PX-320736300 CDM 73630 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEEL BRODENS VIEW 4 VIEWS PX-320736500 CDM 73650 CPT 320 RC inpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TOE PX-320736600 CDM 73660 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ABDOMEN SINGLE VIEW PX-320740000 CDM 74018 CPT 320 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ABDOMEN 2 VIEWS PX-320740200 CDM 74019 CPT 320 RC inpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACUTE ABD MULTIVIEWS W 1 VIEW CXR PX-320740220 CDM 74022 CPT 320 RC inpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CERVICAL ESOPHAGUS W SCOUT/DELAYED W CONTRAST PX-320742100 CDM 74210 CPT 320 RC inpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ESOPHAGUS SINGLE CONTRAST INC. SCOUT CHEST/DELAYED IMAGES PX-320742200 CDM 74220 CPT 320 RC inpatient 512 501.76 All Payors / Plans All Payors / Plans 512 other 512 512 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ESOPHAGUS DOUBLE CONTRAST PX-320742210 CDM 74221 CPT 320 RC inpatient 512 501.76 All Payors / Plans All Payors / Plans 512 other 512 512 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MODIFIED BARIUM SWALLOW W SCOUT/DELAYED IMAGES PX-320742300 CDM 74230 CPT 320 RC inpatient 796 780.08 All Payors / Plans All Payors / Plans 796 other 796 796 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GASTROGRAFIN GI W SCOUT W/WO DELAYED IMAGES PX-320742400 CDM 74240 CPT 320 RC inpatient 625 612.5 All Payors / Plans All Payors / Plans 625 other 625 625 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR SM BOWEL SITZMARKER PX-320742450 CDM 74248 CPT 320 RC inpatient 995 975.1 All Payors / Plans All Payors / Plans 995 other 995 995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UGI DOUBLE CONTRAST PX-320742460 CDM 74246 CPT 320 RC inpatient 739 724.22 All Payors / Plans All Payors / Plans 739 other 739 739 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UPPER GI SERIES PX-320742470 CDM 74246 CPT 320 RC inpatient 739 724.22 All Payors / Plans All Payors / Plans 739 other 739 739 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UGI/SMALL BOWEL PX-320742490 CDM 74248 CPT 320 RC inpatient 995 975.1 All Payors / Plans All Payors / Plans 995 other 995 995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SMALL BOWEL SERIES W SCOUT/SINGLE CONTRAST PX-320742500 CDM 74250 CPT 320 RC inpatient 625 612.5 All Payors / Plans All Payors / Plans 625 other 625 625 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR SM B SERIES VIA ENTEROCLYSIS TUBE PX-320742510 CDM 74251 CPT 320 RC inpatient 3070 3008.6 All Payors / Plans All Payors / Plans 3070 other 3070 3070 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BARIUM ENEMA SINGLE CONTRAST W SCOUT/DELAYED IMAGES PX-320742700 CDM 74270 CPT 320 RC inpatient 910 891.8 All Payors / Plans All Payors / Plans 910 other 910 910 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BARIUM ENEMA W/AIR DOUBELE CONTRAST W SCOUT/DELAYED IMAGES PX-320742800 CDM 74280 CPT 320 RC inpatient 1308 1281.84 All Payors / Plans All Payors / Plans 1308 other 1308 1308 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPER CHOLANGIOGRM PX-320743000 CDM 74300 CPT 320 RC inpatient 2190 2146.2 All Payors / Plans All Payors / Plans 2190 other 2190 2190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPER CHOLAGIOGRAM ADDITIONAL IMAGES PX-320743010 CDM 74301 CPT 320 RC inpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IV PYLEOGRAMS PX-320744000 CDM 74400 CPT 320 RC inpatient 3869 3791.62 All Payors / Plans All Payors / Plans 3869 other 3869 3869 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RETRO PYLEOGRAM PX-320744200 CDM 74420 CPT 320 RC inpatient 881 863.38 All Payors / Plans All Payors / Plans 881 other 881 881 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC UROGRAPHY ANTEGRADE, RAD SUP & INTERPRETATION" PX-320744250 CDM 74425 CPT 320 RC inpatient 2190 2146.2 All Payors / Plans All Payors / Plans 2190 other 2190 2190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYSTOGRAM PX-320744300 CDM 74430 CPT 320 RC inpatient 3723 3648.54 All Payors / Plans All Payors / Plans 3723 other 3723 3723 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URETHROGRAM PX-320744550 CDM 74455 CPT 320 RC inpatient 1679 1645.42 All Payors / Plans All Payors / Plans 1679 other 1679 1679 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR HYSTEROSALPINGOGRAM PX-320747400 CDM 74740 CPT 320 RC inpatient 2409 2360.82 All Payors / Plans All Payors / Plans 2409 other 2409 2409 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SHUNT SERIES PX-320758090 CDM 75809 CPT 320 RC inpatient 292 286.16 All Payors / Plans All Payors / Plans 292 other 292 292 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VENOGRAM PX-320758200 CDM 75820 CPT 320 RC inpatient 365 357.7 All Payors / Plans All Payors / Plans 365 other 365 365 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUORO ONLY-UP TO 1 HR PX-320760000 CDM 76000 CPT 320 RC inpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FOREIGN BODY LOCALIZATION PX-320760100 CDM 76010 CPT 320 RC inpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SINUS TRACT INJECTION PX-320760800 CDM 76080 CPT 320 RC inpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR FLUO CONTRAST LARYNOGOGRAPHY PX-320764992 CDM 76499 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLURO GUIDE NEEDLE PLACEMENT PX-320770020 CDM 77002 CPT 320 RC inpatient 3504 3433.92 All Payors / Plans All Payors / Plans 3504 other 3504 3504 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FOOT ARTHROGRAM PX-320770021 CDM 77002 CPT 320 RC inpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TOE ARTHROGRAM PX-320770022 CDM 77002 CPT 320 RC inpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR EPIDUR DIAG/THER INJ ONLY PX-320770030 CDM 77003 CPT 320 RC inpatient 365 357.7 All Payors / Plans All Payors / Plans 365 other 365 365 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE AGE SURVEY PX-320770720 CDM 77072 CPT 320 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SCANOGRAM PX-320770730 CDM 77073 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LONG BONE SURVEY PX-320770740 CDM 77074 CPT 320 RC inpatient 341 334.18 All Payors / Plans All Payors / Plans 341 other 341 341 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC METASTATIC BONE SURVEY PX-320770750 CDM 77075 CPT 320 RC inpatient 341 334.18 All Payors / Plans All Payors / Plans 341 other 341 341 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE SURVEY COMPLETE PX-320770755 CDM 77075 CPT 320 RC inpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFANT OSSEOUS SURVEY PX-320770760 CDM 77076 CPT 320 RC inpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE SURVEY JOINT 2 OR MORE PX-320770770 CDM 77077 CPT 320 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHEMO,SUBQ/INTRA NON HOR ANTI NEO" PX-331964010 CDM 96401 CPT 331 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMO SUBQ/INTRA HOR ANTI NEO PX-331964020 CDM 96402 CPT 331 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMO ADMIN IV PUSH-SINGL/INITIAL PX-331964090 CDM 96409 CPT 331 RC inpatient 330 323.4 All Payors / Plans All Payors / Plans 330 other 330 330 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMO ADMIN IV PUSH-EACH ADD DRUG PX-331964110 CDM 96411 CPT 331 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SIMULATION, SIMPLE" PX-333772800 CDM 77280 CPT 333 RC inpatient 915 896.7 All Payors / Plans All Payors / Plans 915 other 915 915 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SIMULATION SIMPLE INITIAL PX-333772801 CDM 77280 CPT 333 RC inpatient 915 896.7 All Payors / Plans All Payors / Plans 915 other 915 915 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SIMULATION, INTERMEDIATE" PX-333772850 CDM 77285 CPT 333 RC inpatient 1441 1412.18 All Payors / Plans All Payors / Plans 1441 other 1441 1441 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SIMULATION, COMPLEX" PX-333772900 CDM 77290 CPT 333 RC inpatient 1663 1629.74 All Payors / Plans All Payors / Plans 1663 other 1663 1663 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RESPIRATORY MOTION MGMT PX-333772930 CDM 77293 CPT 333 RC inpatient 1400 1372 All Payors / Plans All Payors / Plans 1400 other 1400 1400 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC 3D TREATMENT PLANNING PX-333772950 CDM 77295 CPT 333 RC inpatient 1026 1005.48 All Payors / Plans All Payors / Plans 1026 other 1026 1026 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BASIC DOSIMETRY CALC PX-333773000 CDM 77300 CPT 333 RC inpatient 125 122.5 All Payors / Plans All Payors / Plans 125 other 125 125 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMRT PLAN PX-333773010 CDM 77301 CPT 333 RC inpatient 5891 5773.18 All Payors / Plans All Payors / Plans 5891 other 5891 5891 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPUTER ISODOSE-SIMPLE PX-333773060 CDM 77306 CPT 333 RC inpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPUTER ISODOSE-COMPLEX PX-333773070 CDM 77307 CPT 333 RC inpatient 513 502.74 All Payors / Plans All Payors / Plans 513 other 513 513 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRACHY THERAPY DOS-SIMPLE PX-333773160 CDM 77316 CPT 333 RC inpatient 444 435.12 All Payors / Plans All Payors / Plans 444 other 444 444 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRACHY THERAPY DOS-INT PX-333773170 CDM 77317 CPT 333 RC inpatient 568 556.64 All Payors / Plans All Payors / Plans 568 other 568 568 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRACHY THERAPY DOS-COMP PX-333773180 CDM 77318 CPT 333 RC inpatient 776 760.48 All Payors / Plans All Payors / Plans 776 other 776 776 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPECIAL BEAM PLAN PX-333773210 CDM 77321 CPT 333 RC inpatient 166 162.68 All Payors / Plans All Payors / Plans 166 other 166 166 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPECIAL DOSIMETRY/TLD/MDM PX-333773310 CDM 77331 CPT 333 RC inpatient 69 67.62 All Payors / Plans All Payors / Plans 69 other 69 69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TREATMENT DEVICES-SIMPLE PX-333773320 CDM 77332 CPT 333 RC inpatient 208 203.84 All Payors / Plans All Payors / Plans 208 other 208 208 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TREATMENT DEVICES-INTERM. PX-333773330 CDM 77333 CPT 333 RC inpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TREATMENT DEVICES-COMPLEX PX-333773340 CDM 77334 CPT 333 RC inpatient 347 340.06 All Payors / Plans All Payors / Plans 347 other 347 347 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PHYSICS, CONSULT., CONT." PX-333773360 CDM 77336 CPT 333 RC inpatient 291 285.18 All Payors / Plans All Payors / Plans 291 other 291 291 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DESIGN MLC DEVICE FOR IMRT PX-333773380 CDM 77338 CPT 333 RC inpatient 1095 1073.1 All Payors / Plans All Payors / Plans 1095 other 1095 1095 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PHYSICS CONSULTATION PX-333773700 CDM 77370 CPT 333 RC inpatient 444 435.12 All Payors / Plans All Payors / Plans 444 other 444 444 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TREATMENT DELIVERY SRS LINEAR PX-333773720 CDM 77372 CPT 333 RC inpatient 4116 4033.68 All Payors / Plans All Payors / Plans 4116 other 4116 4116 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SBRT TREATMENT DELIVERY PER FRAC PX-333773730 CDM 77373 CPT 333 RC inpatient 5225 5120.5 All Payors / Plans All Payors / Plans 5225 other 5225 5225 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMRT TREATMENTS SIMPLE PX-333773850 CDM 77385 CPT 333 RC inpatient 1552 1520.96 All Payors / Plans All Payors / Plans 1552 other 1552 1552 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMRT TREATMENTS COMPLEX PX-333773860 CDM 77386 CPT 333 RC inpatient 1552 1520.96 All Payors / Plans All Payors / Plans 1552 other 1552 1552 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STEREOSCOPIC GUIDE VOL RAD THER PX-333773870 CDM 77387 CPT 333 RC inpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT SCAN FOR THERAPY GUIDE PX-333773871 CDM 77387 CPT 333 RC inpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRMT DELIVERY =>1 MEV, SIMPLE" PX-333774020 CDM 77402 CPT 333 RC inpatient 624 611.52 All Payors / Plans All Payors / Plans 624 other 624 624 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRMT DELIVERY =>1MEV INTERMEDIATE PX-333774070 CDM 77407 CPT 333 RC inpatient 998 978.04 All Payors / Plans All Payors / Plans 998 other 998 998 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRMT DELIVERY =>1MEV, COMPLEX" PX-333774120 CDM 77412 CPT 333 RC inpatient 1067 1045.66 All Payors / Plans All Payors / Plans 1067 other 1067 1067 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PORT FILMS PX-333774170 CDM 77417 CPT 333 RC inpatient 42 41.16 All Payors / Plans All Payors / Plans 42 other 42 42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPECIAL TREATMENT PROCEDURE PX-333774700 CDM 77470 CPT 333 RC inpatient 180 176.4 All Payors / Plans All Payors / Plans 180 other 180 180 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTERCAV. RADIOLEM. SIMPLE PX-333777610 CDM 77761 CPT 333 RC inpatient 735 720.3 All Payors / Plans All Payors / Plans 735 other 735 735 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTERCAV. RADIOLEM. INTER PX-333777620 CDM 77762 CPT 333 RC inpatient 845 828.1 All Payors / Plans All Payors / Plans 845 other 845 845 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTERCAV. RADIOLEM. COMPLEX PX-333777630 CDM 77763 CPT 333 RC inpatient 1095 1073.1 All Payors / Plans All Payors / Plans 1095 other 1095 1095 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HIGH DOSE RATE BRACHYTHERAPY 1CH PX-333777700 CDM 77770 CPT 333 RC inpatient 638 625.24 All Payors / Plans All Payors / Plans 638 other 638 638 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HIGH DOSE RATE BRACHYTHERAPY 2-12 PX-333777710 CDM 77771 CPT 333 RC inpatient 1247 1222.06 All Payors / Plans All Payors / Plans 1247 other 1247 1247 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HIGH DOSE RATE BRACHYTHERAPY >12 PX-333777720 CDM 77772 CPT 333 RC inpatient 2037 1996.26 All Payors / Plans All Payors / Plans 2037 other 2037 2037 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INTERSTITIAL, SIMPLE" PX-333777760 CDM 77776 CPT 333 RC inpatient 887 869.26 All Payors / Plans All Payors / Plans 887 other 887 887 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INTERSTITIAL, INTERMEDIATE" PX-333777770 CDM 77777 CPT 333 RC inpatient 748 733.04 All Payors / Plans All Payors / Plans 748 other 748 748 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INTERSTITIAL, COMPLEX" PX-333777780 CDM 77778 CPT 333 RC inpatient 1109 1086.82 All Payors / Plans All Payors / Plans 1109 other 1109 1109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRACHY TREATMENT HANDLING-LOAD PX-333777900 CDM 77790 CPT 333 RC inpatient 166 162.68 All Payors / Plans All Payors / Plans 166 other 166 166 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMO ADMIN BY INFUSION 0-1 HR PX-335964130 CDM 96413 CPT 335 RC inpatient 594 582.12 All Payors / Plans All Payors / Plans 594 other 594 594 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMO ADMIN BY INFUS EA ADD 1HR PX-335964150 CDM 96415 CPT 335 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMO ADMIN BY INFUSE PROL W PUMP PX-335964160 CDM 96416 CPT 335 RC inpatient 594 582.12 All Payors / Plans All Payors / Plans 594 other 594 594 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMO ADMIN BY INFUSE EA ADDL SEQ PX-335964170 CDM 96417 CPT 335 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMOTX ADMN IA NFS >8 HR PRTBLE IMPLTBL PMP PX-335964250 CDM 96425 CPT 335 RC inpatient 594 582.12 All Payors / Plans All Payors / Plans 594 other 594 594 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC REFILLING & MAINTENANCE PORTABLE PUMP PX-335965210 CDM 96521 CPT 335 RC inpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC REFILL&MAINTENANCE PUMP DRUG DLVR SYSTEMIC PX-335965220 CDM 96522 CPT 335 RC inpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONCURRENT CHEMO INFUSION PX-335965490 CDM 96549 CPT 335 RC inpatient 33 32.34 All Payors / Plans All Payors / Plans 33 other 33 33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMO EXTEND IV INFUS W/PUMP PX-335G04980 CDM G0498 CPT 335 RC inpatient 594 582.12 All Payors / Plans All Payors / Plans 594 other 594 594 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROID UPTAKE SING/MUL QM PX-340780120 CDM 78012 CPT 340 RC inpatient 437 428.26 All Payors / Plans All Payors / Plans 437 other 437 437 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROID SCAN PX-340780130 CDM 78013 CPT 340 RC inpatient 1040 1019.2 All Payors / Plans All Payors / Plans 1040 other 1040 1040 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROID IMAG SING/MUL QM PX-340780140 CDM 78014 CPT 340 RC inpatient 1310 1283.8 All Payors / Plans All Payors / Plans 1310 other 1310 1310 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROID CA METS-WHOLE BODY PX-340780180 CDM 78018 CPT 340 RC inpatient 1643 1610.14 All Payors / Plans All Payors / Plans 1643 other 1643 1643 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARATHYROID PLANAR INC SUBTR PX-340780700 CDM 78070 CPT 340 RC inpatient 1581 1549.38 All Payors / Plans All Payors / Plans 1581 other 1581 1581 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARATHYROID SCAN W SPECT PX-340780710 CDM 78071 CPT 340 RC inpatient 1810 1773.8 All Payors / Plans All Payors / Plans 1810 other 1810 1810 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARATHYROID SCAN W SPECT & CT PX-340780720 CDM 78072 CPT 340 RC inpatient 2038 1997.24 All Payors / Plans All Payors / Plans 2038 other 2038 2038 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NM BONE MARROW IMAGING, WHOLE BODY" PX-340781040 CDM 78104 CPT 340 RC inpatient 1269 1243.62 All Payors / Plans All Payors / Plans 1269 other 1269 1269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LYMPHATICS AND LYMPH NODE IMAGING PX-340781950 CDM 78195 CPT 340 RC inpatient 1810 1773.8 All Payors / Plans All Payors / Plans 1810 other 1810 1810 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC LIVER IMAGING, STATIC ONLY" PX-340782010 CDM 78201 CPT 340 RC inpatient 1019 998.62 All Payors / Plans All Payors / Plans 1019 other 1019 1019 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LIVER IMAGE W VASCULAR FLOW PX-340782020 CDM 78202 CPT 340 RC inpatient 1082 1060.36 All Payors / Plans All Payors / Plans 1082 other 1082 1082 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM LIVER IMAGING SPECT PX-340782050 CDM 78803 CPT 340 RC inpatient 1768 1732.64 All Payors / Plans All Payors / Plans 1768 other 1768 1768 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LIVER IMAGING (SPECT) W VASC FLOW PX-340782060 CDM 78202 CPT 340 RC inpatient 1082 1060.36 All Payors / Plans All Payors / Plans 1082 other 1082 1082 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LIVER/SPLEEN STATIC ONLY PX-340782150 CDM 78215 CPT 340 RC inpatient 1040 1019.2 All Payors / Plans All Payors / Plans 1040 other 1040 1040 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEPABILRY SYS IMAG INC GALLBLADDER PX-340782260 CDM 78226 CPT 340 RC inpatient 1789 1753.22 All Payors / Plans All Payors / Plans 1789 other 1789 1789 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEPABILRY SYS IMAG W PHARMA PX-340782270 CDM 78227 CPT 340 RC inpatient 2454 2404.92 All Payors / Plans All Payors / Plans 2454 other 2454 2454 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM ESOPHAGEAL MOTILITY PX-340782580 CDM 78258 CPT 340 RC inpatient 1144 1121.12 All Payors / Plans All Payors / Plans 1144 other 1144 1144 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GASTROESOPHAGEAL REFLUX PX-340782620 CDM 78262 CPT 340 RC inpatient 1269 1243.62 All Payors / Plans All Payors / Plans 1269 other 1269 1269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM GI GASTRIC EMPTY IMAGE STUDY PX-340782640 CDM 78264 CPT 340 RC inpatient 1810 1773.8 All Payors / Plans All Payors / Plans 1810 other 1810 1810 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM GI GASTRIC W SM BOWEL TRANSIT PX-340782650 CDM 78265 CPT 340 RC inpatient 2122 2079.56 All Payors / Plans All Payors / Plans 2122 other 2122 2122 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NM GI GASTRIC SM BOWEL, COLON MULTI DAYS" PX-340782660 CDM 78266 CPT 340 RC inpatient 2558 2506.84 All Payors / Plans All Payors / Plans 2558 other 2558 2558 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACUTE GI BLOOD LOSS PX-340782780 CDM 78278 CPT 340 RC inpatient 1830 1793.4 All Payors / Plans All Payors / Plans 1830 other 1830 1830 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BOWEL SCAN-MECKELS PX-340782900 CDM 78290 CPT 340 RC inpatient 1810 1773.8 All Payors / Plans All Payors / Plans 1810 other 1810 1810 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERITONEAL VENOUS SHUNT PX-340782910 CDM 78291 CPT 340 RC inpatient 1290 1264.2 All Payors / Plans All Payors / Plans 1290 other 1290 1290 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UNLIST GI PROC HEPAT/GI BLD LOSS PX-340782990 CDM 78299 CPT 340 RC inpatient 229 224.42 All Payors / Plans All Payors / Plans 229 other 229 229 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE SCAN-LIMITED PX-340783000 CDM 78300 CPT 341 RC inpatient 915 896.7 All Payors / Plans All Payors / Plans 915 other 915 915 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE SCAN-WHOLE BODY PX-340783060 CDM 78306 CPT 340 RC inpatient 1269 1243.62 All Payors / Plans All Payors / Plans 1269 other 1269 1269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC 3 PHASE BONE SCAN PX-340783150 CDM 78315 CPT 340 RC inpatient 1810 1773.8 All Payors / Plans All Payors / Plans 1810 other 1810 1810 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE SPECT PX-340783200 CDM 78803 CPT 340 RC inpatient 1768 1732.64 All Payors / Plans All Payors / Plans 1768 other 1768 1768 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYOCARDIAL PERF-SPECT/SINGLE PX-340784510 CDM 78451 CPT 341 RC inpatient 1664 1630.72 All Payors / Plans All Payors / Plans 1664 other 1664 1664 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYOCARDIAL PERF-SPECT/MULTI PX-340784520 CDM 78452 CPT 340 RC inpatient 2392 2344.16 All Payors / Plans All Payors / Plans 2392 other 2392 2392 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MUGA-SINGLE STUDY PX-340784720 CDM 78472 CPT 340 RC inpatient 1102 1079.96 All Payors / Plans All Payors / Plans 1102 other 1102 1102 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM PULM VENT IMAG AEROSOL-GAS PX-340785790 CDM 78579 CPT 340 RC inpatient 978 958.44 All Payors / Plans All Payors / Plans 978 other 978 978 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULM PERFUSION PARTICULATE PX-340785800 CDM 78580 CPT 340 RC inpatient 1227 1202.46 All Payors / Plans All Payors / Plans 1227 other 1227 1227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM PULMONARY VENT PERFUSION IMAG PX-340785820 CDM 78582 CPT 340 RC inpatient 1706 1671.88 All Payors / Plans All Payors / Plans 1706 other 1706 1706 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM PULMON PERFUSION QUAN DIFF PX-340785970 CDM 78597 CPT 340 RC inpatient 1019 998.62 All Payors / Plans All Payors / Plans 1019 other 1019 1019 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM PULMON PERFUSION VENT QUAN DIF PX-340785980 CDM 78598 CPT 340 RC inpatient 1602 1569.96 All Payors / Plans All Payors / Plans 1602 other 1602 1602 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRAIN SCAN <4 VIEWS W VASC FLOW PX-340786010 CDM 78601 CPT 340 RC inpatient 1144 1121.12 All Payors / Plans All Payors / Plans 1144 other 1144 1144 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRAIN SCAN W VASCULAR FLOW PX-340786060 CDM 78606 CPT 340 RC inpatient 1810 1773.8 All Payors / Plans All Payors / Plans 1810 other 1810 1810 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRAIN SPECT PX-340786070 CDM 78803 CPT 340 RC inpatient 1768 1732.64 All Payors / Plans All Payors / Plans 1768 other 1768 1768 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CEREBROSPINAL FLUID FLOW PX-340786300 CDM 78630 CPT 340 RC inpatient 1851 1813.98 All Payors / Plans All Payors / Plans 1851 other 1851 1851 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CNS SHUNT EVALUATION PX-340786450 CDM 78645 CPT 340 RC inpatient 1810 1773.8 All Payors / Plans All Payors / Plans 1810 other 1810 1810 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CSF LEAK PX-340786500 CDM 78650 CPT 340 RC inpatient 1830 1793.4 All Payors / Plans All Payors / Plans 1830 other 1830 1830 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KIDNEY IMAG STATIC ONLY PX-340787000 CDM 78700 CPT 340 RC inpatient 915 896.7 All Payors / Plans All Payors / Plans 915 other 915 915 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM KIDNEY STATIC SCAN W/VASC FLOW PX-340787010 CDM 78701 CPT 340 RC inpatient 1144 1121.12 All Payors / Plans All Payors / Plans 1144 other 1144 1144 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM KIDNEY SCAN-VAS FLOW/FUNCT W/O PX-340787070 CDM 78707 CPT 340 RC inpatient 1123 1100.54 All Payors / Plans All Payors / Plans 1123 other 1123 1123 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KIDNEY IMAG-VASC FLOW/FUN W 1PHAR PX-340787080 CDM 78708 CPT 340 RC inpatient 707 692.86 All Payors / Plans All Payors / Plans 707 other 707 707 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KIDNEY IMAG-VASC FLOW/FUNC W PHAR PX-340787090 CDM 78709 CPT 340 RC inpatient 1810 1773.8 All Payors / Plans All Payors / Plans 1810 other 1810 1810 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KIDNEY SCAN-SPECT PX-340787100 CDM 78803 CPT 340 RC inpatient 1768 1732.64 All Payors / Plans All Payors / Plans 1768 other 1768 1768 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URETHRAL REFLUX STUDY PX-340787400 CDM 78740 CPT 340 RC inpatient 1165 1141.7 All Payors / Plans All Payors / Plans 1165 other 1165 1165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TESTICULAR IMAGIMG WITH FLOW PX-340787610 CDM 78761 CPT 340 RC inpatient 1082 1060.36 All Payors / Plans All Payors / Plans 1082 other 1082 1082 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TUMOR IMAGING SINGLE AREA/SINGLE DAY PX-340788000 CDM 78800 CPT 340 RC inpatient 957 937.86 All Payors / Plans All Payors / Plans 957 other 957 957 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TUMOR IMAGING 2 OR MORE AREAS 1 OR MORE DAYS/SINGLE AREA 2 OR MORE DAYS PX-340788010 CDM 78801 CPT 340 RC inpatient 1352 1324.96 All Payors / Plans All Payors / Plans 1352 other 1352 1352 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TUMOR IMAGING-WB SINGLE DAY PX-340788020 CDM 78802 CPT 340 RC inpatient 1706 1671.88 All Payors / Plans All Payors / Plans 1706 other 1706 1706 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TUMOR IMAGING-SPECT SINGLE AREA SINGLE DAY PX-340788030 CDM 78803 CPT 340 RC inpatient 1768 1732.64 All Payors / Plans All Payors / Plans 1768 other 1768 1768 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TUMOR LOCALIZATION-WB 2 OR > DAYS PX-340788040 CDM 78804 CPT 340 RC inpatient 3120 3057.6 All Payors / Plans All Payors / Plans 3120 other 3120 3120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFLAMMATION IMAGING-WB PX-340788060 CDM 78306 CPT 340 RC inpatient 1269 1243.62 All Payors / Plans All Payors / Plans 1269 other 1269 1269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFLAMMATION IMAGING-SPECT PX-340788070 CDM 78803 CPT 340 RC inpatient 1768 1732.64 All Payors / Plans All Payors / Plans 1768 other 1768 1768 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM TUMOR IMAGING-SPECT CT SINGLE AREA SINGLE DAY PX-340788300 CDM 78830 CPT 340 RC inpatient 2496 2446.08 All Payors / Plans All Payors / Plans 2496 other 2496 2496 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM TUMOR IMAGING-SPECT CT SINGLE AREA/2 DAYS OR 2 AREAS/1DAY PX-340788320 CDM 78832 CPT 340 RC inpatient 4888 4790.24 All Payors / Plans All Payors / Plans 4888 other 4888 4888 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM SPECT CT QUANTIFICATION MEASUREMENT PX-340788350 CDM 78835 CPT 340 RC inpatient 478 468.44 All Payors / Plans All Payors / Plans 478 other 478 478 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RADIOPHARMACEUTICAL THERAPY ORAL PX-340790050 CDM 79005 CPT 340 RC inpatient 291 285.18 All Payors / Plans All Payors / Plans 291 other 291 291 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RADIOPHARMACEUTICAL THERAPY IV PX-340791010 CDM 79101 CPT 340 RC inpatient 291 285.18 All Payors / Plans All Payors / Plans 291 other 291 291 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RADIOPHARM THER MONOCLONAL ANTIBO PX-340794030 CDM 79403 CPT 340 RC inpatient 478 468.44 All Payors / Plans All Payors / Plans 478 other 478 478 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC RADIOPHARMACEUTICAL THERAPY, BY INTRA-ARTICULAR ADMIN" PX-340794450 CDM 79445 CPT 340 RC inpatient 104 101.92 All Payors / Plans All Payors / Plans 104 other 104 104 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC 10MCI GALLIUM PX-343000001 CDM 343 RC inpatient 159.1 155.92 All Payors / Plans All Payors / Plans 159.1 other 159.1 159.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PYROPHOSPHATE PX-343000002 CDM A9538 CPT 343 RC inpatient 29.38 28.79 All Payors / Plans All Payors / Plans 29.38 other 29.38 29.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M DTPA KIT PX-343000003 CDM 343 RC inpatient 22.83 22.37 All Payors / Plans All Payors / Plans 22.83 other 22.83 22.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ULTRATAG KIT PX-343000004 CDM 343 RC inpatient 61.04 59.82 All Payors / Plans All Payors / Plans 61.04 other 61.04 61.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M DISIDA PX-343000005 CDM 343 RC inpatient 28.28 27.71 All Payors / Plans All Payors / Plans 28.28 other 28.28 28.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC F-18 FDG PX-343000006 CDM A9552 CPT 343 RC inpatient 250 245 All Payors / Plans All Payors / Plans 250 other 250 250 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M MAG111 PX-343000007 CDM 343 RC inpatient 132.95 130.29 All Payors / Plans All Payors / Plans 132.95 other 132.95 132.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC P32 PX-343000008 CDM 343 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC Z NM I-123 CAPSULE (200UCI) PX-343000009 CDM A9516 CPT 343 RC inpatient 46.01 45.09 All Payors / Plans All Payors / Plans 46.01 other 46.01 46.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ONCOSCINT PX-343000010 CDM 343 RC inpatient 1915.05 1876.75 All Payors / Plans All Payors / Plans 1915.05 other 1915.05 1915.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OCTREOSCAN PX-343000011 CDM A9572 CPT 343 RC inpatient 2006.47 1966.34 All Payors / Plans All Payors / Plans 2006.47 other 2006.47 2006.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC I131 MIBG PX-343000012 CDM 343 RC inpatient 1280.6 1254.99 All Payors / Plans All Payors / Plans 1280.6 other 1280.6 1280.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM KINEVAC PX-343000013 CDM 343 RC inpatient 88.65 86.88 All Payors / Plans All Payors / Plans 88.65 other 88.65 88.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM TC99M SESTAMIBI PX-343095000 CDM A9500 CPT 343 RC inpatient 75 73.5 All Payors / Plans All Payors / Plans 75 other 75 75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M MDP PX-343095030 CDM A9503 CPT 343 RC inpatient 10.93 10.71 All Payors / Plans All Payors / Plans 10.93 other 10.93 10.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM TL 201 PER MCI PX-343095050 CDM A9505 CPT 343 RC inpatient 15.45 15.14 All Payors / Plans All Payors / Plans 15.45 other 15.45 15.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC Z NM I123 CAP WB PER MCI PX-343095090 CDM A9509 CPT 343 RC inpatient 280.84 275.22 All Payors / Plans All Payors / Plans 280.84 other 280.84 280.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM TC99M TC04 PER MCI PX-343095120 CDM A9512 CPT 343 RC inpatient 11.83 11.59 All Payors / Plans All Payors / Plans 11.83 other 11.83 11.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC04 PX-343095121 CDM A9512 CPT 343 RC inpatient 23.66 23.19 All Payors / Plans All Payors / Plans 23.66 other 23.66 23.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM I131 RX CAP 1ST MCI PX-343095170 CDM A9517 CPT 343 RC inpatient 79.57 77.98 All Payors / Plans All Payors / Plans 79.57 other 79.57 79.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM I131 RX CAP EA ADD MCI PX-343095171 CDM A9517 CPT 343 RC inpatient 12.48 12.23 All Payors / Plans All Payors / Plans 12.48 other 12.48 12.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99 CERETEC PX-343095210 CDM A9521 CPT 343 RC inpatient 1152.01 1128.97 All Payors / Plans All Payors / Plans 1152.01 other 1152.01 1152.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM I131 DX CAP PER MCI PX-343095280 CDM A9528 CPT 343 RC inpatient 9.98 9.78 All Payors / Plans All Payors / Plans 9.98 other 9.98 9.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M MEMBROFENIN PX-343095370 CDM A9537 CPT 343 RC inpatient 79.57 77.98 All Payors / Plans All Payors / Plans 79.57 other 79.57 79.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M DTPA PX-343095390 CDM A9539 CPT 343 RC inpatient 17.81 17.45 All Payors / Plans All Payors / Plans 17.81 other 17.81 17.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M MAA PX-343095400 CDM A9540 CPT 343 RC inpatient 138.95 136.17 All Payors / Plans All Payors / Plans 138.95 other 138.95 138.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M SULFUR COLLOID PX-343095410 CDM A9541 CPT 343 RC inpatient 76.91 75.37 All Payors / Plans All Payors / Plans 76.91 other 76.91 76.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM SULFUR COLLOID TC99M FILTERED PX-343095411 CDM A9541 CPT 343 RC inpatient 571.68 560.25 All Payors / Plans All Payors / Plans 571.68 other 571.68 571.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM SULFUR COLLOID FILTERED 2 PX-343095412 CDM A9541 CPT 343 RC inpatient 285.84 280.12 All Payors / Plans All Payors / Plans 285.84 other 285.84 285.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM IN111 ZEVALIN DX PX-343095420 CDM A9542 CPT 343 RC inpatient 3500 3430 All Payors / Plans All Payors / Plans 3500 other 3500 3500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM Y90 ZEVALIN RX PX-343095430 CDM A9543 CPT 343 RC inpatient 35000 34300 All Payors / Plans All Payors / Plans 35000 other 35000 35000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM IN111 OXINE PER 0.5 MCI PX-343095470 CDM A9547 CPT 343 RC inpatient 1572.48 1541.03 All Payors / Plans All Payors / Plans 1572.48 other 1572.48 1572.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM IN111 DTPA PER 0.5 MCI PX-343095480 CDM A9548 CPT 343 RC inpatient 446.56 437.63 All Payors / Plans All Payors / Plans 446.56 other 446.56 446.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M DMSA PX-343095510 CDM A9551 CPT 343 RC inpatient 412.58 404.33 All Payors / Plans All Payors / Plans 412.58 other 412.58 412.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99 NEUROLITE PX-343095570 CDM A9557 CPT 343 RC inpatient 1380.63 1353.02 All Payors / Plans All Payors / Plans 1380.63 other 1380.63 1380.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XE133 10MCI PX-343095580 CDM A9558 CPT 343 RC inpatient 44.55 43.66 All Payors / Plans All Payors / Plans 44.55 other 44.55 44.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XE133 20MCI PX-343095581 CDM A9558 CPT 343 RC inpatient 64.54 63.25 All Payors / Plans All Payors / Plans 64.54 other 64.54 64.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC Z NM TC99M TAG RRC PER DOSE 30MCI PX-343095600 CDM A9560 CPT 343 RC inpatient 35.64 34.93 All Payors / Plans All Payors / Plans 35.64 other 35.64 35.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M MAG3 PX-343095620 CDM A9562 CPT 343 RC inpatient 168.27 164.9 All Payors / Plans All Payors / Plans 168.27 other 168.27 168.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM P32 PHOSPHOCOL PER MCI PX-343095640 CDM A9564 CPT 343 RC inpatient 4969.1 4869.72 All Payors / Plans All Payors / Plans 4969.1 other 4969.1 4969.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM GA67 GALLIUM PER MCI PX-343095660 CDM A9556 CPT 343 RC inpatient 21.06 20.64 All Payors / Plans All Payors / Plans 21.06 other 21.06 21.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM TC99M DTPA AEROSOL PX-343095670 CDM A9567 CPT 343 RC inpatient 28.6 28.03 All Payors / Plans All Payors / Plans 28.6 other 28.6 28.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM TC99M LABELED WBC PER DOSE PX-343095690 CDM A9569 CPT 343 RC inpatient 1834.14 1797.46 All Payors / Plans All Payors / Plans 1834.14 other 1834.14 1834.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM INDIUM 111 WBC PX-343095700 CDM A9570 CPT 343 RC inpatient 2119.09 2076.71 All Payors / Plans All Payors / Plans 2119.09 other 2119.09 2119.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC I123 MIBG PX-343095820 CDM A9582 CPT 343 RC inpatient 2992.5 2932.65 All Payors / Plans All Payors / Plans 2992.5 other 2992.5 2992.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NM IODINE I-123 IOFLUPANE, DIAG, UP TO 5MCI" PX-343095840 CDM A9584 CPT 343 RC inpatient 1675 1641.5 All Payors / Plans All Payors / Plans 1675 other 1675 1675 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM SR89 METASTRON PER MCI PX-343096000 CDM A9600 CPT 343 RC inpatient 4969.1 4869.72 All Payors / Plans All Payors / Plans 4969.1 other 4969.1 4969.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM QUADRAMET SR153 PX-343096040 CDM A9604 CPT 343 RC inpatient 6441.37 6312.54 All Payors / Plans All Payors / Plans 6441.37 other 6441.37 6441.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM PROSTASCINT PX-343096420 CDM A4642 CPT 343 RC inpatient 2571.88 2520.44 All Payors / Plans All Payors / Plans 2571.88 other 2571.88 2571.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NM YTTIRIUM-90, THERASPHERE GLASS MICROSPHERES, BRACHTHERAPY SOURCE" PX-344000001 CDM C2616 CPT 344 RC inpatient 16262 15936.76 All Payors / Plans All Payors / Plans 16262 other 16262 16262 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT HEAD W/O CONTRAST PX-351704500 CDM 70450 CPT 351 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-HEAD SCAN W CONTRAST PX-351704600 CDM 70460 CPT 351 RC inpatient 155 151.9 All Payors / Plans All Payors / Plans 155 other 155 155 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-HEAD SCAN W/WO CONTRAST PX-351704700 CDM 70470 CPT 351 RC inpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CT ORBIT, SELLA POST FOSSA W/O CONTRAST" PX-351704800 CDM 70480 CPT 351 RC inpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CT ORBIT, SELLA POST FOSSA W CONTRAST" PX-351704810 CDM 70481 CPT 351 RC inpatient 300 294 All Payors / Plans All Payors / Plans 300 other 300 300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CT ORBIT, SELLA POST FOSSA W W/O" PX-351704820 CDM 70482 CPT 351 RC inpatient 332 325.36 All Payors / Plans All Payors / Plans 332 other 332 332 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-MAXILLOFACIAL WO CONTRAST PX-351704860 CDM 70486 CPT 351 RC inpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-MAXILLOFACIAL W CONTRAST PX-351704870 CDM 70487 CPT 351 RC inpatient 161 157.78 All Payors / Plans All Payors / Plans 161 other 161 161 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-MAXILLOFACIAL W/WO CONTRAS PX-351704880 CDM 70488 CPT 351 RC inpatient 207 202.86 All Payors / Plans All Payors / Plans 207 other 207 207 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-NECK SCAN W/O CONTRAST PX-351704900 CDM 70490 CPT 351 RC inpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-NECK SCAN W CONTRAST PX-351704910 CDM 70491 CPT 351 RC inpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-NECK SCAN W/WO CONTRAST PX-351704920 CDM 70492 CPT 351 RC inpatient 300 294 All Payors / Plans All Payors / Plans 300 other 300 300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT LUNG CANCER SCREENING PX-352002970 CDM 71271 CPT 352 RC inpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT PERFUSION CEREBRAL W CONTRAST PX-352004200 CDM 0042T CPT 352 RC inpatient 373 365.54 All Payors / Plans All Payors / Plans 373 other 373 373 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CT GUIDE DRAIN CATH ABD WALL,NECK" PX-352100300 CDM 10030 CPT 352 RC inpatient 181 177.38 All Payors / Plans All Payors / Plans 181 other 181 181 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GU SOFT TIS LOC DEVICE 1ST LESION PX-352100350 CDM 10035 CPT 352 RC inpatient 181 177.38 All Payors / Plans All Payors / Plans 181 other 181 181 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GU SOFT TIS LOC DEVICE EA ADD LESION PX-352100360 CDM 10036 CPT 352 RC inpatient 104 101.92 All Payors / Plans All Payors / Plans 104 other 104 104 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUID RFREQ BONE TUMOR SFT TISS PX-352209820 CDM 20982 CPT 352 RC inpatient 207 202.86 All Payors / Plans All Payors / Plans 207 other 207 207 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUID CRYOBLATION BONE TUMOR PX-352209830 CDM 20983 CPT 352 RC inpatient 207 202.86 All Payors / Plans All Payors / Plans 207 other 207 207 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT LUNG NEEDLE BIOPSY PX-352324080 CDM 32408 CPT 361 RC inpatient 2190 2146.2 All Payors / Plans All Payors / Plans 2190 other 2190 2190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUID CRYOBLATION LIVER TUMOR PX-352473830 CDM 47383 CPT 352 RC inpatient 207 202.86 All Payors / Plans All Payors / Plans 207 other 207 207 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUIDE CATH DRAIN VISCERAL PX-352494050 CDM 49405 CPT 352 RC inpatient 181 177.38 All Payors / Plans All Payors / Plans 181 other 181 181 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUIDE CATH PERITON RETROPER PX-352494060 CDM 49406 CPT 352 RC inpatient 181 177.38 All Payors / Plans All Payors / Plans 181 other 181 181 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUIDE CTH PER RETROP TRANSRECT PX-352494070 CDM 49407 CPT 352 RC inpatient 181 177.38 All Payors / Plans All Payors / Plans 181 other 181 181 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT TMJ (ALSO FOR SELLA) PX-352704800 CDM 70480 CPT 352 RC inpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA HEAD PX-352704960 CDM 70496 CPT 352 RC inpatient 300 294 All Payors / Plans All Payors / Plans 300 other 300 300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA NECK PX-352704980 CDM 70498 CPT 352 RC inpatient 295 289.1 All Payors / Plans All Payors / Plans 295 other 295 295 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT THORAX W/O CONTRAST PX-352712500 CDM 71250 CPT 352 RC inpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-THORAX SCAN W CONTRAST PX-352712600 CDM 71260 CPT 352 RC inpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT THORAX W/CONTRAST CARDIAC PX-352712601 CDM 71260 CPT 352 RC inpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-THORAX W/WO CONTRAST PX-352712700 CDM 71270 CPT 352 RC inpatient 300 294 All Payors / Plans All Payors / Plans 300 other 300 300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA CHEST PX-352712750 CDM 71275 CPT 352 RC inpatient 306 299.88 All Payors / Plans All Payors / Plans 306 other 306 306 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-C SPINE W/O CONTRAST PX-352721250 CDM 72125 CPT 352 RC inpatient 192 188.16 All Payors / Plans All Payors / Plans 192 other 192 192 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-C SPINE W CONTRAST PX-352721260 CDM 72126 CPT 352 RC inpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-C SPINE W/WO CONTRAST PX-352721270 CDM 72127 CPT 352 RC inpatient 300 294 All Payors / Plans All Payors / Plans 300 other 300 300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-T SPINE W/O CONTRAST PX-352721280 CDM 72128 CPT 352 RC inpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-T SPINE W CONTRAST PX-352721290 CDM 72129 CPT 352 RC inpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-T SPINE W/WO CONTRAST PX-352721300 CDM 72130 CPT 352 RC inpatient 300 294 All Payors / Plans All Payors / Plans 300 other 300 300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-L SPINE W/O CONTRAST PX-352721310 CDM 72131 CPT 352 RC inpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-L SPINE W CONTRAST PX-352721320 CDM 72132 CPT 352 RC inpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-L SPINE W/WO CONTRAST PX-352721330 CDM 72133 CPT 352 RC inpatient 300 294 All Payors / Plans All Payors / Plans 300 other 300 300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA PELVIS PX-352721910 CDM 72191 CPT 352 RC inpatient 311 304.78 All Payors / Plans All Payors / Plans 311 other 311 311 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT PELVIS W/O CONTRAST PX-352721920 CDM 72192 CPT 352 RC inpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-PELVIS SCAN W CONTRAST PX-352721930 CDM 72193 CPT 352 RC inpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-PELVIS SCAN W/WO CONTRAST PX-352721940 CDM 72194 CPT 352 RC inpatient 290 284.2 All Payors / Plans All Payors / Plans 290 other 290 290 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT UPPER EXTREM WO CONTRAST PX-352732000 CDM 73200 CPT 352 RC inpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT UPPER EXTREM W CONTRAST PX-352732010 CDM 73201 CPT 352 RC inpatient 238 233.24 All Payors / Plans All Payors / Plans 238 other 238 238 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT UPPER EXTREM WWO CONTRAST PX-352732020 CDM 73202 CPT 350 RC inpatient 316 309.68 All Payors / Plans All Payors / Plans 316 other 316 316 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA UPPER EXTREMITY PX-352732060 CDM 73206 CPT 352 RC inpatient 347 340.06 All Payors / Plans All Payors / Plans 347 other 347 347 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT LOWER EXTREM WO CONTRAST PX-352737000 CDM 73700 CPT 352 RC inpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT LOWER EXTREM W CONTRAST PX-352737010 CDM 73701 CPT 352 RC inpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT LOWER EXTR WWO CONTRAST PX-352737020 CDM 73702 CPT 352 RC inpatient 311 304.78 All Payors / Plans All Payors / Plans 311 other 311 311 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA LOWER EXTREMITY PX-352737060 CDM 73706 CPT 352 RC inpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT ABDOMEN W/O CONTRAST PX-352741500 CDM 74150 CPT 352 RC inpatient 130 127.4 All Payors / Plans All Payors / Plans 130 other 130 130 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-ABDOMEN W CONTRAST PX-352741600 CDM 74160 CPT 352 RC inpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-ABDOMEN W/WO CONTRAST PX-352741700 CDM 74170 CPT 352 RC inpatient 280 274.4 All Payors / Plans All Payors / Plans 280 other 280 280 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA ABD/PEL W CONTRAST PX-352741740 CDM 74174 CPT 352 RC inpatient 404 395.92 All Payors / Plans All Payors / Plans 404 other 404 404 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA ABDOMEN PX-352741750 CDM 74175 CPT 352 RC inpatient 316 309.68 All Payors / Plans All Payors / Plans 316 other 316 316 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT ABD AND PELVIS W/O CONTRAST PX-352741760 CDM 74176 CPT 352 RC inpatient 166 162.68 All Payors / Plans All Payors / Plans 166 other 166 166 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT ABD AND PELVIS W CONTRAST PX-352741770 CDM 74177 CPT 352 RC inpatient 321 314.58 All Payors / Plans All Payors / Plans 321 other 321 321 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT ABD AND PELVIS 1+ SECTION/REG PX-352741780 CDM 74178 CPT 352 RC inpatient 368 360.64 All Payors / Plans All Payors / Plans 368 other 368 368 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T ABD/PELVIS UROGRAM W&W/O PX-352741781 CDM 74178 CPT 352 RC inpatient 368 360.64 All Payors / Plans All Payors / Plans 368 other 368 368 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT HEART WOUT CONTRST CORO CALC PX-352755710 CDM 75571 CPT 352 RC inpatient 104 101.92 All Payors / Plans All Payors / Plans 104 other 104 104 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA HEART W CONTRAST PX-352755720 CDM 75572 CPT 352 RC inpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT CTA HEARTCARD STRU MORPH CONGE PX-352755730 CDM 75573 CPT 352 RC inpatient 383 375.34 All Payors / Plans All Payors / Plans 383 other 383 383 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA HEART CARD W CONTRAST PX-352755740 CDM 75574 CPT 352 RC inpatient 440 431.2 All Payors / Plans All Payors / Plans 440 other 440 440 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA AORTA W RUNOFF W CONTRST POST PX-352756350 CDM 75635 CPT 350 RC inpatient 383 375.34 All Payors / Plans All Payors / Plans 383 other 383 383 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUIDED TUBE PLACEMENT PX-352759890 CDM 75989 CPT 352 RC inpatient 803 786.94 All Payors / Plans All Payors / Plans 803 other 803 803 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-3D/MULTIPLANAR RECONSTRUCTION PX-352763770 CDM 76377 CPT 352 RC inpatient 47 46.06 All Payors / Plans All Payors / Plans 47 other 47 47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUIDED NEEDLE BIOPSY PX-352770120 CDM 77012 CPT 352 RC inpatient 1241 1216.18 All Payors / Plans All Payors / Plans 1241 other 1241 1241 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUIDANCE TISSUE ABLATION PX-352770130 CDM 77013 CPT 352 RC inpatient 2482 2432.36 All Payors / Plans All Payors / Plans 2482 other 2482 2482 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT-THERAPY PLAN PX-352770140 CDM 77014 CPT 352 RC inpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT BONE DENSITY AXIAL 1 OR > SITE PX-352770780 CDM 77078 CPT 352 RC inpatient 150 147 All Payors / Plans All Payors / Plans 150 other 150 150 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000000 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000001 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000002 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000003 CDM 360 RC inpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000004 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000005 CDM 360 RC inpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000006 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000007 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000008 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000009 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000010 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000011 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000012 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000013 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000014 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000015 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000016 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000017 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000018 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000019 CDM 360 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPECIAL PROCEDURES MINUTES PX-360000020 CDM 361 RC inpatient 73 71.54 All Payors / Plans All Payors / Plans 73 other 73 73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM INJ RADIOACT TRAC SENT NODE PX-360387920 CDM 38792 CPT 360 RC inpatient 125 122.5 All Payors / Plans All Payors / Plans 125 other 125 125 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INSERTION DRUG DELIVERY IMPLANT PX-361119810 CDM 11981 CPT 361 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC REMOVE DRUG IMPLANT DEVICE PX-361119820 CDM 11982 CPT 361 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC REMOVE W REINSERTION DRUG IMPLANT PX-361119830 CDM 11983 CPT 361 RC inpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CRYOSURGERY SKIN LESIONS UP TO 14 PX-361171100 CDM 17110 CPT 360 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US PERCUT NDL CORE W IMAG 1ST LES PX-361190830 CDM 19083 CPT 361 RC inpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC INJECTION(S);SINGLE OR MULTIPLE TRIGGER POINTS, 1 OR 2 MUSCLES" PX-361205529 CDM 20552 CPT 361 RC inpatient 29 28.42 All Payors / Plans All Payors / Plans 29 other 29 29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC EXCISE BENIGN LESION TURN, ARM,LEGS .6-1.0 CM" PX-361206009 CDM 11401 CPT 361 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC EXCISE MALIG LESION TRUNK,ARMS,LEGS .6-1.0 CM" PX-361206059 CDM 11601 CPT 361 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC EXCISE MALIG LESION TRUNK,ARMS,LEGS 1.0-2.0 CM" PX-361206109 CDM 11602 CPT 361 RC inpatient 185 181.3 All Payors / Plans All Payors / Plans 185 other 185 185 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC INJECT, INTRALESIONAL UP TO & INCLUDE 7 LESIONS" PX-361206119 CDM 11900 CPT 361 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC ABDOMINAL PARACENTESIS, WITH IMAGE GUIDE" PX-361206129 CDM 49083 CPT 361 RC inpatient 385 377.3 All Payors / Plans All Payors / Plans 385 other 385 385 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC EXCISE BENIGN LESION TRUNK,ARMS,LEGS 1.1-2.0 CM" PX-361266709 CDM 11402 CPT 361 RC inpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC EXCISE BENIGN LESION FACE,EARS,EYELID,NOSE .5CM OR<" PX-361272669 CDM 11440 CPT 361 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC EXCISE BENIGN LESION SCALP,NECK,HANDS,FEET .6-1.0CM" PX-361278409 CDM 11421 CPT 361 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDOTRACHEAL INTUBATION OR ASSIST PX-361315000 CDM 31500 CPT 361 RC inpatient 356 348.88 All Payors / Plans All Payors / Plans 356 other 356 356 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC REMOVAL SKIN TAGS, ANY AREA, UP TO & INCLUDE 15" PX-361325569 CDM 11200 CPT 361 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC INJECTION(S) SINGLE TENDON SHEATH OR LIGAMENT PX-361437609 CDM 20550 CPT 361 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC ARTHROCENT, ASPIRAT &/OR INJECT, INTERM JOINT/BURSA" PX-361437629 CDM 20605 CPT 361 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC I&D ABSCESS, SIMPLE" PX-361490829 CDM 10060 CPT 361 RC inpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC ARTHROCENT,APSIRAT &/OR INJECT, MAJOR JOINT/BURSA" PX-361490839 CDM 20610 CPT 361 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR REP GASTRO JEJUNGO UNDER FLUO PX-361494400 CDM 49440 CPT 361 RC inpatient 256 250.88 All Payors / Plans All Payors / Plans 256 other 256 256 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR REP DUOD/JEJUNO TUBE W FLUORO PX-361494510 CDM 49451 CPT 361 RC inpatient 256 250.88 All Payors / Plans All Payors / Plans 256 other 256 256 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLADDER INSTILLATION ANTICARCIN PX-361517200 CDM 51720 CPT 361 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN I&D VULVA OR PERINEAL ABSCESS PX-361564050 CDM 56405 CPT 361 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN I&D BARTHOLINS GLAND ABSCESS PX-361564200 CDM 56420 CPT 361 RC inpatient 29 28.42 All Payors / Plans All Payors / Plans 29 other 29 29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN DESTR VULVA LESION PX-361565010 CDM 56501 CPT 361 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC GYN DESTR VULVA LESION PX-361565019 CDM 56501 CPT 361 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN VULVAR BIOPSY PX-361566050 CDM 56605 CPT 361 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN COLPOSCOPY VULVA PX-361568200 CDM 56820 CPT 361 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN COLPOSCOPY VULVA W BIOPSY PX-361568210 CDM 56821 CPT 361 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN VAGINA BIOPSY PX-361571000 CDM 57100 CPT 361 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC FIT/INSERTION PESSARY, OTHER INTRAVAGINAL DEVICE" PX-361571609 CDM 57160 CPT 361 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN COLPOSCOPY VAGINA PX-361574200 CDM 57420 CPT 361 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC GYN COLPOSCOPY VAGINA PX-361574209 CDM 57420 CPT 361 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN COLPOSCOPY VAGINA W BIOPSY PX-361574210 CDM 57421 CPT 361 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN COLPOSCOPY CX/UPPER VAGINA PX-361574520 CDM 57452 CPT 361 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN COLPO W CERVICAL BIOPSY/ECC PX-361574540 CDM 57454 CPT 361 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC GYN COLPO W CERVICAL BIOPSY/ECC PX-361574549 CDM 57454 CPT 361 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN COLPOSCOPY W CERVICAL BIOPSY PX-361574550 CDM 57455 CPT 361 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN COLPOSCOPY W ECC PX-361574560 CDM 57456 CPT 361 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN BIOPSY OF CERVIX PX-361575000 CDM 57500 CPT 361 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN ENDOCERVICAL CURETTAGE PX-361575050 CDM 57505 CPT 361 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN ECC PX-361575051 CDM 57505 CPT 361 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC ENDOCERVICL CURRETAGE PX-361575052 CDM 57505 CPT 361 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN CAUTERIZATION CERVIX/CRYOCAUT PX-361575110 CDM 57511 CPT 361 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN ENDOMETRIAL BIOPSY PX-361581000 CDM 58100 CPT 361 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC GYN ENDOMETRIAL BIOPSY PX-361581009 CDM 58100 CPT 361 RC inpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN ENDOMETRIAL BIOPSY W COLP ADD PX-361581100 CDM 58110 CPT 361 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC GYN INSERTION IUD PX-361583009 CDM 58300 CPT 361 RC inpatient 157 153.86 All Payors / Plans All Payors / Plans 157 other 157 157 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN REMOVAL IUD PX-361583010 CDM 58301 CPT 361 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC GYN REMOVAL IUD PX-361583019 CDM 58301 CPT 361 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LUMBAR PUNCTURE PX-361622700 CDM 62328 CPT 361 RC inpatient 967 947.66 All Payors / Plans All Payors / Plans 967 other 967 967 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FACET INJECTION PX-361644120 CDM 64412 CPT 361 RC inpatient 370 362.6 All Payors / Plans All Payors / Plans 370 other 370 370 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CERUMEN REMOVAL PX-361692098 CDM 69209 CPT 361 RC inpatient 29 28.42 All Payors / Plans All Payors / Plans 29 other 29 29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CERUMEN REMOVAL BILATERAL PX-361692099 CDM 69209 CPT 361 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPLICATION ON-BODY INJECTOR TIMED SUBCUTANEOUS INJ PX-361963770 CDM 96377 CPT 361 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANESTHESIOLOGY PX-370000000 CDM 370 RC inpatient 2.1 2.06 All Payors / Plans All Payors / Plans 2.1 other 2.1 2.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PH, HLA MATCHED LEUKORED, EA UNIT" PX-381090520 CDM P9052 CPT 390 RC inpatient 1367 1339.66 All Payors / Plans All Payors / Plans 1367 other 1367 1367 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LEUKOPOOR RBC'S PX-390090160 CDM P9016 CPT 390 RC inpatient 239 234.22 All Payors / Plans All Payors / Plans 239 other 239 239 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RHOGAM (UF) PX-390903840 CDM 90384 CPT 390 RC inpatient 75 73.5 All Payors / Plans All Payors / Plans 75 other 75 75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PSOORALEN TREATED PLATELETS PX-390907300 CDM P9073 CPT 390 RC inpatient 703.7 689.63 All Payors / Plans All Payors / Plans 703.7 other 703.7 703.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLATELET PHERESIS LEUKOREDUCED IRRADIATED PX-390P90370 CDM P9037 CPT 390 RC inpatient 713.5 699.23 All Payors / Plans All Payors / Plans 713.5 other 713.5 713.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RBC LEUKOREDUCED IRRADIATED PX-390P90400 CDM P9040 CPT 390 RC inpatient 239 234.22 All Payors / Plans All Payors / Plans 239 other 239 239 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLASMA PROCESSING FEE PX-391000000 CDM P9017 CPT 390 RC inpatient 56 54.88 All Payors / Plans All Payors / Plans 56 other 56 56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CRYOPRECIPITATE PROCESSING FEE PX-391000001 CDM P9012 CPT 390 RC inpatient 347 340.06 All Payors / Plans All Payors / Plans 347 other 347 347 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RED BLOOD CELL PROCESS FEE PX-391000002 CDM P9016 CPT 390 RC inpatient 228 223.44 All Payors / Plans All Payors / Plans 228 other 228 228 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRANSFUS,BLOOD/BLOOD COMP 0-90MIN" PX-391364300 CDM 36430 CPT 391 RC inpatient 363 355.74 All Payors / Plans All Payors / Plans 363 other 363 363 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRANSF,BLOOD/BLOOD COMP 91-150MIN" PX-391364301 CDM 36430 CPT 391 RC inpatient 528 517.44 All Payors / Plans All Payors / Plans 528 other 528 528 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRANSF,BLOOD/BLOOD COMP 151-210MI" PX-391364302 CDM 36430 CPT 391 RC inpatient 693 679.14 All Payors / Plans All Payors / Plans 693 other 693 693 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRANSF,BLOOD/BLOOD COMP 211-270MI" PX-391364303 CDM 36430 CPT 391 RC inpatient 858 840.84 All Payors / Plans All Payors / Plans 858 other 858 858 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRANSF,BLOOD/BLOOD COMP 271-330MI" PX-391364304 CDM 36430 CPT 391 RC inpatient 1023 1002.54 All Payors / Plans All Payors / Plans 1023 other 1023 1023 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRANSF,BLOOD/BLOOD COMP 331-390MI" PX-391364305 CDM 36430 CPT 391 RC inpatient 1188 1164.24 All Payors / Plans All Payors / Plans 1188 other 1188 1188 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRANSF,BLOOD/BLOOD COMP 391-450MI" PX-391364306 CDM 36430 CPT 391 RC inpatient 1353 1325.94 All Payors / Plans All Payors / Plans 1353 other 1353 1353 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRANSF,BLOOD/BLOOD COMP 451-510MI" PX-391364307 CDM 36430 CPT 391 RC inpatient 1518 1487.64 All Payors / Plans All Payors / Plans 1518 other 1518 1518 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RED BLOOD CELL PROCESS FEE(A) PX-391868900 CDM 86890 CPT 391 RC inpatient 149 146.02 All Payors / Plans All Payors / Plans 149 other 149 149 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PHERESIS (PLATELETS) PX-399090350 CDM P9035 CPT 390 RC inpatient 674 660.52 All Payors / Plans All Payors / Plans 674 other 674 674 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STEREOTACTIC BREAST BIOPSY PX-401190810 CDM 19081 CPT 401 RC inpatient 682 668.36 All Payors / Plans All Payors / Plans 682 other 682 682 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD US BREAST BIOPSY 1ST LESION PX-401190830 CDM 19083 CPT 402 RC inpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US BREAST NEEDLE BIOPSY EA ADD PX-401190840 CDM 19084 CPT 402 RC inpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD MAMMO LOCALIZATION EA ADDL PX-401192820 CDM 19282 CPT 401 RC inpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD US NEEDLE BREAST GUIDE 1ST PX-401192850 CDM 19285 CPT 402 RC inpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BREAST SURGICAL SPECIMEN (2) PX-401760980 CDM 76098 CPT 401 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD DUCTOGRAM RT PX-401770535 CDM 77053 CPT 401 RC inpatient 52 50.96 All Payors / Plans All Payors / Plans 52 other 52 52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD DUCTOGRAM LT PX-401770536 CDM 77053 CPT 401 RC inpatient 52 50.96 All Payors / Plans All Payors / Plans 52 other 52 52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD CAD MAMMOGRAM DIAG UNILATERAL PX-401770650 CDM 77065 CPT 401 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WIRE LOCAL LYMPH NODE ONLY PX-402100350 CDM 10035 CPT 402 RC inpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US NEEDLE LOC BREAST GUIDE ADD PX-402192860 CDM 19286 CPT 402 RC inpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US THORA PX-402325550 CDM 32555 CPT 361 RC inpatient 1168 1144.64 All Payors / Plans All Payors / Plans 1168 other 1168 1168 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUIDE RF ABLAT LIVER OPEN 1OR> PX-402473800 CDM 47380 CPT 402 RC inpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUIDE CRYO ABLAT LIVR OPN 1OR> PX-402473810 CDM 47381 CPT 402 RC inpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUIDE RF ABLAT LIVER PERC 1OR> PX-402473820 CDM 47382 CPT 402 RC inpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUIDE CRYO ABLAT LIVR PER 1OR> PX-402473830 CDM 47383 CPT 402 RC inpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUIDE ABD PARACENTESIS PX-402490830 CDM 49083 CPT 402 RC inpatient 1825 1788.5 All Payors / Plans All Payors / Plans 1825 other 1825 1825 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUID PLEURAL DRAIN TUBE PX-402494050 CDM 49405 CPT 402 RC inpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC US GUID PERIT,RETRO DRAIN TUBE" PX-402494060 CDM 49406 CPT 361 RC inpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUID CTH PER PERITON RETRO PX-402494070 CDM 49407 CPT 402 RC inpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CATH AND INTRO OF SALINE CONTRAST PX-402583400 CDM 58340 CPT 402 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NEONATE CRANIAL SONO PX-402765060 CDM 76506 CPT 402 RC inpatient 682 668.36 All Payors / Plans All Payors / Plans 682 other 682 682 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROID SONOGRAPHY PX-402765360 CDM 76536 CPT 402 RC inpatient 711 696.78 All Payors / Plans All Payors / Plans 711 other 711 711 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEST PX-402766040 CDM 76604 CPT 402 RC inpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US BREAST PX-402766410 CDM 76641 CPT 402 RC inpatient 569 557.62 All Payors / Plans All Payors / Plans 569 other 569 569 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD BREAST ULTRASOUND UNI RT PX-402766415 CDM 76641 CPT 402 RC inpatient 94 92.12 All Payors / Plans All Payors / Plans 94 other 94 94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD BREAST ULTRASOUND UNI LT PX-402766416 CDM 76641 CPT 402 RC inpatient 94 92.12 All Payors / Plans All Payors / Plans 94 other 94 94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD US BREAST UNI LIMITED FOCUS PX-402766420 CDM 76642 CPT 402 RC inpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD BREAST ULTRASOUND LIMITED RT PX-402766425 CDM 76642 CPT 402 RC inpatient 72 70.56 All Payors / Plans All Payors / Plans 72 other 72 72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD BREAST ULTRASOUND LIMITED LT PX-402766426 CDM 76642 CPT 402 RC inpatient 72 70.56 All Payors / Plans All Payors / Plans 72 other 72 72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ABDOMEN COMPLETE PX-402767000 CDM 76700 CPT 402 RC inpatient 654 640.92 All Payors / Plans All Payors / Plans 654 other 654 654 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ABDOMEN LIMITED B PX-402767050 CDM 76705 CPT 402 RC inpatient 512 501.76 All Payors / Plans All Payors / Plans 512 other 512 512 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RETROPERITONEAL COMPLETE PX-402767700 CDM 76770 CPT 402 RC inpatient 625 612.5 All Payors / Plans All Payors / Plans 625 other 625 625 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US RETROPERITONEAL LTD PX-402767750 CDM 76775 CPT 402 RC inpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SONOGRAM OF TRANSPLANT KIDNEY PX-402767760 CDM 76776 CPT 402 RC inpatient 967 947.66 All Payors / Plans All Payors / Plans 967 other 967 967 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPINAL CANAL PX-402768000 CDM 76800 CPT 402 RC inpatient 654 640.92 All Payors / Plans All Payors / Plans 654 other 654 654 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OB 1ST TRIMESTER PX-402768010 CDM 76801 CPT 402 RC inpatient 597 585.06 All Payors / Plans All Payors / Plans 597 other 597 597 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OB 2ND & 3RD TRIMESTER PX-402768050 CDM 76805 CPT 402 RC inpatient 739 724.22 All Payors / Plans All Payors / Plans 739 other 739 739 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PREGNANCY EXAM MULTIPLE GESTATION PX-402768100 CDM 76810 CPT 402 RC inpatient 341 334.18 All Payors / Plans All Payors / Plans 341 other 341 341 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OB COMPLETE DETAILED PX-402768110 CDM 76811 CPT 402 RC inpatient 682 668.36 All Payors / Plans All Payors / Plans 682 other 682 682 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US OB COMPLETE DETAILED EA ADDL GESTATION PX-402768120 CDM 76812 CPT 402 RC inpatient 910 891.8 All Payors / Plans All Payors / Plans 910 other 910 910 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US OB NUCHAL TRANSLUCENCY 1 GEST PX-402768130 CDM 76813 CPT 402 RC inpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US OB NUCHAL TRANSLUCENCY ADD GES PX-402768140 CDM 76814 CPT 402 RC inpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US OB LIMITED PX-402768150 CDM 76815 CPT 402 RC inpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC US, PREGNANT UTERUS, TRANSVAGINAL" PX-402768170 CDM 76817 CPT 402 RC inpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIOPHYS PROFILE W/ NON STRESS PX-402768190 CDM 76819 CPT 402 RC inpatient 398 390.04 All Payors / Plans All Payors / Plans 398 other 398 398 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DOPPLER FETAL UMBILICAL ARTERY PX-402768200 CDM 76820 CPT 402 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DOPPLER FETAL MIDDLE CEREBRAL ART PX-402768210 CDM 76821 CPT 402 RC inpatient 455 445.9 All Payors / Plans All Payors / Plans 455 other 455 455 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRANSVAGINAL SONOGRAM PX-402768300 CDM 76830 CPT 402 RC inpatient 711 696.78 All Payors / Plans All Payors / Plans 711 other 711 711 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HYSTEROSONOGRAPHY SALINE SOL PX-402768310 CDM 76831 CPT 402 RC inpatient 219 214.62 All Payors / Plans All Payors / Plans 219 other 219 219 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PELVIC SONOGRAM PX-402768560 CDM 76856 CPT 402 RC inpatient 597 585.06 All Payors / Plans All Payors / Plans 597 other 597 597 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SONO PELVIS LIMITED PX-402768570 CDM 76857 CPT 402 RC inpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SCROTUM SONOGRAM PX-402768700 CDM 76870 CPT 402 RC inpatient 284 278.32 All Payors / Plans All Payors / Plans 284 other 284 284 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXTREMITY PX-402768810 CDM 76881 CPT 402 RC inpatient 711 696.78 All Payors / Plans All Payors / Plans 711 other 711 711 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US AXILLARY PX-402768820 CDM 76882 CPT 402 RC inpatient 85 83.3 All Payors / Plans All Payors / Plans 85 other 85 85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US HIPS BILATERAL PX-402768850 CDM 76885 CPT 402 RC inpatient 881 863.38 All Payors / Plans All Payors / Plans 881 other 881 881 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUIDANCE TISSUE ABLATION PX-402769400 CDM 76940 CPT 402 RC inpatient 1095 1073.1 All Payors / Plans All Payors / Plans 1095 other 1095 1095 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ULTRASONIC NEEDLE GUIDE BIOPSY PX-402769420 CDM 76942 CPT 402 RC inpatient 1095 1073.1 All Payors / Plans All Payors / Plans 1095 other 1095 1095 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL PSA INJECTION U/S GUIDE PX-402769421 CDM 76942 CPT 402 RC inpatient 1095 1073.1 All Payors / Plans All Payors / Plans 1095 other 1095 1095 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMNINOCENTESIS PX-402769460 CDM 76946 CPT 402 RC inpatient 341 334.18 All Payors / Plans All Payors / Plans 341 other 341 341 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC US GUIDANCE,INTRAOPERATIVE" PX-402769980 CDM 76998 CPT 402 RC inpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY REHAB-OTHER PX-410002390 CDM G0239 CPT 410 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY REHAB-OTHER >36 PX-410020390 CDM G0239 CPT 410 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MANUAL VENTILATION PX-410147992 CDM 94799 CPT 410 RC inpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SUCTIONING PX-410317200 CDM 31720 CPT 410 RC inpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPR PX-410929500 CDM 92950 CPT 410 RC inpatient 320 313.6 All Payors / Plans All Payors / Plans 320 other 320 320 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MECH VENT ADULT PX-410940020 CDM 94002 CPT 410 RC inpatient 1000 980 All Payors / Plans All Payors / Plans 1000 other 1000 1000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VENTILATOR - 1ST DAY PX-410940021 CDM 94002 CPT 410 RC inpatient 960 940.8 All Payors / Plans All Payors / Plans 960 other 960 960 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MECH VENT NEONATE PX-410940022 CDM 94002 CPT 410 RC inpatient 1200 1176 All Payors / Plans All Payors / Plans 1200 other 1200 1200 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MECH VENT SUBSEQUENT ADULT PX-410940030 CDM 94003 CPT 410 RC inpatient 1000 980 All Payors / Plans All Payors / Plans 1000 other 1000 1000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VENTILATOR/SUBSEQUENT DAYS PX-410940031 CDM 94003 CPT 410 RC inpatient 840 823.2 All Payors / Plans All Payors / Plans 840 other 840 840 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MECH VENT SUBSEQUENT NEONATE PX-410940032 CDM 94003 CPT 410 RC inpatient 1200 1176 All Payors / Plans All Payors / Plans 1200 other 1200 1200 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MDI INITIAL PX-410946404 CDM 94640 CPT 410 RC inpatient 160 156.8 All Payors / Plans All Payors / Plans 160 other 160 160 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONT NEB W/BRONCHODILATOR FIRST HR PX-410946407 CDM 94644 CPT 410 RC inpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONT NEB W/BRONCHODILAT ADDL HR PX-410946408 CDM 94645 CPT 410 RC inpatient 112 109.76 All Payors / Plans All Payors / Plans 112 other 112 112 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HAND HELD NEBULIZER/IPPB/MDI-IP PX-410946409 CDM 94640 CPT 410 RC inpatient 1920 1881.6 All Payors / Plans All Payors / Plans 1920 other 1920 1920 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HAND HELD NEBULIZER/IBB/MDI-OP PX-410946410 CDM 94640 CPT 410 RC inpatient 160 156.8 All Payors / Plans All Payors / Plans 160 other 160 160 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPAP PX-410946600 CDM 94660 CPT 410 RC inpatient 480 470.4 All Payors / Plans All Payors / Plans 480 other 480 480 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIPAP/CPAP PX-410946601 CDM 94660 CPT 410 RC inpatient 469 459.62 All Payors / Plans All Payors / Plans 469 other 469 469 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPT&POSTUAL DRAIN INITIAL RX 2POS PX-410946670 CDM 94667 CPT 410 RC inpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPT&POSTUAL DRAIN INITIAL RX 4POS PX-410946671 CDM 94667 CPT 410 RC inpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACAPELLA INITIAL RX PX-410946672 CDM 94667 CPT 410 RC inpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INEXSUFFILATOR INITIAL RX PX-410946673 CDM 94667 CPT 410 RC inpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPT&POSTUAL DRAIN SUBSEQ RX 2 POS PX-410946680 CDM 94668 CPT 410 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPT&POSTUAL DRAIN SUBSEQ RX 4 POS PX-410946681 CDM 94668 CPT 410 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACAPELLA SUB RX PX-410946682 CDM 94668 CPT 410 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INEXSUFFILATOR SUB RX PX-410946683 CDM 94668 CPT 410 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULSE OXIMETRY CONTINUOUS PX-410947620 CDM 94762 CPT 410 RC inpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPREHENSIVE PATIENT ASSESSMENTS PX-410947991 CDM 94799 CPT 410 RC inpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDOTRACHEAL TUBE CARE NON VENTED PX-410947992 CDM 94799 CPT 410 RC inpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRACHEOSTOMY TUBE CARE PX-410947993 CDM 94799 CPT 410 RC inpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPONTANEOUS MECHANICS NON VENTED PX-410947994 CDM 94799 CPT 410 RC inpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONTINOUS AEROSOL RX INITIAL DAY PX-410947995 CDM 94799 CPT 410 RC inpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONTINOUS AEROSOL RX SUBSEQ DAY PX-410947996 CDM 94799 CPT 410 RC inpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OXYGEN THERAPY INITIAL DAY PX-410947997 CDM 94799 CPT 410 RC inpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OXYGEN THERAPY SUBSEQ DAY PX-410947998 CDM 94799 CPT 410 RC inpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HBO2 TX - 16-46 MIN PX-413991830 CDM G0277 CPT 413 RC inpatient 391 383.18 All Payors / Plans All Payors / Plans 391 other 391 391 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HBO PER 30 MINS PX-413991831 CDM 99183 CPT 413 RC inpatient 782 766.36 All Payors / Plans All Payors / Plans 782 other 782 782 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HBO2 TX - 78-108 MIN PX-413991832 CDM G0277 CPT 413 RC inpatient 1173 1149.54 All Payors / Plans All Payors / Plans 1173 other 1173 1173 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HBO2 TX - 109-139 MIN PX-413991833 CDM G0277 CPT 413 RC inpatient 1564 1532.72 All Payors / Plans All Payors / Plans 1564 other 1564 1564 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG ARM SPLINT 23-37 PX-420291050 CDM 29105 CPT 420 RC inpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG ARM SPLINT 38-52 PX-420291051 CDM 29105 CPT 420 RC inpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG ARM SPLINT 53-67 PX-420291052 CDM 29105 CPT 420 RC inpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG ARM SPLINT 68-82 PX-420291053 CDM 29105 CPT 420 RC inpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG ARM SPLINT 8-22 PX-420291054 CDM 29105 CPT 420 RC inpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM STATIC 8-22 PX-420291250 CDM 29125 CPT 420 RC inpatient 316 309.68 All Payors / Plans All Payors / Plans 316 other 316 316 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM STATIC 23-37 PX-420291251 CDM 29125 CPT 420 RC inpatient 316 309.68 All Payors / Plans All Payors / Plans 316 other 316 316 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM STATIC 38-52 PX-420291252 CDM 29125 CPT 420 RC inpatient 316 309.68 All Payors / Plans All Payors / Plans 316 other 316 316 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM STATIC 53-67 PX-420291253 CDM 29125 CPT 420 RC inpatient 316 309.68 All Payors / Plans All Payors / Plans 316 other 316 316 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM STATIC 68-82 PX-420291254 CDM 29125 CPT 420 RC inpatient 316 309.68 All Payors / Plans All Payors / Plans 316 other 316 316 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM SPLINT DYNAM 8-22 PX-420291260 CDM 29126 CPT 420 RC inpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM DYNAMIC 23-37 PX-420291261 CDM 29126 CPT 420 RC inpatient 406 397.88 All Payors / Plans All Payors / Plans 406 other 406 406 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM DYNAMIC 38-52 PX-420291262 CDM 29126 CPT 420 RC inpatient 608 595.84 All Payors / Plans All Payors / Plans 608 other 608 608 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM DYNAMIC 53-67 PX-420291263 CDM 29126 CPT 420 RC inpatient 811 794.78 All Payors / Plans All Payors / Plans 811 other 811 811 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM DYNAMIC 68-82 PX-420291264 CDM 29126 CPT 420 RC inpatient 1014 993.72 All Payors / Plans All Payors / Plans 1014 other 1014 1014 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT STATIC 8-22 PX-420291301 CDM 29130 CPT 420 RC inpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT STATIC 23-37 PX-420291302 CDM 29130 CPT 420 RC inpatient 270 264.6 All Payors / Plans All Payors / Plans 270 other 270 270 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT STATIC 38-52 PX-420291303 CDM 29130 CPT 420 RC inpatient 406 397.88 All Payors / Plans All Payors / Plans 406 other 406 406 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT STATIC 53-67 PX-420291304 CDM 29130 CPT 420 RC inpatient 541 530.18 All Payors / Plans All Payors / Plans 541 other 541 541 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT STATIC 68-82 PX-420291305 CDM 29130 CPT 420 RC inpatient 676 662.48 All Payors / Plans All Payors / Plans 676 other 676 676 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FING SPLINT DYN 8-22 PX-420291310 CDM 29131 CPT 420 RC inpatient 169 165.62 All Payors / Plans All Payors / Plans 169 other 169 169 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT DYNAMIC 23-37 PX-420291311 CDM 29131 CPT 420 RC inpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT DYNAMIC 38-52 PX-420291312 CDM 29131 CPT 420 RC inpatient 507 496.86 All Payors / Plans All Payors / Plans 507 other 507 507 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT DYNAMIC 53-67 PX-420291313 CDM 29131 CPT 420 RC inpatient 676 662.48 All Payors / Plans All Payors / Plans 676 other 676 676 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT DYNAMIC 68-82 PX-420291314 CDM 29131 CPT 420 RC inpatient 845 828.1 All Payors / Plans All Payors / Plans 845 other 845 845 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG LEG SPLINT 8-22 PX-420295050 CDM 29505 CPT 420 RC inpatient 429 420.42 All Payors / Plans All Payors / Plans 429 other 429 429 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG LEG SPLINT 23-37 PX-420295051 CDM 29505 CPT 420 RC inpatient 429 420.42 All Payors / Plans All Payors / Plans 429 other 429 429 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG LEG SPLINT 38-52 PX-420295052 CDM 29505 CPT 420 RC inpatient 429 420.42 All Payors / Plans All Payors / Plans 429 other 429 429 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG LEG SPLINT 53-67 PX-420295053 CDM 29505 CPT 420 RC inpatient 429 420.42 All Payors / Plans All Payors / Plans 429 other 429 429 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG LEG SPLINT 68-82 PX-420295054 CDM 29505 CPT 420 RC inpatient 429 420.42 All Payors / Plans All Payors / Plans 429 other 429 429 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT LEG SPLINT 8-22 PX-420295150 CDM 29515 CPT 420 RC inpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT LEG SPLINT 23-37 PX-420295151 CDM 29515 CPT 420 RC inpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT LEG SPLINT 38-52 PX-420295152 CDM 29515 CPT 420 RC inpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT LEG SPLINT 53-67 PX-420295153 CDM 29515 CPT 420 RC inpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT LEG SPLINT 68-82 PX-420295154 CDM 29515 CPT 420 RC inpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STRAPPING UNA BOOT 8-22 PX-420295800 CDM 29580 CPT 420 RC inpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STRAPPING UNA BOOT 23-37 PX-420295801 CDM 29580 CPT 420 RC inpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STRAPPING UNNA BOOT 38-52 PX-420295802 CDM 29580 CPT 420 RC inpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STRAPPING UNA BOOT 53-67 PX-420295803 CDM 29580 CPT 420 RC inpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STRAPPING UNA BOOT 68-82 PX-420295804 CDM 29580 CPT 420 RC inpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM L LEG/FT 8-22 PX-420295810 CDM 29581 CPT 420 RC inpatient 474 464.52 All Payors / Plans All Payors / Plans 474 other 474 474 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COMP L LEG/FT23-37 PX-420295811 CDM 29581 CPT 420 RC inpatient 474 464.52 All Payors / Plans All Payors / Plans 474 other 474 474 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COMP L LEG/FT38-52 PX-420295812 CDM 29581 CPT 420 RC inpatient 474 464.52 All Payors / Plans All Payors / Plans 474 other 474 474 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COMP L FEG/FT53-67 PX-420295813 CDM 29581 CPT 420 RC inpatient 474 464.52 All Payors / Plans All Payors / Plans 474 other 474 474 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COMP L LEG/FT 68-82 PX-420295814 CDM 29581 CPT 420 RC inpatient 474 464.52 All Payors / Plans All Payors / Plans 474 other 474 474 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APPL MLT-LAY COMP THIG/LEG8-22 PX-420295820 CDM 29582 CPT 420 RC inpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COMP THI/LEG 23-37 PX-420295821 CDM 29583 CPT 420 RC inpatient 406 397.88 All Payors / Plans All Payors / Plans 406 other 406 406 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COMP THI/LEG 38-52 PX-420295822 CDM 29584 CPT 420 RC inpatient 608 595.84 All Payors / Plans All Payors / Plans 608 other 608 608 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COMP THI/LEG 53-67 PX-420295823 CDM 29585 CPT 420 RC inpatient 811 794.78 All Payors / Plans All Payors / Plans 811 other 811 811 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COMP THI/LEG 68-73 PX-420295824 CDM 29586 CPT 420 RC inpatient 1014 993.72 All Payors / Plans All Payors / Plans 1014 other 1014 1014 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UPARM/FO8-22 PX-420295830 CDM 29583 CPT 420 RC inpatient 169 165.62 All Payors / Plans All Payors / Plans 169 other 169 169 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FO23-37 PX-420295831 CDM 29583 CPT 420 RC inpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FO38-52 PX-420295832 CDM 29583 CPT 420 RC inpatient 507 496.86 All Payors / Plans All Payors / Plans 507 other 507 507 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FO53-67 PX-420295833 CDM 29583 CPT 420 RC inpatient 676 662.48 All Payors / Plans All Payors / Plans 676 other 676 676 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FO68-73 PX-420295834 CDM 29583 CPT 420 RC inpatient 845 828.1 All Payors / Plans All Payors / Plans 845 other 845 845 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FI8-22 PX-420295840 CDM 29584 CPT 420 RC inpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FI23-37 PX-420295841 CDM 29584 CPT 420 RC inpatient 406 397.88 All Payors / Plans All Payors / Plans 406 other 406 406 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FI38-52 PX-420295842 CDM 29584 CPT 420 RC inpatient 608 595.84 All Payors / Plans All Payors / Plans 608 other 608 608 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FI53-67 PX-420295843 CDM 29584 CPT 420 RC inpatient 811 794.78 All Payors / Plans All Payors / Plans 811 other 811 811 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FI 68-82 PX-420295844 CDM 29584 CPT 420 RC inpatient 1014 993.72 All Payors / Plans All Payors / Plans 1014 other 1014 1014 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIOFEEDBACK TRAINING 8-22 MIN PX-420909111 CDM 90911 CPT 420 RC inpatient 118 115.64 All Payors / Plans All Payors / Plans 118 other 118 118 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIOFEEDBACK TRAINING 23-37 MIN PX-420909112 CDM 90911 CPT 420 RC inpatient 237 232.26 All Payors / Plans All Payors / Plans 237 other 237 237 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIOFEEDBACK TRAINING 38-52 MIN PX-420909113 CDM 90911 CPT 420 RC inpatient 355 347.9 All Payors / Plans All Payors / Plans 355 other 355 355 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIOFEEDBACK TRAINING 53-67 MIN PX-420909114 CDM 90911 CPT 420 RC inpatient 473 463.54 All Payors / Plans All Payors / Plans 473 other 473 473 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIOFEEDBACK TRAINING 68-82 MIN PX-420909115 CDM 90911 CPT 420 RC inpatient 592 580.16 All Payors / Plans All Payors / Plans 592 other 592 592 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CANALITH REPOSITIONING PROC PX-420959920 CDM 95992 CPT 420 RC inpatient 113 110.74 All Payors / Plans All Payors / Plans 113 other 113 113 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT DEVEL SCREEN W INTER RPT 8-22 PX-420961100 CDM 96114 CPT 420 RC inpatient 152 148.96 All Payors / Plans All Payors / Plans 152 other 152 152 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RE EVALUATION 8-22 MIN PX-420970020 CDM 97164 CPT 420 RC inpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RE EVALUATION 23-37 MIN PX-420970021 CDM 97164 CPT 420 RC inpatient 271 265.58 All Payors / Plans All Payors / Plans 271 other 271 271 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RE EVALUATION 38-52 MIN PX-420970022 CDM 97164 CPT 420 RC inpatient 406 397.88 All Payors / Plans All Payors / Plans 406 other 406 406 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RE EVALUATION 53-67 MIN PX-420970023 CDM 97164 CPT 420 RC inpatient 541 530.18 All Payors / Plans All Payors / Plans 541 other 541 541 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT MECHANICAL TRACT 8-22 PX-420970120 CDM 97012 CPT 420 RC inpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRACTION (MECHANICAL) PX-420970121 CDM 97012 CPT 420 RC inpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT MECHANICAL TRACT 38-52 PX-420970122 CDM 97012 CPT 420 RC inpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT MECHANCIAL TRACT 53-67 PX-420970123 CDM 97012 CPT 420 RC inpatient 270 264.6 All Payors / Plans All Payors / Plans 270 other 270 270 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT MECHANICAL TRACT 68-82 PX-420970124 CDM 97012 CPT 420 RC inpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ELECTRICAL STIMULATN UNATT NON WOUND PX-420970141 CDM 97014 CPT 420 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXTREM PUMP 8-22 MIN PX-420970160 CDM 97016 CPT 420 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXTREM PUMP 23-37 PX-420970161 CDM 97016 CPT 420 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXTREM PUMP 38-52 PX-420970162 CDM 97016 CPT 420 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXTREM PUMP 53-67 PX-420970163 CDM 97016 CPT 420 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXTREM PUMP 68-82 MIN PX-420970164 CDM 97016 CPT 420 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARAFFIN BATH 8-22 MIN PX-420970180 CDM 97018 CPT 420 RC inpatient 34 33.32 All Payors / Plans All Payors / Plans 34 other 34 34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARAFFIN BATH 23-37 MIN PX-420970181 CDM 97018 CPT 420 RC inpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARAFFIN BATH 38-52 MIN PX-420970182 CDM 97018 CPT 420 RC inpatient 101 98.98 All Payors / Plans All Payors / Plans 101 other 101 101 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARAFFIN BATH 53-67 MIN PX-420970183 CDM 97018 CPT 420 RC inpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARAFFIN BATH 68-82 PX-420970184 CDM 97018 CPT 420 RC inpatient 169 165.62 All Payors / Plans All Payors / Plans 169 other 169 169 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT E-STIM NOT WC MANUAL 8-22 PX-420970320 CDM 97032 CPT 420 RC inpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IONTOPHORESIS ONE OR MORE AREA 15 PX-420970330 CDM 97033 CPT 420 RC inpatient 85 83.3 All Payors / Plans All Payors / Plans 85 other 85 85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ULTRASOUND PX-420970350 CDM 97035 CPT 420 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUIDOTHERAPY 8-22 MIN PX-420970390 CDM 97039 CPT 420 RC inpatient 34 33.32 All Payors / Plans All Payors / Plans 34 other 34 34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUIDOTHERAPY 23-37 PX-420970391 CDM 97039 CPT 420 RC inpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUIDOTHERAPY 38-52 PX-420970392 CDM 97039 CPT 420 RC inpatient 101 98.98 All Payors / Plans All Payors / Plans 101 other 101 101 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUIDOTHERAPY 53-67 MIN PX-420970393 CDM 97039 CPT 420 RC inpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THERAPEUTIC EXERCISES TH PX-420971100 CDM 97110 CPT 420 RC inpatient 90 88.2 All Payors / Plans All Payors / Plans 90 other 90 90 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NEUROMUSCULAR REEDUCATION PX-420971120 CDM 97112 CPT 420 RC inpatient 113 110.74 All Payors / Plans All Payors / Plans 113 other 113 113 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMBULATION TRAIN PX-420971160 CDM 97116 CPT 420 RC inpatient 90 88.2 All Payors / Plans All Payors / Plans 90 other 90 90 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MASSAGE 15 MIN PX-420971240 CDM 97124 CPT 420 RC inpatient 113 110.74 All Payors / Plans All Payors / Plans 113 other 113 113 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MANUAL THERAPY PX-420971400 CDM 97140 CPT 420 RC inpatient 90 88.2 All Payors / Plans All Payors / Plans 90 other 90 90 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT GROUP THERAPY 8-22 MIN 2 PTS PX-420971500 CDM 97150 CPT 420 RC inpatient 101 98.98 All Payors / Plans All Payors / Plans 101 other 101 101 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THERAPEUTIC EX. GROUP PX-420971501 CDM 97150 CPT 420 RC inpatient 101 98.98 All Payors / Plans All Payors / Plans 101 other 101 101 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT GROUP THERAPY 38-52 MIN 2 PTS PX-420971502 CDM 97150 CPT 420 RC inpatient 101 98.98 All Payors / Plans All Payors / Plans 101 other 101 101 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT GROUP THERAPY 8-22 MIN 3 PTS PX-420971503 CDM 97150 CPT 420 RC inpatient 152 148.96 All Payors / Plans All Payors / Plans 152 other 152 152 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT GROUP THERAPY 23-37 MIN 3 PTS PX-420971504 CDM 97150 CPT 420 RC inpatient 152 148.96 All Payors / Plans All Payors / Plans 152 other 152 152 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT GROUP THERAPY 38-52 MIN 3 PTS PX-420971505 CDM 97150 CPT 420 RC inpatient 152 148.96 All Payors / Plans All Payors / Plans 152 other 152 152 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT GROUP THERAPY 8-22 MIN 4 PTS PX-420971506 CDM 97150 CPT 420 RC inpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT GROUP THERAPY 23-37 MIN 4 PTS PX-420971507 CDM 97150 CPT 420 RC inpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT GROUP THERAPY 38-52 MIN 4 PTS PX-420971508 CDM 97150 CPT 420 RC inpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION LOW COMPLEXITY 8-22 MIN PX-420971610 CDM 97161 CPT 420 RC inpatient 180 176.4 All Payors / Plans All Payors / Plans 180 other 180 180 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION LOW COMPLEXITY 23-37 MIN PX-420971611 CDM 97161 CPT 420 RC inpatient 361 353.78 All Payors / Plans All Payors / Plans 361 other 361 361 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION LOW COMPLEXITY 38-52 MIN PX-420971612 CDM 97161 CPT 420 RC inpatient 541 530.18 All Payors / Plans All Payors / Plans 541 other 541 541 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION LOW COMPLEXITY 53-67 MIN PX-420971613 CDM 97161 CPT 420 RC inpatient 722 707.56 All Payors / Plans All Payors / Plans 722 other 722 722 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION LOW COMPLEXITY 68-82 MIN PX-420971614 CDM 97161 CPT 420 RC inpatient 902 883.96 All Payors / Plans All Payors / Plans 902 other 902 902 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION MOD COMPLEXITY 8-22 MIN PX-420971620 CDM 97162 CPT 420 RC inpatient 180 176.4 All Payors / Plans All Payors / Plans 180 other 180 180 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION MOD COMPLEXITY 23-37MIN PX-420971621 CDM 97162 CPT 420 RC inpatient 361 353.78 All Payors / Plans All Payors / Plans 361 other 361 361 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION MOD COMPLEXITY 38-52 MIN PX-420971622 CDM 97162 CPT 420 RC inpatient 541 530.18 All Payors / Plans All Payors / Plans 541 other 541 541 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION MOD COMPLEXITY 53-67 MIN PX-420971623 CDM 97162 CPT 420 RC inpatient 722 707.56 All Payors / Plans All Payors / Plans 722 other 722 722 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION MOD COMPLEXITY 68-82 MIN PX-420971624 CDM 97162 CPT 420 RC inpatient 902 883.96 All Payors / Plans All Payors / Plans 902 other 902 902 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION HIGH COMPLEXITY 8-22 MIN PX-420971630 CDM 97163 CPT 420 RC inpatient 180 176.4 All Payors / Plans All Payors / Plans 180 other 180 180 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION HIGH COMPLEXITY 23-37 MIN PX-420971631 CDM 97163 CPT 420 RC inpatient 361 353.78 All Payors / Plans All Payors / Plans 361 other 361 361 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION HIGH COMPLEXITY 38-52 MIN PX-420971632 CDM 97163 CPT 420 RC inpatient 541 530.18 All Payors / Plans All Payors / Plans 541 other 541 541 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION HIGH COMPLEXITY 53-67 MIN PX-420971633 CDM 97163 CPT 420 RC inpatient 722 707.56 All Payors / Plans All Payors / Plans 722 other 722 722 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION HIGH COMPLEXITY 68-82 MIN PX-420971634 CDM 97163 CPT 420 RC inpatient 902 883.96 All Payors / Plans All Payors / Plans 902 other 902 902 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FUNCTIONAL ACTIVITY TH PX-420975300 CDM 97530 CPT 420 RC inpatient 158 154.84 All Payors / Plans All Payors / Plans 158 other 158 158 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT TRMT/SENSORIMO IND 15 MIN PX-420975330 CDM 97533 CPT 420 RC inpatient 85 83.3 All Payors / Plans All Payors / Plans 85 other 85 85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT SELF CARE/HOME MGMT 15 MIN PX-420975350 CDM 97535 CPT 420 RC inpatient 101 98.98 All Payors / Plans All Payors / Plans 101 other 101 101 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMM/WORK REINTEGRATION 15 MIN PX-420975370 CDM 97537 CPT 420 RC inpatient 85 83.3 All Payors / Plans All Payors / Plans 85 other 85 85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WHEELCHARI MGMT/PROPOLUSION 15MIN PX-420975420 CDM 97542 CPT 420 RC inpatient 113 110.74 All Payors / Plans All Payors / Plans 113 other 113 113 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT WC SELECT DEBRIDE <=20 CM PX-420975970 CDM 97597 CPT 420 RC inpatient 496 486.08 All Payors / Plans All Payors / Plans 496 other 496 496 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT WC SELECT DEBRIDE >20 CM PX-420975980 CDM 97598 CPT 420 RC inpatient 180 176.4 All Payors / Plans All Payors / Plans 180 other 180 180 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NON-SELECT DEBRIDEMENT/WOUND CARE PX-420976020 CDM 97602 CPT 420 RC inpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FABRICATION/ORTHOTIC PX-420977600 CDM 97760 CPT 420 RC inpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROSTHETIC TRAIN UP/LOW 15MIN PX-420977610 CDM 97761 CPT 420 RC inpatient 158 154.84 All Payors / Plans All Payors / Plans 158 other 158 158 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHECKOUT ORTHO/PROTH EST PT 15 MI PX-420977620 CDM 97763 CPT 420 RC inpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 38-52 2 PTS PX-430171500 CDM 97150 CPT 430 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 38-52 3 PTS PX-430171501 CDM 97150 CPT 430 RC inpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 38-52 4 PTS PX-430171502 CDM 97150 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 53-67 2 PTS PX-430171503 CDM 97150 CPT 430 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 53-67 3 PTS PX-430171504 CDM 97150 CPT 430 RC inpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 53-67 4 PTS PX-430171505 CDM 97150 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT SENSORIMO 15 MIN 2 PTS PX-430171506 CDM 97150 CPT 430 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/SENSORIMO 15 MIN 3 PTS PX-430171507 CDM 97150 CPT 430 RC inpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/SENSORIMO 15 MIN 4 PTS PX-430171508 CDM 97150 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT COGNITIVE SKILLS 15 MIN 2 PTS PX-430171509 CDM 97150 CPT 430 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT COGNITIVE SKILL 15 MIN 3 PTS PX-430171510 CDM 97150 CPT 430 RC inpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT COGNITIVE SKILLS 15 MIN 4 PTS PX-430171511 CDM 97150 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT ASSIST/ADAPT EQUIP 8-22 2 PTS PX-430171512 CDM 97150 CPT 430 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AS/AD EQUIP GRP 8-22 MIN 3 PTS PX-430171513 CDM 97150 CPT 430 RC inpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT ASSIST/ADAPT EQUIP 8-22 4 PTS PX-430171514 CDM 97150 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 8-22 MIN 2 PTS PX-430171515 CDM 97150 CPT 430 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 8-22 3 PTS PX-430171516 CDM 97150 CPT 430 RC inpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 8-22 MIN 4 PTS PX-430171517 CDM 97150 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 23-37 MIN 2 PTS PX-430171518 CDM 97150 CPT 430 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 23-37 3 PTS PX-430171519 CDM 97150 CPT 430 RC inpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 23-37 MIN 4 PTS PX-430171520 CDM 97150 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 38-52 MIN 2 PTS PX-430171521 CDM 97150 CPT 430 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 38-52 MIN 3 PTS PX-430171522 CDM 97150 CPT 430 RC inpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 38-52 MIN 4 PTS PX-430171523 CDM 97150 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 53-67 MIN 2 PTS PX-430171524 CDM 97150 CPT 430 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 53-67 MIN 3 PTS PX-430171525 CDM 97150 CPT 430 RC inpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 53-67 MIN 4 PTS PX-430171526 CDM 97150 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG ARM SPLNT SHLDR-HAND 8-22 PX-430291050 CDM 29105 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG ARM SPLNT SHLDR-HAND 23-37 PX-430291051 CDM 29105 CPT 430 RC inpatient 218 213.64 All Payors / Plans All Payors / Plans 218 other 218 218 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG ARM SPLNT SHLDR-HAND 38-52 PX-430291052 CDM 29105 CPT 430 RC inpatient 327 320.46 All Payors / Plans All Payors / Plans 327 other 327 327 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG ARM SPLNT SHLDR-HAND 53-67 PX-430291053 CDM 29105 CPT 430 RC inpatient 436 427.28 All Payors / Plans All Payors / Plans 436 other 436 436 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG ARM SPLNT SHLDR-HAND 68-82 PX-430291054 CDM 29105 CPT 430 RC inpatient 545 534.1 All Payors / Plans All Payors / Plans 545 other 545 545 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL STATIC 8-22 PX-430291250 CDM 29125 CPT 430 RC inpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL STATIC 23-37 PX-430291251 CDM 29125 CPT 430 RC inpatient 182 178.36 All Payors / Plans All Payors / Plans 182 other 182 182 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL STATIC 38-52 PX-430291252 CDM 29125 CPT 430 RC inpatient 273 267.54 All Payors / Plans All Payors / Plans 273 other 273 273 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT SHORT ARM SPL STATIC 53-67 PX-430291253 CDM 29125 CPT 430 RC inpatient 364 356.72 All Payors / Plans All Payors / Plans 364 other 364 364 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL STATIC 68-82 PX-430291254 CDM 29125 CPT 430 RC inpatient 455 445.9 All Payors / Plans All Payors / Plans 455 other 455 455 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL DYNAMIC 8-22 PX-430291260 CDM 29126 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL DYNAMIC 23-37 PX-430291261 CDM 29126 CPT 430 RC inpatient 218 213.64 All Payors / Plans All Payors / Plans 218 other 218 218 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL DYNAMIC 38-52 PX-430291262 CDM 29126 CPT 430 RC inpatient 327 320.46 All Payors / Plans All Payors / Plans 327 other 327 327 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL DYNAMIC 53-67 PX-430291263 CDM 29126 CPT 430 RC inpatient 436 427.28 All Payors / Plans All Payors / Plans 436 other 436 436 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL DYNAMIC 68-82 PX-430291264 CDM 29126 CPT 430 RC inpatient 545 534.1 All Payors / Plans All Payors / Plans 545 other 545 545 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT STATIC 8-22 PX-430291300 CDM 29130 CPT 430 RC inpatient 73 71.54 All Payors / Plans All Payors / Plans 73 other 73 73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT STATIC 23-37 PX-430291301 CDM 29130 CPT 430 RC inpatient 145 142.1 All Payors / Plans All Payors / Plans 145 other 145 145 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT STATIC 38-52 PX-430291302 CDM 29130 CPT 430 RC inpatient 218 213.64 All Payors / Plans All Payors / Plans 218 other 218 218 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT STATIC 53-67 PX-430291303 CDM 29130 CPT 430 RC inpatient 291 285.18 All Payors / Plans All Payors / Plans 291 other 291 291 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT FINGER SPLINT STATIC 68-82 PX-430291304 CDM 29130 CPT 430 RC inpatient 364 356.72 All Payors / Plans All Payors / Plans 364 other 364 364 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT DYNAMIC 8-22 PX-430291310 CDM 29131 CPT 430 RC inpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT DYNAMIC 23-37 PX-430291311 CDM 29131 CPT 430 RC inpatient 182 178.36 All Payors / Plans All Payors / Plans 182 other 182 182 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT DYNAMIC 38-52 PX-430291312 CDM 29131 CPT 430 RC inpatient 273 267.54 All Payors / Plans All Payors / Plans 273 other 273 273 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT DYNAMIC 53-67 PX-430291313 CDM 29131 CPT 430 RC inpatient 364 356.72 All Payors / Plans All Payors / Plans 364 other 364 364 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT DYNAMIC 68-82 PX-430291314 CDM 29131 CPT 430 RC inpatient 455 445.9 All Payors / Plans All Payors / Plans 455 other 455 455 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG LEG SPL THI-ANK/TOES 8-22 PX-430295050 CDM 29505 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG LEG SPL THI-ANK/TOES 23-37 PX-430295051 CDM 29505 CPT 430 RC inpatient 218 213.64 All Payors / Plans All Payors / Plans 218 other 218 218 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG LEG SPL THI-ANK/TOES 38-52 PX-430295052 CDM 29505 CPT 430 RC inpatient 327 320.46 All Payors / Plans All Payors / Plans 327 other 327 327 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG LEG SPL THI-ANK/TOES 53-67 PX-430295053 CDM 29505 CPT 430 RC inpatient 436 427.28 All Payors / Plans All Payors / Plans 436 other 436 436 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG LEG SPL THI-ANK/TOES 68-82 PX-430295054 CDM 29505 CPT 430 RC inpatient 545 534.1 All Payors / Plans All Payors / Plans 545 other 545 545 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHRT LEG SPL CALF-FOOT 8-22 PX-430295150 CDM 29515 CPT 430 RC inpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHRT LEG SPL CALF-FOOT23-37 PX-430295151 CDM 29515 CPT 430 RC inpatient 182 178.36 All Payors / Plans All Payors / Plans 182 other 182 182 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHRT LEG SPL CALF-FOOT38-52 PX-430295152 CDM 29515 CPT 430 RC inpatient 273 267.54 All Payors / Plans All Payors / Plans 273 other 273 273 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHRT LEG SP CALF-FOOT 68-82 PX-430295153 CDM 29515 CPT 430 RC inpatient 455 445.9 All Payors / Plans All Payors / Plans 455 other 455 455 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT STRAPPING UNNA BOOT 8-22 PX-430295800 CDM 29580 CPT 430 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT STRAPPING UNNA BOOT 23-37 PX-430295801 CDM 29580 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT STRAPPING UNNA BOOT 38-52 PX-430295802 CDM 29580 CPT 430 RC inpatient 164 160.72 All Payors / Plans All Payors / Plans 164 other 164 164 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT STRAPPING UNNA BOOT 53-67 PX-430295803 CDM 29580 CPT 430 RC inpatient 218 213.64 All Payors / Plans All Payors / Plans 218 other 218 218 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT STRAPPING UNNA BOOT 68-82 PX-430295804 CDM 29580 CPT 430 RC inpatient 273 267.54 All Payors / Plans All Payors / Plans 273 other 273 273 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP L LEG/FT 8-22 PX-430295810 CDM 29581 CPT 430 RC inpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP L LEG/FT 23-37 PX-430295811 CDM 29581 CPT 430 RC inpatient 182 178.36 All Payors / Plans All Payors / Plans 182 other 182 182 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP L LEG/FT 38-52 PX-430295812 CDM 29581 CPT 430 RC inpatient 273 267.54 All Payors / Plans All Payors / Plans 273 other 273 273 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP L LEG/FT 53-67 PX-430295813 CDM 29581 CPT 430 RC inpatient 364 356.72 All Payors / Plans All Payors / Plans 364 other 364 364 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L L LEG/FT 68-82 PX-430295814 CDM 29581 CPT 430 RC inpatient 455 445.9 All Payors / Plans All Payors / Plans 455 other 455 455 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP MLT-LAY COMP THI/LEG 8-22 PX-430295820 CDM 29582 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP MLT-LAY COMP THI/LEG 23-37 PX-430295821 CDM 29582 CPT 430 RC inpatient 218 213.64 All Payors / Plans All Payors / Plans 218 other 218 218 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP MLT-LAY COMP THI/LEG 38-52 PX-430295822 CDM 29582 CPT 430 RC inpatient 327 320.46 All Payors / Plans All Payors / Plans 327 other 327 327 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP MLT-LAY COMP THI/LEG 53-67 PX-430295823 CDM 29582 CPT 430 RC inpatient 436 427.28 All Payors / Plans All Payors / Plans 436 other 436 436 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP MLT-LAY COMP THI/LEG68-73 PX-430295824 CDM 29582 CPT 430 RC inpatient 545 534.1 All Payors / Plans All Payors / Plans 545 other 545 545 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FOR 8-22 PX-430295830 CDM 29583 CPT 430 RC inpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FOR 23-37 PX-430295831 CDM 29583 CPT 430 RC inpatient 182 178.36 All Payors / Plans All Payors / Plans 182 other 182 182 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FOR 38-52 PX-430295832 CDM 29583 CPT 430 RC inpatient 273 267.54 All Payors / Plans All Payors / Plans 273 other 273 273 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FOR 53-67 PX-430295833 CDM 29583 CPT 430 RC inpatient 364 356.72 All Payors / Plans All Payors / Plans 364 other 364 364 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FOR 68-73 PX-430295834 CDM 29583 CPT 430 RC inpatient 455 445.9 All Payors / Plans All Payors / Plans 455 other 455 455 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FING 8-22 PX-430295840 CDM 29584 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP APP M/L COMP UP ARM/FING 23-37 PX-430295841 CDM 29584 CPT 430 RC inpatient 218 213.64 All Payors / Plans All Payors / Plans 218 other 218 218 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FING 38-52 PX-430295842 CDM 29584 CPT 430 RC inpatient 327 320.46 All Payors / Plans All Payors / Plans 327 other 327 327 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FING 53-67 PX-430295843 CDM 29584 CPT 430 RC inpatient 436 427.28 All Payors / Plans All Payors / Plans 436 other 436 436 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FING 68-82 PX-430295844 CDM 29584 CPT 430 RC inpatient 545 534.1 All Payors / Plans All Payors / Plans 545 other 545 545 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DEVEL SCREEN W INTER RPT 8-22 PX-430961100 CDM 96110 CPT 430 RC inpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DEVEL SCREEN W INTER RPT 23-37 PX-430961102 CDM 96110 CPT 430 RC inpatient 164 160.72 All Payors / Plans All Payors / Plans 164 other 164 164 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DEVEL SCREEN W INTER RPT 38-52 PX-430961103 CDM 96110 CPT 430 RC inpatient 245 240.1 All Payors / Plans All Payors / Plans 245 other 245 245 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DEVEL SCREEN W INTER RPT 53-67 PX-430961104 CDM 96110 CPT 430 RC inpatient 327 320.46 All Payors / Plans All Payors / Plans 327 other 327 327 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DEVEL SCREEN W INTER RPT 68-82 PX-430961105 CDM 96110 CPT 430 RC inpatient 409 400.82 All Payors / Plans All Payors / Plans 409 other 409 409 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DEVEL TEST EXT W/INT RPT 15MIN PX-430961106 CDM 96110 CPT 430 RC inpatient 436 427.28 All Payors / Plans All Payors / Plans 436 other 436 436 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT STANDARD COGNIT TEST 31MINOR> PX-430961250 CDM 96125 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT REASSESSMENT INDIVIDUAL 8-22 PX-430970040 CDM 97168 CPT 430 RC inpatient 72 70.56 All Payors / Plans All Payors / Plans 72 other 72 72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT REASSESSMENT INDIVIDUAL 23-37 PX-430970041 CDM 97168 CPT 430 RC inpatient 144 141.12 All Payors / Plans All Payors / Plans 144 other 144 144 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT REASSESSMENT INDIVIDUAL 38-52 PX-430970042 CDM 97168 CPT 430 RC inpatient 215 210.7 All Payors / Plans All Payors / Plans 215 other 215 215 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT REASSESSMENT INDIVIDUAL 53-67 PX-430970043 CDM 97168 CPT 430 RC inpatient 287 281.26 All Payors / Plans All Payors / Plans 287 other 287 287 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT MECHANICAL TRACT 8-22 PX-430970120 CDM 97012 CPT 430 RC inpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT MECHANICAL TRACT 23-37 PX-430970121 CDM 97012 CPT 430 RC inpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT MECHANICAL TRACT 38-52 PX-430970122 CDM 97012 CPT 430 RC inpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT MECHANICAL TRACT 53-67 PX-430970123 CDM 97012 CPT 430 RC inpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PARAFFIN BATH 8-22 PX-430970180 CDM 97018 CPT 430 RC inpatient 18 17.64 All Payors / Plans All Payors / Plans 18 other 18 18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARAFFIN BATH PX-430970181 CDM 97018 CPT 430 RC inpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PARAFFIN BATH 38-52 PX-430970182 CDM 97018 CPT 430 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PARAFFIN BATH 53-67 PX-430970183 CDM 97018 CPT 430 RC inpatient 73 71.54 All Payors / Plans All Payors / Plans 73 other 73 73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PARAFFIN BATH 68-82 PX-430970184 CDM 97018 CPT 430 RC inpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT ELEC STIMUL MANUAL 15 MIN PX-430970320 CDM 97032 CPT 430 RC inpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT IONTOPHORESIS 15 MIN PX-430970330 CDM 97033 CPT 430 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT CONTRAST BATH 15 MIN PX-430970340 CDM 97034 CPT 430 RC inpatient 27 26.46 All Payors / Plans All Payors / Plans 27 other 27 27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT ULTRASOUND 15 MIN PX-430970350 CDM 97035 CPT 430 RC inpatient 27 26.46 All Payors / Plans All Payors / Plans 27 other 27 27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT FLUIDTHERAPY 8-22 PX-430970390 CDM 97039 CPT 430 RC inpatient 18 17.64 All Payors / Plans All Payors / Plans 18 other 18 18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT FLUIDTHERAPY 23-37 PX-430970391 CDM 97039 CPT 430 RC inpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT THERAPEUTIC EXERCISE 15 MIN TH PX-430971100 CDM 97110 CPT 430 RC inpatient 48 47.04 All Payors / Plans All Payors / Plans 48 other 48 48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT NEUROMUSCULAR REED 15 MIN PX-430971120 CDM 97112 CPT 430 RC inpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT MASSAGE 15 MIN PX-430971240 CDM 97124 CPT 430 RC inpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT COGNITIVE SLILLS IND EA ADD'L 15 MIN PX-430971301 CDM 97130 CPT 430 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT MANUAL THERAPY 15 MIN PX-430971400 CDM 97140 CPT 430 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DAILY LIVING SKILLS 15 MIN 2PT PX-430971500 CDM 97150 CPT 430 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THERAPEUTIC EX. GROUP PX-430971501 CDM 97150 CPT 430 RC inpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DAILY LIVING SKILLS 15MIN 4PTS PX-430971502 CDM 97150 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 8-22 2 PTS PX-430971503 CDM 97150 CPT 430 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 8-22 3 PTS PX-430971504 CDM 97150 CPT 430 RC inpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 8-22 4 PTS PX-430971505 CDM 97150 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 23-37 2 PTS PX-430971506 CDM 97150 CPT 430 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 23-37 3 PTS PX-430971507 CDM 97150 CPT 430 RC inpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 23-47 4 PTS PX-430971508 CDM 97150 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION LOW COMPLEXITY 8-22 PX-430971650 CDM 97165 CPT 430 RC inpatient 96 94.08 All Payors / Plans All Payors / Plans 96 other 96 96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION LOW COMPLEXITY 23-37 PX-430971651 CDM 97165 CPT 430 RC inpatient 191 187.18 All Payors / Plans All Payors / Plans 191 other 191 191 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION LOW COMPLEXITY 38-52 PX-430971652 CDM 97165 CPT 430 RC inpatient 287 281.26 All Payors / Plans All Payors / Plans 287 other 287 287 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION LOW COMPLEXITY 53-67 PX-430971653 CDM 97165 CPT 430 RC inpatient 383 375.34 All Payors / Plans All Payors / Plans 383 other 383 383 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION MOD COMPLEXITY 8-22 PX-430971660 CDM 97166 CPT 430 RC inpatient 96 94.08 All Payors / Plans All Payors / Plans 96 other 96 96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION MOD COMPLEXITY 23-37 PX-430971661 CDM 97166 CPT 430 RC inpatient 191 187.18 All Payors / Plans All Payors / Plans 191 other 191 191 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION MOD COMPLEXITY 38-52 PX-430971662 CDM 97166 CPT 430 RC inpatient 287 281.26 All Payors / Plans All Payors / Plans 287 other 287 287 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION MOD COMPLEXITY 53-67 PX-430971663 CDM 97166 CPT 430 RC inpatient 383 375.34 All Payors / Plans All Payors / Plans 383 other 383 383 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION HIGH COMPLEXITY 8-22 PX-430971670 CDM 97167 CPT 430 RC inpatient 96 94.08 All Payors / Plans All Payors / Plans 96 other 96 96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION HIGH COMPLEXITY 23-37 PX-430971671 CDM 97167 CPT 430 RC inpatient 191 187.18 All Payors / Plans All Payors / Plans 191 other 191 191 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION HIGH COMPLEXITY 38-52 PX-430971672 CDM 97167 CPT 430 RC inpatient 287 281.26 All Payors / Plans All Payors / Plans 287 other 287 287 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION HIGH COMPLEXITY 53-67 PX-430971673 CDM 97167 CPT 430 RC inpatient 383 375.34 All Payors / Plans All Payors / Plans 383 other 383 383 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT FUNCTIONAL ACTIVITY 15 MIN TH PX-430975300 CDM 97530 CPT 430 RC inpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS IND 8-22 PX-430975320 CDM 97127 CPT 430 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS IND 23-37 PX-430975321 CDM 97127 CPT 430 RC inpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS IND 38-52 PX-430975322 CDM 97127 CPT 430 RC inpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS IND 53-67 PX-430975323 CDM 97127 CPT 430 RC inpatient 182 178.36 All Payors / Plans All Payors / Plans 182 other 182 182 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT COGNITIVIE SKILLS IND INITIAL 15 MIN PX-430975324 CDM 97129 CPT 430 RC inpatient 48 47.04 All Payors / Plans All Payors / Plans 48 other 48 48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/SENSORIMO IND 15 MIN PX-430975330 CDM 97533 CPT 430 RC inpatient 167 163.66 All Payors / Plans All Payors / Plans 167 other 167 167 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT COMM/WORK REINTEGRATION 15 MIN PX-430975371 CDM 97537 CPT 430 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT WHEELCHAIR MGMT/PROP 15 MIN PX-430975420 CDM 97542 CPT 430 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT WC SELECT DEBRIDE <= 20 CM PX-430975970 CDM 97597 CPT 430 RC inpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT WC SELECT DEBRIDE > 20 CM PX-430975980 CDM 97598 CPT 430 RC inpatient 218 213.64 All Payors / Plans All Payors / Plans 218 other 218 218 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT ORTHOTIC MGMT 15 MIN PX-430977600 CDM 97760 CPT 430 RC inpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PROSTHETIC TRAIN UP/LOW EXT 15 PX-430977610 CDM 97761 CPT 430 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT RECHECK PROST/ORTH 15 MIN PX-430977620 CDM 97763 CPT 430 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DAILY LIVING SKILLS 15 MIN PX-430985350 CDM 97535 CPT 430 RC inpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST BASIC TREATMENT/8-22 MIN IND PX-440925070 CDM 92507 CPT 440 RC inpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST BASIC TREATMENT/23-37 MIN IND PX-440925071 CDM 92507 CPT 440 RC inpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST BASIC TREATMENT/38-52 MIN IND PX-440925072 CDM 92507 CPT 440 RC inpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST BASIC TREATMENT/53-67 MIN IND PX-440925073 CDM 92507 CPT 440 RC inpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST SP THERAPY GRP OF 2-4 8-22 MIN PX-440925080 CDM 92508 CPT 440 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST SP THERAPY GROUP OF 2-4 23-37 PX-440925081 CDM 92508 CPT 440 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST SP THERAPY GROUP OF 2-4 38-52 PX-440925082 CDM 92508 CPT 440 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST SP THERAPY GROUP OF 2-4 53-67 PX-440925083 CDM 92508 CPT 440 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST SP GROUP 5 OR MORE 8-22 PX-440925084 CDM 92508 CPT 440 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST SP GROUP 5 OR MORE 23-37 PX-440925085 CDM 92508 CPT 440 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST SP GROUP 5 OR MORE 38-52 MIN PX-440925086 CDM 92508 CPT 440 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST SP GROUP 5 OR MORE 53-68 MIN PX-440925087 CDM 92508 CPT 440 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL SOUND/LANG COMPRE 8-22 PX-440925230 CDM 92523 CPT 444 RC inpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL SOUND/LANG COMPRE 23-37 PX-440925231 CDM 92523 CPT 440 RC inpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL SOUND/LANG COMPRE 38-52 PX-440925232 CDM 92523 CPT 440 RC inpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL SOUND/LANG COMPRE 53-67 PX-440925233 CDM 92523 CPT 440 RC inpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL SOUND/LANG COMPRE 68-82 PX-440925234 CDM 92523 CPT 440 RC inpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL SOUND/LANG COMPRE 83-97 PX-440925235 CDM 92523 CPT 440 RC inpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL SOUND/LANG COMPRE 98-112 PX-440925236 CDM 92523 CPT 440 RC inpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL SOUND/LANG COMPRE 113-127 PX-440925237 CDM 92523 CPT 440 RC inpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL BEHAV QUAL VOICE 8-22 PX-440925240 CDM 92524 CPT 440 RC inpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL BEHAV QUAL VOICE 23-37 PX-440925241 CDM 92524 CPT 440 RC inpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL BEHAV QUAL VOICE 38-52 PX-440925242 CDM 92524 CPT 440 RC inpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL BEHAV QUAL VOICE 53-67 PX-440925243 CDM 92524 CPT 440 RC inpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL BEHAV QUAL VOICE 68-82 PX-440925244 CDM 92524 CPT 440 RC inpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL BEHAV QUAL VOICE 83-97 PX-440925245 CDM 92524 CPT 440 RC inpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL BEHAV QUAL VOICE 98-112 PX-440925246 CDM 92524 CPT 440 RC inpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL BEHAV QUAL VOICE 113-127 PX-440925247 CDM 92524 CPT 440 RC inpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT SWALLOW/ORAL FEED 8-22MN PX-440925260 CDM 92526 CPT 440 RC inpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT SWALLOW/ORAL FEED/23-37 PX-440925261 CDM 92526 CPT 440 RC inpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT SWALLOW/ORAL FEED/38-52 PX-440925262 CDM 92526 CPT 440 RC inpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT SWALLOW/ORAL FEED/53-67 PX-440925263 CDM 92526 CPT 440 RC inpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL USE/FIT VOICE PROST 8-22 PX-440925970 CDM 92597 CPT 440 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL USE/FIT VOICE PROST 23-37 PX-440925971 CDM 92597 CPT 440 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL USE/FIT VOICE PROS 38-52 PX-440925972 CDM 92597 CPT 440 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL USE/FIT VOICE PROS 53-67 PX-440925973 CDM 92597 CPT 440 RC inpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL NONSP AUG/ALT DEV 8-22 PX-440926050 CDM 92605 CPT 440 RC inpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL NON SP AUG/ALT DEV 23-37 PX-440926051 CDM 92605 CPT 440 RC inpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL NON SP AUG/ALT DEV 38-52 PX-440926052 CDM 92605 CPT 440 RC inpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL NON SP AUG/ALT DEV 53-67 PX-440926053 CDM 92605 CPT 440 RC inpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT PROGRM NON SP DEV 8-22 PX-440926060 CDM 92606 CPT 440 RC inpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT/PROG NON SP DEV 23-37 PX-440926061 CDM 92606 CPT 440 RC inpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT/PROG NON SP DEVICE 38-52 PX-440926062 CDM 92606 CPT 440 RC inpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT/PROG NON SP DEVICE 53-67 PX-440926063 CDM 92606 CPT 440 RC inpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EV SP GEN AUG/ALT DEVICE 1 HR PX-440926070 CDM 92607 CPT 440 RC inpatient 194 190.12 All Payors / Plans All Payors / Plans 194 other 194 194 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EV SP GEN AUG/ALT DEVICE 30MIN PX-440926080 CDM 92608 CPT 440 RC inpatient 76 74.48 All Payors / Plans All Payors / Plans 76 other 76 76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT/PROG SP GEN DEVICE 8-22 PX-440926090 CDM 92609 CPT 440 RC inpatient 162 158.76 All Payors / Plans All Payors / Plans 162 other 162 162 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT/PROG SP GEN DEVICE 23-37 PX-440926091 CDM 92609 CPT 440 RC inpatient 162 158.76 All Payors / Plans All Payors / Plans 162 other 162 162 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT/PROG SP GEN DEVICE 38-52 PX-440926092 CDM 92609 CPT 440 RC inpatient 162 158.76 All Payors / Plans All Payors / Plans 162 other 162 162 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT/PROG SP GEN DEVICE 53-67 PX-440926093 CDM 92609 CPT 440 RC inpatient 162 158.76 All Payors / Plans All Payors / Plans 162 other 162 162 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL ORAL/PHARYN SWALLOW 8-22 PX-440926100 CDM 92610 CPT 440 RC inpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL ORAL/PHARYN SWALLOW 23-37 PX-440926101 CDM 92610 CPT 440 RC inpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL ORAL/PHARYN SWALLOW 38-52 PX-440926102 CDM 92610 CPT 440 RC inpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL ORAL/PHARYN SWALLOW 53-67 PX-440926103 CDM 92610 CPT 440 RC inpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL ORAL/PHARYN SWALLOW 68-82 PX-440926104 CDM 92610 CPT 440 RC inpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL ORAL/PHARYN/SWALLOW 83-97 PX-440926105 CDM 92610 CPT 440 RC inpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL ORAL/PHARYN/SWALLOW98-112 PX-440926106 CDM 92610 CPT 440 RC inpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL ORAL/PHARYN/SWALL 113-127 PX-440926107 CDM 92610 CPT 440 RC inpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST MOTION FLUORO EVAL SWALLOW8-22 PX-440926110 CDM 92611 CPT 440 RC inpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST MOTION FLUORO EVAL SWALL 23-37 PX-440926111 CDM 92611 CPT 440 RC inpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST MOTION FLUORO EVAL SWALL 38-52 PX-440926112 CDM 92611 CPT 440 RC inpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST MOTION FLUORO EVAL SWALL 53-67 PX-440926113 CDM 92611 CPT 440 RC inpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST MOTION FLUORO SWAL 68-82 PX-440926114 CDM 92611 CPT 440 RC inpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST MOTION FLUORO EVAL SWAL 83-97 PX-440926115 CDM 92611 CPT 440 RC inpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST MOTION FLUORO EVAL SWAL 98-112 PX-440926116 CDM 92611 CPT 440 RC inpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST MOTION FLUORO EVAL SWAL113-127 PX-440926117 CDM 92611 CPT 440 RC inpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ST FLEXIBLE FIBEROPTIC ENDOSC EVAL SWALLOW 8-22 PX-440926120 CDM 92612 CPT 440 RC inpatient 496 486.08 All Payors / Plans All Payors / Plans 496 other 496 496 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ST FLEXIBLE FIBEROPTIC ENDOSC EVAL SWALLOW 23-37 PX-440926121 CDM 92612 CPT 440 RC inpatient 496 486.08 All Payors / Plans All Payors / Plans 496 other 496 496 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ST FLEXIBLE FIBEROPTIC ENDOSC EVAL SWALLOW 38-52 PX-440926122 CDM 92612 CPT 440 RC inpatient 496 486.08 All Payors / Plans All Payors / Plans 496 other 496 496 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ST FLEXIBLE FIBEROPTIC ENDOSC EVAL SWALLOW 53-67 PX-440926123 CDM 92612 CPT 440 RC inpatient 496 486.08 All Payors / Plans All Payors / Plans 496 other 496 496 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST ASSESS APHASIA W/RPT PER HR PX-440961050 CDM 96105 CPT 440 RC inpatient 119 116.62 All Payors / Plans All Payors / Plans 119 other 119 119 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST DEVELOPMNTL TEST/LMTD 8-22 PX-440961100 CDM 96110 CPT 440 RC inpatient 32 31.36 All Payors / Plans All Payors / Plans 32 other 32 32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST DEVELOPMNTL TEST/LMTD 23-37 PX-440961101 CDM 96110 CPT 440 RC inpatient 32 31.36 All Payors / Plans All Payors / Plans 32 other 32 32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST DEVELOPMNTL TEST/LMTD 38-52 PX-440961102 CDM 96110 CPT 440 RC inpatient 32 31.36 All Payors / Plans All Payors / Plans 32 other 32 32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST DEVELOPMNTL TEST/LMTD 53-67 PX-440961103 CDM 96110 CPT 440 RC inpatient 32 31.36 All Payors / Plans All Payors / Plans 32 other 32 32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST STANDARD COGNITIVE PERFORMANCE TESTING PX-440961250 CDM 96125 CPT 440 RC inpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST ORAL MOTOR EXERC 15 MIN TPR PX-440971100 CDM 97110 CPT 440 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST THER EXNEUROMUSC/ 15 MIN PX-440971120 CDM 97112 CPT 440 RC inpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST DEVELOP COGNITIVE SKILLS EA ADD'L 15 MIN PX-440971301 CDM 97130 CPT 440 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST DEVELOP COGNITIVE SKILLS INITIAL 15 MN PX-440975320 CDM 97129 CPT 440 RC inpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TRMT/SENSORIMO IND 15 MIN PX-440975330 CDM 97533 CPT 440 RC inpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TEP CHECKOUT EST PT 15 MIN PX-440977620 CDM 97763 CPT 440 RC inpatient 119 116.62 All Payors / Plans All Payors / Plans 119 other 119 119 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ER-BRIEF VISIT PX-451992810 CDM 99281 CPT 451 RC inpatient 110 107.8 All Payors / Plans All Payors / Plans 110 other 110 110 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ER-SCREENING PX-451992811 CDM 99281 CPT 451 RC inpatient 110 107.8 All Payors / Plans All Payors / Plans 110 other 110 110 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ER-EXTENDED CARE PX-452000000 CDM 452 RC inpatient 110 107.8 All Payors / Plans All Payors / Plans 110 other 110 110 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ER-INTERMEDIATE VISIT PX-452992820 CDM 99282 CPT 452 RC inpatient 110 107.8 All Payors / Plans All Payors / Plans 110 other 110 110 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ER-EXTENDED VISIT PX-452992830 CDM 99283 CPT 452 RC inpatient 220 215.6 All Payors / Plans All Payors / Plans 220 other 220 220 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ER-INTENSIVE VISIT PX-452992840 CDM 99284 CPT 452 RC inpatient 440 431.2 All Payors / Plans All Payors / Plans 440 other 440 440 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ER-COMPREHENSIVE VISIT PX-452992850 CDM 99285 CPT 452 RC inpatient 770 754.6 All Payors / Plans All Payors / Plans 770 other 770 770 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RT CAPILLARY ABG DRAW PX-460364160 CDM 36416 CPT 460 RC inpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RT BLOOD GAS PUNCTURE PX-460366000 CDM 36600 CPT 460 RC inpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PF ARTERIAL GASES PX-460366001 CDM 36600 CPT 460 RC inpatient 138 135.24 All Payors / Plans All Payors / Plans 138 other 138 138 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARTERIAL LINE SET UP PX-460366200 CDM 36620 CPT 460 RC inpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SCREENING SPIROMETRY PX-460940101 CDM 94010 CPT 460 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INCENTIVE SPIROMETRY INITIAL PX-460940102 CDM 94010 CPT 460 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INCENTIVE SPIROMETRY SUBSEQUENT PX-460940103 CDM 94010 CPT 460 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SCREENING SPIRO. C BD PX-460940600 CDM 94060 CPT 460 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRONCHIAL CHALLENGE PX-460940700 CDM 94070 CPT 460 RC inpatient 775 759.5 All Payors / Plans All Payors / Plans 775 other 775 775 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITAL CAPACITY PX-460941500 CDM 94150 CPT 460 RC inpatient 72 70.56 All Payors / Plans All Payors / Plans 72 other 72 72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MAXIMUM VOLUME VENT PX-460942000 CDM 94200 CPT 460 RC inpatient 111 108.78 All Payors / Plans All Payors / Plans 111 other 111 111 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEASUREMENT OF CO LEVEL PX-460942500 CDM 94250 CPT 460 RC inpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WALK TEST PX-460946202 CDM 94618 CPT 460 RC inpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY STRESS TESTING PX-460946204 CDM 94618 CPT 460 RC inpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPAP SET-UP AND MANAGEMENT PX-460946600 CDM 94660 CPT 460 RC inpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEMONSTRATION OF NEBULAZATION PX-460946640 CDM 94664 CPT 460 RC inpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIFFUSION/VOLUME PX-460947290 CDM 94729 CPT 460 RC inpatient 185 181.3 All Payors / Plans All Payors / Plans 185 other 185 185 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEMBRANE DIFFUSION CAPACITY PX-460947291 CDM 94729 CPT 460 RC inpatient 185 181.3 All Payors / Plans All Payors / Plans 185 other 185 185 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PF PULSE OX PX-460947600 CDM 94760 CPT 460 RC inpatient 74 72.52 All Payors / Plans All Payors / Plans 74 other 74 74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULSE OXIMETRY PX-460947601 CDM 94760 CPT 460 RC inpatient 32 31.36 All Payors / Plans All Payors / Plans 32 other 32 32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PF PULSE OX PX-460947602 CDM 94760 CPT 460 RC inpatient 74 72.52 All Payors / Plans All Payors / Plans 74 other 74 74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MULTIPLE DETERIMATION PULSE OX/EXERC PX-460947611 CDM 94761 CPT 460 RC inpatient 240 235.2 All Payors / Plans All Payors / Plans 240 other 240 240 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULSE OXIMETRY MULTIPLE READINGS PX-460947612 CDM 94761 CPT 460 RC inpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERICARDIALCENTESIS W/ECHO PX-480769300 CDM 76930 CPT 480 RC inpatient 1460 1430.8 All Payors / Plans All Payors / Plans 1460 other 1460 1460 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EK CARDIOVERSION PX-480929600 CDM 92960 CPT 480 RC inpatient 202 197.96 All Payors / Plans All Payors / Plans 202 other 202 202 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONGENITAL ECHO (2D)/M PX-480933030 CDM 93303 CPT 480 RC inpatient 202 197.96 All Payors / Plans All Payors / Plans 202 other 202 202 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONGENITAL ECHO 2D LTD F/U PX-480933040 CDM 93304 CPT 480 RC inpatient 90 88.2 All Payors / Plans All Payors / Plans 90 other 90 90 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EC ECHO 2D-M DOPPLER/COLOR PX-480933060 CDM 93306 CPT 480 RC inpatient 269 263.62 All Payors / Plans All Payors / Plans 269 other 269 269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ECHOCARDIOGRAM (2D)/M PX-480933070 CDM 93307 CPT 480 RC inpatient 202 197.96 All Payors / Plans All Payors / Plans 202 other 202 202 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ECHO 2D LIMITED/FOLLOW-UP PX-480933080 CDM 93308 CPT 480 RC inpatient 90 88.2 All Payors / Plans All Payors / Plans 90 other 90 90 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARDIAC DOPPLER PX-480933200 CDM 93320 CPT 480 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARDIAC DOPPLER FOLLOW-UP PX-480933210 CDM 93321 CPT 480 RC inpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DOPPLER COLOR FLOW PX-480933250 CDM 93325 CPT 480 RC inpatient 22 21.56 All Payors / Plans All Payors / Plans 22 other 22 22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYOCARD STRAIN IMG SPECKLE TRCK ASSMT PX-480933560 CDM 93356 CPT 480 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EK TILT TABLE 45 MIN OR LESS PX-480936600 CDM 93660 CPT 480 RC inpatient 269 263.62 All Payors / Plans All Payors / Plans 269 other 269 269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EK TILT TABLE >45 MIN PX-480936601 CDM 93660 CPT 480 RC inpatient 404 395.92 All Payors / Plans All Payors / Plans 404 other 404 404 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARDIAC CATH LAB SUPPLIES PX-481000000 CDM 481 RC inpatient 532.56 521.91 All Payors / Plans All Payors / Plans 532.56 other 532.56 532.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CL CARDIAC CATH MINUTES PX-481000020 CDM 481 RC inpatient 73 71.54 All Payors / Plans All Payors / Plans 73 other 73 73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EP EP MINUTES PX-481000030 CDM 481 RC inpatient 73 71.54 All Payors / Plans All Payors / Plans 73 other 73 73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXER TOLERANCE TEST PX-482930170 CDM 93017 CPT 482 RC inpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARDIOVASCULAR STRESS TEST PX-482930171 CDM 93017 CPT 482 RC inpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXER TOLERANCE TEST PX-482930172 CDM 93017 CPT 482 RC inpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRANSESOPHAGEAL ECHO PX-483933120 CDM 93312 CPT 483 RC inpatient 269 263.62 All Payors / Plans All Payors / Plans 269 other 269 269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STRESS/PHARMACOLOGICAL ECHO PX-483933500 CDM 93350 CPT 483 RC inpatient 269 263.62 All Payors / Plans All Payors / Plans 269 other 269 269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC DIAB SELF MGMT, IND 30 MIN" PX-510001089 CDM G0108 CPT 942 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC DIAB SELF MGMT, GROUP 30 MIN" PX-510001099 CDM G0109 CPT 942 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTERDISCIPLINARY VISIT PX-510001750 CDM G0175 CPT 510 RC inpatient 362 354.76 All Payors / Plans All Payors / Plans 362 other 362 362 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC MED NUT THER IND 2ND REG EA 15 MIN PX-510002709 CDM G0270 CPT 942 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC MED NUTRU THER GROUP 30 MIN PX-510002719 CDM G0271 CPT 942 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC FIRST ANNUAL WELLNESS VISIT MEDICARE 0-10 MIN PX-510004385 CDM G0438 CPT 510 RC inpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC FIRST ANNUAL WELLNESS VISIT MEDICARE 11-25 MIN PX-510004386 CDM G0438 CPT 510 RC inpatient 121 118.58 All Payors / Plans All Payors / Plans 121 other 121 121 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC FIRST ANNUAL WELLNESS VISIT MEDICARE 26-45 MIN PX-510004387 CDM G0438 CPT 510 RC inpatient 211 206.78 All Payors / Plans All Payors / Plans 211 other 211 211 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC FIRST ANNUAL WELLNESS VISIT MEDICARE 46-90 MIN PX-510004388 CDM G0438 CPT 510 RC inpatient 453 443.94 All Payors / Plans All Payors / Plans 453 other 453 453 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC FIRST ANNUAL WELLNESS VISIT MEDICARE 90 MIN OR GREATER PX-510004389 CDM G0438 CPT 510 RC inpatient 543 532.14 All Payors / Plans All Payors / Plans 543 other 543 543 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SUBSEQUENT ANNUAL WELLNESS VISIT MEDICARE 0-10 MIN PX-510004395 CDM G0439 CPT 510 RC inpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SUBSEQUENT ANNUAL WELLNESS VISIT MEDICARE 11-25 MIN PX-510004396 CDM G0439 CPT 510 RC inpatient 121 118.58 All Payors / Plans All Payors / Plans 121 other 121 121 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SUBSEQUENT ANNUAL WELLNESS VISIT MEDICARE 26-45 MIN PX-510004397 CDM G0439 CPT 510 RC inpatient 211 206.78 All Payors / Plans All Payors / Plans 211 other 211 211 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SUBSEQUENT WELLNESS VISIT MEDICARE 46-90 MIN PX-510004398 CDM G0439 CPT 510 RC inpatient 453 443.94 All Payors / Plans All Payors / Plans 453 other 453 453 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SUBSEQUENT ANNUAL WELLNESS VISIT MEDICARE 90 MIN OR GREATER PX-510004399 CDM G0439 CPT 510 RC inpatient 543 532.14 All Payors / Plans All Payors / Plans 543 other 543 543 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC EXCHANGE TRANSFUSION, BLOOD" PX-510364550 CDM 36455 CPT 510 RC inpatient 693 679.14 All Payors / Plans All Payors / Plans 693 other 693 693 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APHERESIS WHITE BLOOD CELLS PX-510365110 CDM 36511 CPT 510 RC inpatient 1650 1617 All Payors / Plans All Payors / Plans 1650 other 1650 1650 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APHERESIS RED BLOOD CELLS PX-510365120 CDM 36512 CPT 510 RC inpatient 1650 1617 All Payors / Plans All Payors / Plans 1650 other 1650 1650 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APHERESIS PLATELETS PX-510365130 CDM 36513 CPT 510 RC inpatient 1650 1617 All Payors / Plans All Payors / Plans 1650 other 1650 1650 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APHERESIS PLASMA PHERESIS PX-510365140 CDM 36514 CPT 510 RC inpatient 1650 1617 All Payors / Plans All Payors / Plans 1650 other 1650 1650 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COLL OF BLOOD VENOUS ACCESS DEV PX-510365910 CDM 36591 CPT 510 RC inpatient 264 258.72 All Payors / Plans All Payors / Plans 264 other 264 264 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DECLOT THROMBO AGENT DEV/CATHETER PX-510365930 CDM 36593 CPT 510 RC inpatient 330 323.4 All Payors / Plans All Payors / Plans 330 other 330 330 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC IMMUNIZATION EA ADD PX-510904729 CDM 90472 CPT 510 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC IMMUN ORAL OR INTRANASAL PX-510904739 CDM 90473 CPT 510 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC IMMUN ORAL EA ADDL PX-510904749 CDM 90474 CPT 510 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INJECTION - SUB Q OR IM PX-510963720 CDM 96372 CPT 510 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC INJECTION PX-510963729 CDM 96372 CPT 260 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC IV PUSH PX-510963749 CDM 96374 CPT 260 RC inpatient 330 323.4 All Payors / Plans All Payors / Plans 330 other 330 330 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC MED NUTR THER IND INITIAL PX-510978029 CDM 97802 CPT 942 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC MED NUT THER, IND RE ASSES" PX-510978039 CDM 97803 CPT 942 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC MED NUT THER, GROUP RE" PX-510978049 CDM 97804 CPT 942 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TELEPHONE MEDICAL DISCUSSION 5-10 MINUTES PX-510989660 CDM 98966 CPT 510 RC inpatient 30 29.4 All Payors / Plans All Payors / Plans 30 other 30 30 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TELEPHONE MEDICAL DISCUSSION 11-20 MINUTES PX-510989670 CDM 98967 CPT 510 RC inpatient 30 29.4 All Payors / Plans All Payors / Plans 30 other 30 30 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TELEPHONE MEDICAL DISCUSSION 21-30 MINUTES PX-510989680 CDM 98968 CPT 510 RC inpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC OP VISIT, NEW 0-10 MIN" PX-510992010 CDM 99202 CPT 510 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC DOT PHYSICAL NEW PX-510992017 CDM 99202 CPT 510 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SPORTS/SCHOOL PHYSICAL NEW PX-510992018 CDM 99202 CPT 510 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PRE EMPLOYMENT PHYSICAL NEW PX-510992019 CDM 99202 CPT 510 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT NEW 11-25 MIN PX-510992020 CDM 99202 CPT 510 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT NEW 26-45 MIN PX-510992030 CDM 99203 CPT 510 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT NEW 46-90 MIN PX-510992040 CDM 99204 CPT 510 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT NEW 90 MIN OR > PX-510992050 CDM 99205 CPT 510 RC inpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT EST 0-10 MIN PX-510992110 CDM 99211 CPT 510 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC DOT PHYSICAL ESTABLISHED PX-510992117 CDM 99211 CPT 510 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC DOT SPORTS/SCHOOL PHYSICAL ESTABLISHED PX-510992118 CDM 99211 CPT 510 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PRE EMPLOYMENT PHYSICAL ESTABLISHED PX-510992119 CDM 99211 CPT 510 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT EST 11-25 MIN PX-510992120 CDM 99212 CPT 510 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT EST 26-45 MIN PX-510992130 CDM 99213 CPT 510 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT EST 46-90 MIN PX-510992140 CDM 99214 CPT 510 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT EST 90 MIN OR > PX-510992150 CDM 99215 CPT 510 RC inpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PROLONGED FIRST HOUR PX-510993549 CDM 99354 CPT 510 RC inpatient 151 147.98 All Payors / Plans All Payors / Plans 151 other 151 151 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PROLONGED EA ADDITIONAL 30 MIN PX-510993559 CDM 99355 CPT 510 RC inpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTIVE VISIT 12-17 0-10 MIN PX-510993845 CDM 99384 CPT 510 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 12-17 11-25 MIN PX-510993846 CDM 99384 CPT 510 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 12-17 26-45 MIN PX-510993847 CDM 99384 CPT 510 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 12-17 46-90 MIN PX-510993848 CDM 99384 CPT 510 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 12-17 90 MIN OR GREATER PX-510993849 CDM 99384 CPT 510 RC inpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTIVE VISIT 18-39 0-10 MIN PX-510993855 CDM 99385 CPT 510 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 18-39 11-25 MIN PX-510993856 CDM 99385 CPT 510 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 18-39 26-45 MIN PX-510993857 CDM 99385 CPT 510 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 18-39 46-90 MIN PX-510993858 CDM 99385 CPT 510 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 18-39 90 MIN OR GREATER PX-510993859 CDM 99385 CPT 510 RC inpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTIVE VISIT 40-64 0-10 MIN PX-510993865 CDM 99386 CPT 510 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 40-64 11-25 MIN PX-510993866 CDM 99386 CPT 510 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 40-64 26-45 MIN PX-510993867 CDM 99386 CPT 510 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 40-64 46-90 MIN PX-510993868 CDM 99386 CPT 510 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 40-64 90 MIN OR GREATER PX-510993869 CDM 99386 CPT 510 RC inpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTIVE VISIT AGE 65+ 0-10 MIN PX-510993875 CDM 99387 CPT 510 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT AGE 65+ 11-25 MIN PX-510993876 CDM 99387 CPT 510 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT AGE 65+ 26-45 MIN PX-510993877 CDM 99387 CPT 510 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT AGE 65+ 46-90 MIN PX-510993878 CDM 99387 CPT 510 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT AGE 65+ 90 MIN OR GREATER PX-510993879 CDM 99387 CPT 510 RC inpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTIVE VISIT 12-17 0-10 MIN PX-510993945 CDM 99394 CPT 510 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 12-17 11-25 MIN PX-510993946 CDM 99394 CPT 510 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 12-17 26-45 MIN PX-510993947 CDM 99394 CPT 510 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 12-17 46-90 MIN PX-510993948 CDM 99394 CPT 510 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 12-17 90 MIN OR GREATER PX-510993949 CDM 99394 CPT 510 RC inpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTIVE VISIT 18-39 0-10 MIN PX-510993955 CDM 99395 CPT 510 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 18-39 11-25 MIN PX-510993956 CDM 99395 CPT 510 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 18-39 26-45 MIN PX-510993957 CDM 99395 CPT 510 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 18-39 46-90 MIN PX-510993958 CDM 99395 CPT 510 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 18-39 90 MIN OR GREATER PX-510993959 CDM 99395 CPT 510 RC inpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTIVE VISIT 40-64 0-10 MIN PX-510993965 CDM 99396 CPT 510 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 40-64 11-25 MIN PX-510993966 CDM 99396 CPT 510 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 40-64 26-45 MIN PX-510993967 CDM 99396 CPT 510 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 40-64 46-90 MIN PX-510993968 CDM 99396 CPT 510 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 40-64 90 MIN OR GREATER PX-510993969 CDM 99396 CPT 510 RC inpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTIVE VISIT AGE 65+ 0-10 MIN PX-510993975 CDM 99397 CPT 510 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT AGE 65+ 11-25 MIN PX-510993976 CDM 99397 CPT 510 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT AGE 65+ 26-45 MIN PX-510993977 CDM 99397 CPT 510 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT AGE 65+ 46-90 MIN PX-510993978 CDM 99397 CPT 510 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT AGE 65+ 90 MIN OR GREATER PX-510993979 CDM 99397 CPT 510 RC inpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHRT LEG SP CALF-FOOT 53-67 PX-530295150 CDM 29515 CPT 530 RC inpatient 364 356.72 All Payors / Plans All Payors / Plans 364 other 364 364 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD MRI BREAST BIOPSY PX-610190850 CDM 19085 CPT 610 RC inpatient 190 186.2 All Payors / Plans All Payors / Plans 190 other 190 190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD MRI BREAST BIOPSY EA ADDL PX-610190860 CDM 19086 CPT 610 RC inpatient 190 186.2 All Payors / Plans All Payors / Plans 190 other 190 190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-TMJ PX-610703360 CDM 70336 CPT 610 RC inpatient 888 870.24 All Payors / Plans All Payors / Plans 888 other 888 888 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-TMJ W CONTRAST PX-610703361 CDM 70336 CPT 610 RC inpatient 888 870.24 All Payors / Plans All Payors / Plans 888 other 888 888 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-TMJ W/WO CONTRAST PX-610703362 CDM 70336 CPT 610 RC inpatient 888 870.24 All Payors / Plans All Payors / Plans 888 other 888 888 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MRI ORBIT, FACE, OR NECK W/O" PX-610705400 CDM 70540 CPT 610 RC inpatient 837 820.26 All Payors / Plans All Payors / Plans 837 other 837 837 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MRI ORBIT, FACE, OR NECK W" PX-610705420 CDM 70542 CPT 610 RC inpatient 913 894.74 All Payors / Plans All Payors / Plans 913 other 913 913 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MRI ORBIT, FACE, OR NECK W WO" PX-610705430 CDM 70543 CPT 610 RC inpatient 1103 1080.94 All Payors / Plans All Payors / Plans 1103 other 1103 1103 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-CHEST PX-610715500 CDM 71550 CPT 610 RC inpatient 1217 1192.66 All Payors / Plans All Payors / Plans 1217 other 1217 1217 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-CHEST W CONTRAST PX-610715510 CDM 71551 CPT 610 RC inpatient 1331 1304.38 All Payors / Plans All Payors / Plans 1331 other 1331 1331 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-CHEST W/WO CONTRAST PX-610715520 CDM 71552 CPT 610 RC inpatient 1661 1627.78 All Payors / Plans All Payors / Plans 1661 other 1661 1661 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-PELVIS PX-610721950 CDM 72195 CPT 610 RC inpatient 1078 1056.44 All Payors / Plans All Payors / Plans 1078 other 1078 1078 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-PELVIS W CONTRAST PX-610721960 CDM 72196 CPT 610 RC inpatient 1154 1130.92 All Payors / Plans All Payors / Plans 1154 other 1154 1154 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-PELVIS W/WO CONTRAST PX-610721970 CDM 72197 CPT 610 RC inpatient 1395 1367.1 All Payors / Plans All Payors / Plans 1395 other 1395 1395 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI UPPER EXTREM WO CONTRAST PX-610732180 CDM 73218 CPT 610 RC inpatient 1065 1043.7 All Payors / Plans All Payors / Plans 1065 other 1065 1065 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI UPPER EXTREM W CONTRAST PX-610732190 CDM 73219 CPT 610 RC inpatient 1141 1118.18 All Payors / Plans All Payors / Plans 1141 other 1141 1141 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI UPPER EXTREM W WO CONTRAST PX-610732200 CDM 73220 CPT 610 RC inpatient 1395 1367.1 All Payors / Plans All Payors / Plans 1395 other 1395 1395 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI UPPER EXTREM JOINT WO CONT PX-610732210 CDM 73221 CPT 610 RC inpatient 596 584.08 All Payors / Plans All Payors / Plans 596 other 596 596 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI UPPER EXTREM JOINT W CONT PX-610732220 CDM 73222 CPT 610 RC inpatient 1052 1030.96 All Payors / Plans All Payors / Plans 1052 other 1052 1052 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI UPPER EXTREM JOINT WWO CONT PX-610732230 CDM 73223 CPT 610 RC inpatient 1293 1267.14 All Payors / Plans All Payors / Plans 1293 other 1293 1293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI LOWER EXTREM JOINT WWO CONT PX-610732730 CDM 73723 CPT 610 RC inpatient 1293 1267.14 All Payors / Plans All Payors / Plans 1293 other 1293 1293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI LOWER EXTREM WO CONTRAST PX-610737180 CDM 73718 CPT 610 RC inpatient 1052 1030.96 All Payors / Plans All Payors / Plans 1052 other 1052 1052 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI LOWER EXTREM W CONTRAST PX-610737190 CDM 73719 CPT 610 RC inpatient 1154 1130.92 All Payors / Plans All Payors / Plans 1154 other 1154 1154 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI LOWER EXTREM WWO CONTRAST PX-610737200 CDM 73720 CPT 610 RC inpatient 1407 1378.86 All Payors / Plans All Payors / Plans 1407 other 1407 1407 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI LOWER EXTREM JOINT WO CONT PX-610737210 CDM 73721 CPT 610 RC inpatient 596 584.08 All Payors / Plans All Payors / Plans 596 other 596 596 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI LOWER EXTREM JOINT W CONT PX-610737220 CDM 73722 CPT 610 RC inpatient 1065 1043.7 All Payors / Plans All Payors / Plans 1065 other 1065 1065 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI LOWER EXTREM JOINT WWO CONT PX-610737230 CDM 73723 CPT 610 RC inpatient 1293 1267.14 All Payors / Plans All Payors / Plans 1293 other 1293 1293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI ABDOMEN WO CONTRAST PX-610741810 CDM 74181 CPT 610 RC inpatient 926 907.48 All Payors / Plans All Payors / Plans 926 other 926 926 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI ABDOMEN W CONTRAST PX-610741820 CDM 74182 CPT 610 RC inpatient 1306 1279.88 All Payors / Plans All Payors / Plans 1306 other 1306 1306 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI ABDOMEN W WO CONTRAST PX-610741830 CDM 74183 CPT 610 RC inpatient 1407 1378.86 All Payors / Plans All Payors / Plans 1407 other 1407 1407 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI FETAL FIRST GESTATION PX-610747120 CDM 74712 CPT 610 RC inpatient 1179 1155.42 All Payors / Plans All Payors / Plans 1179 other 1179 1179 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI FETAL EACH ADD GESTATION PX-610747130 CDM 74713 CPT 610 RC inpatient 495 485.1 All Payors / Plans All Payors / Plans 495 other 495 495 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-CARDIAC MORPHOLOGY W/O CONT PX-610755570 CDM 75557 CPT 610 RC inpatient 723 708.54 All Payors / Plans All Payors / Plans 723 other 723 723 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI CARDIAC W STRESS IMAGING PX-610755590 CDM 75559 CPT 610 RC inpatient 1052 1030.96 All Payors / Plans All Payors / Plans 1052 other 1052 1052 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-CARDIAC MORPHOLOGY W CONTRAST PX-610755610 CDM 75561 CPT 610 RC inpatient 1052 1030.96 All Payors / Plans All Payors / Plans 1052 other 1052 1052 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI CARD W&WO STRESS IMAG PX-610755630 CDM 75563 CPT 610 RC inpatient 1281 1255.38 All Payors / Plans All Payors / Plans 1281 other 1281 1281 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI CARD W FLOW VEL STRESS IMG PX-610755650 CDM 75565 CPT 610 RC inpatient 152 148.96 All Payors / Plans All Payors / Plans 152 other 152 152 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-GUIDANCE TISSUE ABLATION PX-610770220 CDM 77022 CPT 610 RC inpatient 190 186.2 All Payors / Plans All Payors / Plans 190 other 190 190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD MRI BREAST UNILATERAL W/WO CONTRAST PX-610770480 CDM 77048 CPT 610 RC inpatient 1636 1603.28 All Payors / Plans All Payors / Plans 1636 other 1636 1636 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD MRI BREAST BILATERAL W/WO CONTRAST PX-610770490 CDM 77049 CPT 610 RC inpatient 1623 1590.54 All Payors / Plans All Payors / Plans 1623 other 1623 1623 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD MRI BREAST UNILATERAL NO CONTRAST PX-610770580 CDM 77046 CPT 610 RC inpatient 1636 1603.28 All Payors / Plans All Payors / Plans 1636 other 1636 1636 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD MRI BREAST BILATERAL NO CONTRAST PX-610770590 CDM 77047 CPT 610 RC inpatient 1623 1590.54 All Payors / Plans All Payors / Plans 1623 other 1623 1623 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI BRAIN WO CONTRAST PX-611705510 CDM 70551 CPT 611 RC inpatient 558 546.84 All Payors / Plans All Payors / Plans 558 other 558 558 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MRI BRAIN W CONTRAST PX-611705520 CDM 70552 CPT 611 RC inpatient 824 807.52 All Payors / Plans All Payors / Plans 824 other 824 824 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI SPECTROSCOPY PX-611763900 CDM 76390 CPT 611 RC inpatient 1344 1317.12 All Payors / Plans All Payors / Plans 1344 other 1344 1344 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-C-SPINE PX-612721410 CDM 72141 CPT 612 RC inpatient 533 522.34 All Payors / Plans All Payors / Plans 533 other 533 533 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-C SPINE W CONTRAST PX-612721420 CDM 72142 CPT 612 RC inpatient 837 820.26 All Payors / Plans All Payors / Plans 837 other 837 837 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-T-SPINE PX-612721460 CDM 72146 CPT 612 RC inpatient 533 522.34 All Payors / Plans All Payors / Plans 533 other 533 533 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-T-SPINE W CONTRAST PX-612721470 CDM 72147 CPT 612 RC inpatient 837 820.26 All Payors / Plans All Payors / Plans 837 other 837 837 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-L-SPINE PX-612721480 CDM 72148 CPT 612 RC inpatient 533 522.34 All Payors / Plans All Payors / Plans 533 other 533 533 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-L-SPINE W CONTRAST PX-612721490 CDM 72149 CPT 612 RC inpatient 837 820.26 All Payors / Plans All Payors / Plans 837 other 837 837 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-C SPINE W/WO CONTRAST PX-612721560 CDM 72156 CPT 612 RC inpatient 938 919.24 All Payors / Plans All Payors / Plans 938 other 938 938 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-T SPINE W/WO CONTRAST PX-612721570 CDM 72157 CPT 612 RC inpatient 951 931.98 All Payors / Plans All Payors / Plans 951 other 951 951 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-L-SPINE W/WO CONTRAST PX-612721580 CDM 72158 CPT 612 RC inpatient 938 919.24 All Payors / Plans All Payors / Plans 938 other 938 938 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRA HEAD WO CONTRAST PX-615705440 CDM 70544 CPT 615 RC inpatient 1179 1155.42 All Payors / Plans All Payors / Plans 1179 other 1179 1179 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRA-NECK PX-615705470 CDM 70547 CPT 615 RC inpatient 1192 1168.16 All Payors / Plans All Payors / Plans 1192 other 1192 1192 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRA LOWER EXTREMITY PX-616737250 CDM 73725 CPT 616 RC inpatient 1103 1080.94 All Payors / Plans All Payors / Plans 1103 other 1103 1103 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRA-CHEST PX-618715550 CDM 71555 CPT 618 RC inpatient 1103 1080.94 All Payors / Plans All Payors / Plans 1103 other 1103 1103 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRA-PELVIS PX-618721980 CDM 72198 CPT 618 RC inpatient 1116 1093.68 All Payors / Plans All Payors / Plans 1116 other 1116 1116 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRA UPPER EXTREMITY PX-618732250 CDM 73225 CPT 618 RC inpatient 1154 1130.92 All Payors / Plans All Payors / Plans 1154 other 1154 1154 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRA ABDOMEN W WO CONTRAST PX-618741850 CDM 74185 CPT 618 RC inpatient 1116 1093.68 All Payors / Plans All Payors / Plans 1116 other 1116 1116 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRE-OP/POST-OP CARE PX-710000000 CDM 710 RC inpatient 1190 1166.2 All Payors / Plans All Payors / Plans 1190 other 1190 1190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VAGINAL DELIVERY PX-720000000 CDM 720 RC inpatient 3336 3269.28 All Payors / Plans All Payors / Plans 3336 other 3336 3336 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VAGINAL DELIVERY VAC-FORCEPS PX-720000001 CDM 720 RC inpatient 3614 3541.72 All Payors / Plans All Payors / Plans 3614 other 3614 3614 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VAGINAL DELIVERY W/ EPIDURAL PX-720000002 CDM 720 RC inpatient 4170 4086.6 All Payors / Plans All Payors / Plans 4170 other 4170 4170 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VAG DEL W EPID-VAC-FORCEP PX-720000003 CDM 720 RC inpatient 4448 4359.04 All Payors / Plans All Payors / Plans 4448 other 4448 4448 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VAG DEL PRIOR CSEC(VBAC) PX-720000004 CDM 720 RC inpatient 4448 4359.04 All Payors / Plans All Payors / Plans 4448 other 4448 4448 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MULTIPLE BIRTH - TWINS PX-720000005 CDM 720 RC inpatient 834 817.32 All Payors / Plans All Payors / Plans 834 other 834 834 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MULTIPLE BIRTH - TRIPLETS PX-720000006 CDM 720 RC inpatient 1251 1225.98 All Payors / Plans All Payors / Plans 1251 other 1251 1251 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INDUCTION PX-720000007 CDM 720 RC inpatient 556 544.88 All Payors / Plans All Payors / Plans 556 other 556 556 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NON-STRESS TEST PX-720000008 CDM 720 RC inpatient 695 681.1 All Payors / Plans All Payors / Plans 695 other 695 695 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STRESS TEST PX-720000009 CDM 720 RC inpatient 695 681.1 All Payors / Plans All Payors / Plans 695 other 695 695 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMNIOCENTESIS PX-720000010 CDM 720 RC inpatient 417 408.66 All Payors / Plans All Payors / Plans 417 other 417 417 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ULTRASOUND PX-720000011 CDM 720 RC inpatient 417 408.66 All Payors / Plans All Payors / Plans 417 other 417 417 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXT. NEONATE ROTATION PX-720000012 CDM 720 RC inpatient 1390 1362.2 All Payors / Plans All Payors / Plans 1390 other 1390 1390 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LABOR ROOM - SCH CS PX-720000013 CDM 720 RC inpatient 2502 2451.96 All Payors / Plans All Payors / Plans 2502 other 2502 2502 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LABOR ROOM - NON-SCH CS PX-720000014 CDM 720 RC inpatient 5143 5040.14 All Payors / Plans All Payors / Plans 5143 other 5143 5143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SCHEDULED C-SEC W MINOR SURGERY PX-720000015 CDM 720 RC inpatient 2780 2724.4 All Payors / Plans All Payors / Plans 2780 other 2780 2780 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NON-SCHED C-SEC W MINOR SURGERY PX-720000016 CDM 720 RC inpatient 5421 5312.58 All Payors / Plans All Payors / Plans 5421 other 5421 5421 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC L&D OR ADD'L MAJOR SURGERY PX-720000017 CDM 720 RC inpatient 5282 5176.36 All Payors / Plans All Payors / Plans 5282 other 5282 5282 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC L&D OR ADD'L MINOR SURG PX-720000018 CDM 720 RC inpatient 1112 1089.76 All Payors / Plans All Payors / Plans 1112 other 1112 1112 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DOUBLE SET-UP/FAILED FORCEP/VAC PX-720000019 CDM 720 RC inpatient 278 272.44 All Payors / Plans All Payors / Plans 278 other 278 278 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DELIVERY OUTSIDE HOSPITAL PX-720000020 CDM 720 RC inpatient 1668 1634.64 All Payors / Plans All Payors / Plans 1668 other 1668 1668 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OUTPATIENT MATERNAL OBSERVATION PX-720000021 CDM 720 RC inpatient 139 136.22 All Payors / Plans All Payors / Plans 139 other 139 139 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NEONATAL CARE PX-720000022 CDM 720 RC inpatient 556 544.88 All Payors / Plans All Payors / Plans 556 other 556 556 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FETAL DEMISE 2ND OR 3RD TRIMESTER PX-720000023 CDM 720 RC inpatient 4170 4086.6 All Payors / Plans All Payors / Plans 4170 other 4170 4170 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FETAL DEMISE 2ND/3RD TRIM W/EPID PX-720000024 CDM 720 RC inpatient 5004 4903.92 All Payors / Plans All Payors / Plans 5004 other 5004 5004 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMNIOINFUSION PX-720000025 CDM 720 RC inpatient 834 817.32 All Payors / Plans All Payors / Plans 834 other 834 834 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTRAUTERIN PRES CATH MONIT(IUPC) PX-720000026 CDM 720 RC inpatient 278 272.44 All Payors / Plans All Payors / Plans 278 other 278 278 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MULTIPLE BIRTH QUADS PX-720000027 CDM 720 RC inpatient 1668 1634.64 All Payors / Plans All Payors / Plans 1668 other 1668 1668 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ASSESSMENT/TRIAGE SERVICE PX-720000028 CDM 720 RC inpatient 139 136.22 All Payors / Plans All Payors / Plans 139 other 139 139 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CIRCUMCISION PX-720000029 CDM 723 RC inpatient 417 408.66 All Payors / Plans All Payors / Plans 417 other 417 417 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OUTPATIENT MATERNAL INTENSIVE CARE PX-720000030 CDM 720 RC inpatient 278 272.44 All Payors / Plans All Payors / Plans 278 other 278 278 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ELECTROCARDIOGRAM PX-730930050 CDM 93005 CPT 730 RC inpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EKG (UNREG RATE) PX-730930051 CDM 93005 CPT 730 RC inpatient 15.25 14.95 All Payors / Plans All Payors / Plans 15.25 other 15.25 15.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ML EKG (UNREG RATE) PX-730930052 CDM 93005 CPT 730 RC inpatient 15.25 14.95 All Payors / Plans All Payors / Plans 15.25 other 15.25 15.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC ELECTROCARDIOGRAM PX-730930059 CDM 93005 CPT 730 RC inpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RHYTHM STRIP PX-730930410 CDM 93041 CPT 730 RC inpatient 22 21.56 All Payors / Plans All Payors / Plans 22 other 22 22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXT ECG CONNECTION >48HR UP TO 7 DAYS PX-730932410 CDM 93242 CPT 731 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXT ECG CONNECTION >7 UP TO 15 DAYS PX-730932450 CDM 93246 CPT 731 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARDIAC EVENT RECORDER HOOK-UP PX-730932700 CDM 93270 CPT 730 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HOLTER MONITOR HOOK-UP PX-731932250 CDM 93225 CPT 731 RC inpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HOLTER 24 HOUR PX-731932260 CDM 93226 CPT 731 RC inpatient 225 220.5 All Payors / Plans All Payors / Plans 225 other 225 225 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HOLTER 48 HOUR PX-731932261 CDM 93226 CPT 731 RC inpatient 449 440.02 All Payors / Plans All Payors / Plans 449 other 449 449 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ABORTED HOLTER CHARGE PX-731932262 CDM 93226 CPT 731 RC inpatient 67 65.66 All Payors / Plans All Payors / Plans 67 other 67 67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POLYSOM AGE <6 W/PARAM 4OR> PX-740957820 CDM 95782 CPT 740 RC inpatient 4387 4299.26 All Payors / Plans All Payors / Plans 4387 other 4387 4387 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SLEEP STUDY UNATTENDED WATCH PAT PX-740958000 CDM 95800 CPT 740 RC inpatient 629 616.42 All Payors / Plans All Payors / Plans 629 other 629 629 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MULT SLEEP LATENCY TEST PX-740958050 CDM 95805 CPT 740 RC inpatient 1800 1764 All Payors / Plans All Payors / Plans 1800 other 1800 1800 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POLYSOM AGE 6>W/PARAM 4 OR> PX-740958100 CDM 95810 CPT 740 RC inpatient 2447 2398.06 All Payors / Plans All Payors / Plans 2447 other 2447 2447 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POLYSOM AGE 6> SPLIT/CPAP PX-740958110 CDM 95811 CPT 740 RC inpatient 2587 2535.26 All Payors / Plans All Payors / Plans 2587 other 2587 2587 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EEG PX-740958190 CDM 95819 CPT 740 RC inpatient 1765 1729.7 All Payors / Plans All Payors / Plans 1765 other 1765 1765 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VISUAL EVOKED RESPONSE PX-740958191 CDM 95819 CPT 740 RC inpatient 1765 1729.7 All Payors / Plans All Payors / Plans 1765 other 1765 1765 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDOSCOPY(MINUTES) PX-750000001 CDM 750 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ESOPHAGEAL MANOMETRY PX-750910100 CDM 91010 CPT 750 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROLONGED ACID REFLUX TEST PX-750910340 CDM 91034 CPT 750 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRAVO STUDY-ELECTRODE PH PX-750910350 CDM 91035 CPT 750 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SMALL BOWEL GI CAPUSULE ENDO PX-750911100 CDM 91110 CPT 750 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AGILE TEST CAPSULE ENDO PX-750912990 CDM 91299 CPT 750 RC inpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC I&D ABSCESS-SINGLE PX-761100600 CDM 10060 CPT 761 RC inpatient 328 321.44 All Payors / Plans All Payors / Plans 328 other 328 328 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC I&D ABSCESS-MULTIPLE PX-761100610 CDM 10061 CPT 761 RC inpatient 641 628.18 All Payors / Plans All Payors / Plans 641 other 641 641 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC I&D HEMATOMA, SEROMA" PX-761101400 CDM 10140 CPT 761 RC inpatient 542 531.16 All Payors / Plans All Payors / Plans 542 other 542 542 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PUNCTURE ASPIRATION OF ABSCESS PX-761101600 CDM 10160 CPT 761 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC I&D POST-OP WOUND PX-761101800 CDM 10180 CPT 761 RC inpatient 328 321.44 All Payors / Plans All Payors / Plans 328 other 328 328 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE SUB Q PX-761110420 CDM 11042 CPT 761 RC inpatient 470 460.6 All Payors / Plans All Payors / Plans 470 other 470 470 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE SUB Q W/MOD PX-761110421 CDM 11042 CPT 761 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE MUSCLE PX-761110430 CDM 11043 CPT 761 RC inpatient 499 489.02 All Payors / Plans All Payors / Plans 499 other 499 499 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE MUSCLE W/MOD PX-761110431 CDM 11043 CPT 761 RC inpatient 314 307.72 All Payors / Plans All Payors / Plans 314 other 314 314 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE BONE PX-761110440 CDM 11044 CPT 761 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE SUB Q EA ADD 20 SQ CM PX-761110450 CDM 11045 CPT 761 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE MUSCLE EACH ADD. 20SQ PX-761110460 CDM 11046 CPT 761 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE BONE EA ADD 20 SQ CM PX-761110470 CDM 11047 CPT 761 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARING BENIGN LESION - ONE PX-761110550 CDM 11055 CPT 761 RC inpatient 328 321.44 All Payors / Plans All Payors / Plans 328 other 328 328 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARING BENIGN LESION - 2-4 PX-761110560 CDM 11056 CPT 761 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARING BENIGN LESION >4 PX-761110570 CDM 11057 CPT 761 RC inpatient 570 558.6 All Payors / Plans All Payors / Plans 570 other 570 570 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TANGENTIAL BIOPSY OF SKIN PX-761111020 CDM 11102 CPT 761 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TANGENTIAL BIOPSY OF SKIN EACH ADD'L PX-761111030 CDM 11103 CPT 761 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PUNCH BIOPSY OF SKIN PX-761111040 CDM 11104 CPT 761 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PUNCH BIOPSY OF SKIN EACH ADD'L PX-761111050 CDM 11105 CPT 761 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INSICIONAL BIOSPY OF SKIN PX-761111060 CDM 11106 CPT 761 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INSICIONAL BIOSPY OF SKIN EACH ADD'L PX-761111070 CDM 11107 CPT 761 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXCISIONAL BIOPSY MALIGNANT LESION .5CM OR LESS PX-761116000 CDM 11600 CPT 761 RC inpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXCISIONAL BIOPSY MALIGNANT LESION .6-1.0 CM PX-761116010 CDM 11601 CPT 761 RC inpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXCISIONAL BIOPSY MALIGNANT LESION 1.1-2.0 CM PX-761116020 CDM 11602 CPT 761 RC inpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRIM NONDYSTROPHIC NAILS, ANY NO." PX-761117190 CDM 11719 CPT 761 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE NAIL 1-5 PX-761117200 CDM 11720 CPT 761 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE NAIL >5 PX-761117210 CDM 11721 CPT 761 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AVULSION OF NAIL PLATE SINGLE PX-761117300 CDM 11730 CPT 761 RC inpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC AVULSION OF NAIL PLATE, EA ADDL" PX-761117320 CDM 11732 CPT 761 RC inpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXCISION NAIL PARTIAL OR COMPLETE PX-761117500 CDM 11750 CPT 761 RC inpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CLOSURE SURGICAL WOUND, EXTESIVE/COMPLICATED" PX-761131600 CDM 13160 CPT 761 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ADJ TISS XFER HEAD,FAC, HAND <10 SQCM" PX-761140400 CDM 14040 CPT 761 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GFT SKIN SUB T/A/L >100CM 1ST 25 PX-761152710 CDM 15271 CPT 761 RC inpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GFT SKIN SUB T/A/L <100CM ADD 25 PX-761152720 CDM 15272 CPT 761 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GFT SKIN SUB T/A/L >100CM 1ST 100 PX-761152730 CDM 15273 CPT 761 RC inpatient 713 698.74 All Payors / Plans All Payors / Plans 713 other 713 713 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GFT SKIN SUB T/A/L >100CM EA ADDL PX-761152740 CDM 15274 CPT 761 RC inpatient 356 348.88 All Payors / Plans All Payors / Plans 356 other 356 356 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GFT SKIN SUB F/S/E <100CM 1ST 25 PX-761152750 CDM 15275 CPT 761 RC inpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GFT SKIN SUB F/S <100CM EA ADD 25 PX-761152760 CDM 15276 CPT 761 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GFT SKIN SUB F/S/E >100CM 1ST 100 PX-761152770 CDM 15277 CPT 761 RC inpatient 713 698.74 All Payors / Plans All Payors / Plans 713 other 713 713 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GFT SKIN SUB F/S>100CM EA ADD 100 PX-761152780 CDM 15278 CPT 761 RC inpatient 356 348.88 All Payors / Plans All Payors / Plans 356 other 356 356 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESS/DEBRIDE PART THICK BURN <5% PX-761160200 CDM 16020 CPT 761 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESS/DEBRIDE PART THICK BURN 5-10% PX-761160250 CDM 16025 CPT 761 RC inpatient 157 153.86 All Payors / Plans All Payors / Plans 157 other 157 157 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESS/DEBRIDE PART THICK BURN >10% PX-761160300 CDM 16030 CPT 761 RC inpatient 299 293.02 All Payors / Plans All Payors / Plans 299 other 299 299 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMICAL CAUTERIZATION PX-761172500 CDM 17250 CPT 761 RC inpatient 328 321.44 All Payors / Plans All Payors / Plans 328 other 328 328 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BONE BIOSPY-SUPERFICIAL RIBS, ILIUM, STERNUM,SPINOUS" PX-761202400 CDM 20240 CPT 761 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BONE BIOPSY-DEEP BONE HUMERUS,ISCHIUM,FEMUR" PX-761202450 CDM 20245 CPT 761 RC inpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INCISION SUBCUT TOE TENDON PX-761280100 CDM 28010 CPT 761 RC inpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TENOTOMY,OPEN,FLEXOR,FOOT SNG/MUL" PX-761282300 CDM 28230 CPT 761 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TENOTOMY, TOE SINGLE TENDON" PX-761282320 CDM 28232 CPT 761 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC AMPUTATION TOE, I-P JT" PX-761288250 CDM 28825 CPT 761 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPLY TL CONTACT LEG CAST PX-761294450 CDM 29445 CPT 761 RC inpatient 741 726.18 All Payors / Plans All Payors / Plans 741 other 741 741 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPLY UNNA BOOT PX-761295800 CDM 29580 CPT 761 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPLY UNNA BOOT BILATERAL PX-761295805 CDM 29580 CPT 761 RC inpatient 641 628.18 All Payors / Plans All Payors / Plans 641 other 641 641 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPLY PROFORE PX-761295810 CDM 29581 CPT 761 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPLY PROFORE BILATERAL PX-761295811 CDM 29581 CPT 761 RC inpatient 641 628.18 All Payors / Plans All Payors / Plans 641 other 641 641 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE MARROW/ASPIRATION PX-761382210 CDM 38221 CPT 761 RC inpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE OPEN PX-761975970 CDM 97597 CPT 761 RC inpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE OPEN WOUND W/MOD PX-761975971 CDM 97597 CPT 761 RC inpatient 185 181.3 All Payors / Plans All Payors / Plans 185 other 185 185 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE OPEN EACH ADD. 20SQ PX-761975980 CDM 97598 CPT 761 RC inpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WC NEGATIVE PRESSURE <=50 CM PX-761976052 CDM 97605 CPT 761 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NEG PRESSURE WOUND TREATMENT >50CM PX-761976062 CDM 97606 CPT 761 RC inpatient 684 670.32 All Payors / Plans All Payors / Plans 684 other 684 684 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WC TOTAL WOUND SURFACE <=50CM PX-761976070 CDM 97607 CPT 761 RC inpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TOTAL WOUND SURFACE >50CM PX-761976080 CDM 97608 CPT 761 RC inpatient 684 670.32 All Payors / Plans All Payors / Plans 684 other 684 684 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OBSERVATION CARVE OUT PX-762003780 CDM G0378 CPT 762 RC inpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OBSERVATION SERVICE PX-762003781 CDM G0378 CPT 762 RC inpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFLUENZA ADMINISTRATION PX-771000080 CDM G0008 CPT 771 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PNEUMOCOCCAL ADMINISTRATION PX-771000090 CDM G0009 CPT 771 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEP B ADMINISTRATION PX-771000100 CDM G0010 CPT 771 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PNEUMO VACCINE ADMIN PX-771904717 CDM 90471 CPT 771 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC IMMUNIZATION PX-771904718 CDM 90471 CPT 771 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC FLU VACCINE ADMIN PX-771904719 CDM 90471 CPT 771 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INJ TIXAGEVIMAB/CILAGAVIMAB PX-771M02200 CDM M0220 CPT 771 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LITHOTRIPSY PX-790505900 CDM 50590 CPT 790 RC inpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH MED ASSIST IND TX PER 15 MIN PX-900000049 CDM H0004 CPT 900 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH IOP PER 15 MIN PX-900000159 CDM H0015 CPT 906 RC inpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PSYCHIATRIC DIAGNOSTIC EVALUATION PX-900907910 CDM 90791 CPT 900 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH PSYCH ASSESSMENT PX-900907919 CDM 90791 CPT 900 RC inpatient 396 388.08 All Payors / Plans All Payors / Plans 396 other 396 396 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PSYCHIATRIC EVAL W/MED SERVICES PX-900907929 CDM 90792 CPT 900 RC inpatient 495 485.1 All Payors / Plans All Payors / Plans 495 other 495 495 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH THERAPY 30 MIN IND PX-900908329 CDM 90832 CPT 914 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH THERAPY 45 MIN IND PX-900908349 CDM 90834 CPT 914 RC inpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH THERAPY 60 MIN IND PX-900908379 CDM 90837 CPT 914 RC inpatient 297 291.06 All Payors / Plans All Payors / Plans 297 other 297 297 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH PSYCHOTHERAPY CRISIS 60 MIN PX-900908399 CDM 90839 CPT 914 RC inpatient 297 291.06 All Payors / Plans All Payors / Plans 297 other 297 297 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH PSYCHOTHERAPY CRISIS ADD 30 MIN PX-900908409 CDM 90840 CPT 914 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GROUP PSYCHOTHERAPY PX-912004100 CDM G0410 CPT 912 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PSYCHOTHERAPY 30 MINUTES PX-912908320 CDM 90832 CPT 912 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PSYCHOTHERAPY 45 MINUTES PX-912908340 CDM 90834 CPT 912 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FAMILY PSYCHOTHERAPY PX-912908470 CDM 90847 CPT 912 RC inpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GROUP PSYCHOTHERAPY ENTIRE DAY PX-912908530 CDM 90853 CPT 912 RC inpatient 672 658.56 All Payors / Plans All Payors / Plans 672 other 672 672 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GROUP PSYCHOTHERAPY HALF DAY PX-912908531 CDM 90853 CPT 912 RC inpatient 336 329.28 All Payors / Plans All Payors / Plans 336 other 336 336 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH GROUP THERAPY PX-915908539 CDM 90853 CPT 915 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH FAMILY PSYCHOTHERAPY W/O PATIENT PX-916908469 CDM 90846 CPT 916 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH FAMILY PSYCHOTHERAPY W/ PATIENT PX-916908479 CDM 90847 CPT 916 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH MULTIPLE FAMILY GROUP THERAPY PX-916908499 CDM 90849 CPT 916 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SLEEP STUDY UNATTENDED PX-920958061 CDM 95806 CPT 920 RC inpatient 524 513.52 All Payors / Plans All Payors / Plans 524 other 524 524 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL VEIN MAPPING PX-921003650 CDM 93985 CPT 921 RC inpatient 540 529.2 All Payors / Plans All Payors / Plans 540 other 540 540 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL AAA SCREEN INITIAL PX-921003890 CDM 76706 CPT 402 RC inpatient 540 529.2 All Payors / Plans All Payors / Plans 540 other 540 540 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL CAROTID DUPLEX BILATERAL PX-921938800 CDM 93880 CPT 921 RC inpatient 1308 1281.84 All Payors / Plans All Payors / Plans 1308 other 1308 1308 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL CAROTID DUPLEX UNILATERAL PX-921938820 CDM 93882 CPT 921 RC inpatient 824 807.52 All Payors / Plans All Payors / Plans 824 other 824 824 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VL TRANSCRANIAL DOPPLER, COMPLETE" PX-921938860 CDM 93886 CPT 921 RC inpatient 1848 1811.04 All Payors / Plans All Payors / Plans 1848 other 1848 1848 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VL TRANSCRANIAL DOPPLER, LIMITED" PX-921938880 CDM 93888 CPT 921 RC inpatient 995 975.1 All Payors / Plans All Payors / Plans 995 other 995 995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL QUANTIT CAROTID INTIMA BILAT PX-921938950 CDM 93895 CPT 921 RC inpatient 824 807.52 All Payors / Plans All Payors / Plans 824 other 824 824 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL SINGLE LEVEL BILATERAL PX-921939220 CDM 93922 CPT 921 RC inpatient 597 585.06 All Payors / Plans All Payors / Plans 597 other 597 597 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANKLE BRACHIAL INDEX VASCULAR CENTER PX-921939221 CDM 93922 CPT 921 RC inpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL MULTIPLE LEVEL BILATERAL PX-921939230 CDM 93923 CPT 921 RC inpatient 910 891.8 All Payors / Plans All Payors / Plans 910 other 910 910 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ATERIAL DOPPLER-LOWER-VASCULAR LAB PX-921939231 CDM 93923 CPT 921 RC inpatient 341 334.18 All Payors / Plans All Payors / Plans 341 other 341 341 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX LEA BILATERAL PX-921939250 CDM 93925 CPT 921 RC inpatient 1763 1727.74 All Payors / Plans All Payors / Plans 1763 other 1763 1763 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX LEA UNILATERAL PX-921939260 CDM 93926 CPT 921 RC inpatient 1023 1002.54 All Payors / Plans All Payors / Plans 1023 other 1023 1023 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX UEA BILATERAL PX-921939300 CDM 93930 CPT 921 RC inpatient 1336 1309.28 All Payors / Plans All Payors / Plans 1336 other 1336 1336 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX UEA UNILATERAL PX-921939310 CDM 93931 CPT 921 RC inpatient 824 807.52 All Payors / Plans All Payors / Plans 824 other 824 824 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL VENOUS DOPPLER PX-921939650 CDM 93965 CPT 921 RC inpatient 525.25 514.75 All Payors / Plans All Payors / Plans 525.25 other 525.25 525.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX VENOUS MAP BILAT PX-921939700 CDM 93970 CPT 921 RC inpatient 1308 1281.84 All Payors / Plans All Payors / Plans 1308 other 1308 1308 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX VENOUS MAP UNILAT PX-921939710 CDM 93971 CPT 921 RC inpatient 796 780.08 All Payors / Plans All Payors / Plans 796 other 796 796 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL RENAL ARTERY DUPLEX COMPLETE PX-921939750 CDM 93975 CPT 921 RC inpatient 1791 1755.18 All Payors / Plans All Payors / Plans 1791 other 1791 1791 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL RENAL ARTERY DUPLEX LIMITED PX-921939760 CDM 93976 CPT 921 RC inpatient 995 975.1 All Payors / Plans All Payors / Plans 995 other 995 995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL AORTIC DUPLEX SCAN COMPLETE PX-921939780 CDM 93978 CPT 921 RC inpatient 1222 1197.56 All Payors / Plans All Payors / Plans 1222 other 1222 1222 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL AORTIC DUPLEX SCAN LIMITED PX-921939790 CDM 93979 CPT 921 RC inpatient 768 752.64 All Payors / Plans All Payors / Plans 768 other 768 768 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX HD ART/VEN PENILE COMPLETE PX-921939800 CDM 93980 CPT 921 RC inpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX HD ART/VEN PENILE LTD PX-921939810 CDM 93981 CPT 921 RC inpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VL DUPLEX ART/VEN PRE-OP VESSEL MAPPING, UNILATERAL" PX-921939860 CDM 93986 CPT 921 RC inpatient 256 250.88 All Payors / Plans All Payors / Plans 256 other 256 256 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX HD ART AV GRAFT PX-921939900 CDM 93990 CPT 921 RC inpatient 1080 1058.4 All Payors / Plans All Payors / Plans 1080 other 1080 1080 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BODY PLETHYSMOGRAPHY PX-921947260 CDM 94726 CPT 921 RC inpatient 175 171.5 All Payors / Plans All Payors / Plans 175 other 175 175 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG ANAL OR URETHRAL SPHINCTER PX-922517850 CDM 51785 CPT 922 RC inpatient 350 343 All Payors / Plans All Payors / Plans 350 other 350 350 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG CRANIAL NERVES UNI PX-922958670 CDM 95867 CPT 922 RC inpatient 262 256.76 All Payors / Plans All Payors / Plans 262 other 262 262 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG LMT LIMBS/AXIAL MUSCLES PX-922958700 CDM 95870 CPT 922 RC inpatient 350 343 All Payors / Plans All Payors / Plans 350 other 350 350 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG EA EXTREM 4 OR LESS MUSCLES PX-922958850 CDM 95885 CPT 922 RC inpatient 192 188.16 All Payors / Plans All Payors / Plans 192 other 192 192 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG EA EXTREM 5 OR MORE MUSCLES PX-922958860 CDM 95886 CPT 922 RC inpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG NON EXTREMITY PX-922958870 CDM 95887 CPT 922 RC inpatient 210 205.8 All Payors / Plans All Payors / Plans 210 other 210 210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG NERVE CONDUCTINO 1-2 STUDIES PX-922959070 CDM 95907 CPT 922 RC inpatient 210 205.8 All Payors / Plans All Payors / Plans 210 other 210 210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG NERVE CONDUCTION 3-4 STUDIES PX-922959080 CDM 95908 CPT 922 RC inpatient 280 274.4 All Payors / Plans All Payors / Plans 280 other 280 280 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG NERVE CONDUCTION 5-6 STUDIES PX-922959090 CDM 95909 CPT 922 RC inpatient 332 325.36 All Payors / Plans All Payors / Plans 332 other 332 332 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG NERVE CONDUCTION 7-8 STUDIES PX-922959100 CDM 95910 CPT 922 RC inpatient 437 428.26 All Payors / Plans All Payors / Plans 437 other 437 437 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG NERVE CONDUCTION 9-10 STUDIES PX-922959110 CDM 95911 CPT 922 RC inpatient 489 479.22 All Payors / Plans All Payors / Plans 489 other 489 489 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG NERVE CONDUCTION 11-12 STUDY PX-922959120 CDM 95912 CPT 922 RC inpatient 489 479.22 All Payors / Plans All Payors / Plans 489 other 489 489 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG NERVE CONDUCT 13OR MORE STUDY PX-922959130 CDM 95913 CPT 922 RC inpatient 542 531.16 All Payors / Plans All Payors / Plans 542 other 542 542 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INHALATION BRONCHIAL CHALLENGE PX-924950700 CDM 95070 CPT 924 RC inpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PHLEBOTOMY-THERAPEUTIC PX-940991591 CDM 99195 CPT 940 RC inpatient 94.5 92.61 All Payors / Plans All Payors / Plans 94.5 other 94.5 94.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PHLEBOTOMY (PHLE) PX-940991950 CDM 99195 CPT 940 RC inpatient 94.5 92.61 All Payors / Plans All Payors / Plans 94.5 other 94.5 94.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIABETES OP SELF MGMT INDIV. PX-942001080 CDM G0108 CPT 942 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC D IABETES OP SELF MGMT GROUP PX-942001090 CDM G0109 CPT 942 RC inpatient 65 63.7 All Payors / Plans All Payors / Plans 65 other 65 65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MNT CHG BENE COND IN 15 MIN EA PX-942002700 CDM G0270 CPT 942 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MNT CHG BENE COND GRP 30 MIN PX-942002710 CDM G0271 CPT 942 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLUCOSE MONITOR CONTINOUS PT EQUIP PX-942952490 CDM 95249 CPT 942 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLUCOSE MONITOR CONTINUOUS PX-942952500 CDM 95250 CPT 942 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MNT INITIAL ASSESS IND 15 MIN PX-942978020 CDM 97802 CPT 942 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MNT INTERV & REASS IND 15 MIN PX-942978030 CDM 97803 CPT 942 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MNT INIT/FOLLOWUP GROUP 30MIN PX-942978040 CDM 97804 CPT 942 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIABETES OP SELF MGMT IND. RN PX-942990780 CDM 98960 CPT 942 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIABETES OP SELF MGMT GROUP 2-4 PX-942990781 CDM 98961 CPT 942 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIABETES OP SELF MGMT GROUP 5-8 PX-942990782 CDM 98962 CPT 942 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SMOKING CESSATION-INTERMEDIATE PX-942994060 CDM 99406 CPT 942 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SMOKING CESSATION 3-10 MIN PX-942994069 CDM 99406 CPT 942 RC inpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SMOKING CESSATION - INTENSIVE PX-942994070 CDM 99407 CPT 942 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SMOKING CESSATION > 10 MIN PX-942994079 CDM 99407 CPT 942 RC inpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERIPHERAL ARTERIAL DISEASE REHAB PX-943936680 CDM 93668 CPT 943 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERIPHERAL ARTERIAL DISEASE REHAB >36 PX-943936681 CDM 93668 CPT 943 RC inpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARDIAC REHAB THERAPY >36 PX-943937980 CDM 93798 CPT 943 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARDIAC REHAB THERAPY PX-943937981 CDM 93798 CPT 943 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INITIAL ASSESSMENT - C REHAB PX-943937982 CDM 93798 CPT 943 RC inpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY REHAB-COPD PX-948004240 CDM G0424 CPT 948 RC inpatient 151 147.98 All Payors / Plans All Payors / Plans 151 other 151 151 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY REHAB-COPD >36 PX-948042400 CDM G0424 CPT 948 RC inpatient 151 147.98 All Payors / Plans All Payors / Plans 151 other 151 151 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY REHAB W/O CONTINUOUS OXIMETRY MONITOR PX-948946250 CDM 94625 CPT 948 RC inpatient 495 485.1 All Payors / Plans All Payors / Plans 495 other 495 495 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY REHAB W/O CONTINUOUS OXIMETRY MONITOR>36 PX-948946251 CDM 94625 CPT 948 RC inpatient 495 485.1 All Payors / Plans All Payors / Plans 495 other 495 495 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY REHAB W/ CONTINUOUS OXIMETRY MONITOR PX-948946260 CDM 94626 CPT 948 RC inpatient 528 517.44 All Payors / Plans All Payors / Plans 528 other 528 528 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY REHAB W/ CONTINUOUS OXIMETRY MONITOR>36 PX-948946261 CDM 94626 CPT 948 RC inpatient 528 517.44 All Payors / Plans All Payors / Plans 528 other 528 528 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INITIAL HOSPITAL CARE/DAY PX-988992211 CDM 99221 CPT 988 RC inpatient 165.44 162.13 All Payors / Plans All Payors / Plans 165.44 other 165.44 165.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INITIAL HOSPITAL CARE/DAY 50 MINUTES 99222 PX-988992221 CDM 99222 CPT 988 RC inpatient 261.1 255.88 All Payors / Plans All Payors / Plans 261.1 other 261.1 261.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INITIAL HOSPITAL CARE/DAY 70 MINUTES 99223 PX-988992231 CDM 99223 CPT 988 RC inpatient 346 339.08 All Payors / Plans All Payors / Plans 346 other 346 346 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MRI BRAIN W WO CONTRAST PX-IMG271B CDM 70553 CPT 611 RC inpatient 938 919.24 All Payors / Plans All Payors / Plans 938 other 938 938 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUIDE SCLEROTHERAPY PX-IMG9700 CDM 49185 CPT 402 RC inpatient 371.75 364.32 All Payors / Plans All Payors / Plans 371.75 other 371.75 371.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFUSION HYDRATION 0-1 HR PX-260963600 CDM 96360 CPT 260 RC outpatient 264 258.72 All Payors / Plans All Payors / Plans 264 other 264 264 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFUSION HYDRATION EACH ADD HR PX-260963610 CDM 96361 CPT 260 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFUSION THERAPY NON CHEMO 0-1HR PX-260963650 CDM 96365 CPT 260 RC outpatient 594 582.12 All Payors / Plans All Payors / Plans 594 other 594 594 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFUSION NON CHEMO EACH ADD HR PX-260963660 CDM 96366 CPT 260 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFUS NON CHEMO SEQUENTIAL 0-1HR PX-260963670 CDM 96367 CPT 260 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFUSION THERPAY CONCURRENT PX-260963680 CDM 96368 CPT 260 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INJ. NON CHEMO INTRAMUSCULAR/SUB PX-260963720 CDM 96372 CPT 260 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INJ. NON CHEMO IV PUSH INITIAL PX-260963740 CDM 96374 CPT 260 RC outpatient 330 323.4 All Payors / Plans All Payors / Plans 330 other 330 330 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INJ NON CHEMO IV PUSH SEQUENTIAL PX-260963750 CDM 96375 CPT 260 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC THERAPEUTIC,PROPHYLATIC,DIAG INJ EA ADD'L PUSH NEW DRUG" PX-260963760 CDM 96376 CPT 260 RC outpatient 33 32.34 All Payors / Plans All Payors / Plans 33 other 33 33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR INTRATHECAL INJ OF CHEMO PX-260964500 CDM 96450 CPT 260 RC outpatient 1138.5 1115.73 All Payors / Plans All Payors / Plans 1138.5 other 1138.5 1138.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IRRIGATION IMPLANTED VENOUS ACCES PX-260965230 CDM 96523 CPT 260 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APHERESIS SUPPLIES PX-27000000 CDM 270 RC outpatient 811.78 795.54 All Payors / Plans All Payors / Plans 811.78 other 811.78 811.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IODINE RADIOELEMENT BRACHYTHERAPY PX-270000015 CDM Q3001 CPT 270 RC outpatient 70 68.6 All Payors / Plans All Payors / Plans 70 other 70 70 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PALADIUM RADIOELEMENT BRACHYTHER PX-270000016 CDM Q3001 CPT 270 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIALYSIS SUPPLIES PX-270001000 CDM 270 RC outpatient 102 99.96 All Payors / Plans All Payors / Plans 102 other 102 102 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERITONEAL DIALYSIS SUPPLY PX-270001050 CDM 270 RC outpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIOPATCH W/SORBA DRESSING KIT PX-270002000 CDM 270 RC outpatient 34.47 33.78 All Payors / Plans All Payors / Plans 34.47 other 34.47 34.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EPIDURAL CUSTOM ANESTHESIA TRAY PX-270009010 CDM 270 RC outpatient 54.2 53.12 All Payors / Plans All Payors / Plans 54.2 other 54.2 54.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONTIN EPIDURAL ANESTH TRAY PX-270009011 CDM 270 RC outpatient 23.92 23.44 All Payors / Plans All Payors / Plans 23.92 other 23.92 23.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CUSTOM SPINAL ANESTH TRAY PX-270009012 CDM 270 RC outpatient 41.98 41.14 All Payors / Plans All Payors / Plans 41.98 other 41.98 41.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRAY BLUE RHINE PERCU TRACH PX-270009013 CDM 270 RC outpatient 352.2 345.16 All Payors / Plans All Payors / Plans 352.2 other 352.2 352.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLEXSEAL FMS KIT PX-270009014 CDM 270 RC outpatient 318 311.64 All Payors / Plans All Payors / Plans 318 other 318 318 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLEXISEAL REPLACEMENT BAGS PX-270009015 CDM 270 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UNIVERSAL KNEE DRESSING PX-270009016 CDM 270 RC outpatient 18.25 17.89 All Payors / Plans All Payors / Plans 18.25 other 18.25 18.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ELASTOPLAST 2 PX-270009017 CDM 270 RC outpatient 3.84 3.76 All Payors / Plans All Payors / Plans 3.84 other 3.84 3.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OXYCEL PX-270009018 CDM 270 RC outpatient 74.22 72.74 All Payors / Plans All Payors / Plans 74.22 other 74.22 74.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESSING RESTORE PX-270009019 CDM 270 RC outpatient 4.68 4.59 All Payors / Plans All Payors / Plans 4.68 other 4.68 4.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESSING TEGADERM 3M X 15CM PX-270009020 CDM 270 RC outpatient 4.14 4.06 All Payors / Plans All Payors / Plans 4.14 other 4.14 4.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESSING PX-270009021 CDM 270 RC outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DRESS-GUAZE,PLAIN/IODAFORM" PX-270009022 CDM 270 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SURGICEL-2 & 4 INCH PX-270009023 CDM 270 RC outpatient 21 20.58 All Payors / Plans All Payors / Plans 21 other 21 21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DECUBITUS CARE SUPPLIES PX-270009024 CDM 270 RC outpatient 9.06 8.88 All Payors / Plans All Payors / Plans 9.06 other 9.06 9.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PACK MAX BARRIER PROTECTION PX-270009025 CDM 270 RC outpatient 28.72 28.15 All Payors / Plans All Payors / Plans 28.72 other 28.72 28.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PACK SUPPLEMENTAL PICC LINE PX-270009026 CDM 270 RC outpatient 16.25 15.93 All Payors / Plans All Payors / Plans 16.25 other 16.25 16.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTRODUCER CATHETER PX-270009027 CDM 270 RC outpatient 17.28 16.93 All Payors / Plans All Payors / Plans 17.28 other 17.28 17.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TENCKHOFT ADULT CATHETER PX-270009028 CDM 270 RC outpatient 49.8 48.8 All Payors / Plans All Payors / Plans 49.8 other 49.8 49.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COUDE FOLEY CATHETER PX-270009029 CDM 270 RC outpatient 13.54 13.27 All Payors / Plans All Payors / Plans 13.54 other 13.54 13.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CATHETER KIT, MULTI-LUMEN" PX-270009030 CDM 270 RC outpatient 94.98 93.08 All Payors / Plans All Payors / Plans 94.98 other 94.98 94.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SUCTION DRAIN PX-270009031 CDM 270 RC outpatient 9.91 9.71 All Payors / Plans All Payors / Plans 9.91 other 9.91 9.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AUTOFUSION HEMOVAC PX-270009032 CDM 270 RC outpatient 130.45 127.84 All Payors / Plans All Payors / Plans 130.45 other 130.45 130.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEMOVAC PX-270009033 CDM 270 RC outpatient 18.83 18.45 All Payors / Plans All Payors / Plans 18.83 other 18.83 18.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HUMIDIFER PX-270009034 CDM 270 RC outpatient 19.54 19.15 All Payors / Plans All Payors / Plans 19.54 other 19.54 19.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LAVACATOR PX-270009035 CDM 270 RC outpatient 11.11 10.89 All Payors / Plans All Payors / Plans 11.11 other 11.11 11.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BURN CARE PACK PX-270009036 CDM 270 RC outpatient 7.44 7.29 All Payors / Plans All Payors / Plans 7.44 other 7.44 7.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SUMP PUMP PX-270009037 CDM 270 RC outpatient 77.22 75.68 All Payors / Plans All Payors / Plans 77.22 other 77.22 77.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SUCTION RESERVOIR PX-270009038 CDM 270 RC outpatient 8.35 8.18 All Payors / Plans All Payors / Plans 8.35 other 8.35 8.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RECTAL TUBE PX-270009047 CDM 270 RC outpatient 5.96 5.84 All Payors / Plans All Payors / Plans 5.96 other 5.96 5.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KEOFEED STOMACH TUBE PX-270009048 CDM 270 RC outpatient 21 20.58 All Payors / Plans All Payors / Plans 21 other 21 21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BREAST PUMP KIT DOUBLE PX-270009049 CDM 270 RC outpatient 29.76 29.16 All Payors / Plans All Payors / Plans 29.76 other 29.76 29.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENTERIC FEEDING BAG PX-270009050 CDM 270 RC outpatient 3.9 3.82 All Payors / Plans All Payors / Plans 3.9 other 3.9 3.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRANSFUSION FILTER PX-270009051 CDM 270 RC outpatient 10.25 10.05 All Payors / Plans All Payors / Plans 10.25 other 10.25 10.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE MARROW TRAY PX-270009052 CDM 270 RC outpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SUTURE TRAY PX-270009053 CDM 270 RC outpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERCUTANEOUS TRACH TRAY PX-270009054 CDM 270 RC outpatient 396 388.08 All Payors / Plans All Payors / Plans 396 other 396 396 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIOPSY NEEDLE PX-270009055 CDM 270 RC outpatient 18.56 18.19 All Payors / Plans All Payors / Plans 18.56 other 18.56 18.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ULTRASONIC TIPS (EYES) PX-270009056 CDM 270 RC outpatient 72 70.56 All Payors / Plans All Payors / Plans 72 other 72 72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SAGE ORAL CARE KITS PX-270009057 CDM 270 RC outpatient 21.4 20.97 All Payors / Plans All Payors / Plans 21.4 other 21.4 21.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SAGE PREVLON BOOT PX-270009058 CDM 270 RC outpatient 11.23 11.01 All Payors / Plans All Payors / Plans 11.23 other 11.23 11.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEROYAL 24 WEDGE M60-032 PX-270009059 CDM 270 RC outpatient 11.52 11.29 All Payors / Plans All Payors / Plans 11.52 other 11.52 11.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEROYAL 24 BARIA WDG M60-033 PX-270009060 CDM 270 RC outpatient 27.97 27.41 All Payors / Plans All Payors / Plans 27.97 other 27.97 27.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENTERAL RADIOPAQUE FEED TUBE PX-270009061 CDM 270 RC outpatient 17.92 17.56 All Payors / Plans All Payors / Plans 17.92 other 17.92 17.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BARD FECAL BAG PX-270009062 CDM 270 RC outpatient 13.46 13.19 All Payors / Plans All Payors / Plans 13.46 other 13.46 13.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MINI CHEST DRAIN PX-270009063 CDM 270 RC outpatient 72.22 70.78 All Payors / Plans All Payors / Plans 72.22 other 72.22 72.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEELZUP DISP HEEL PROTECTOR PX-270009064 CDM 270 RC outpatient 46.8 45.86 All Payors / Plans All Payors / Plans 46.8 other 46.8 46.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEELZUP BAR DISP HEEL PROTECT PX-270009065 CDM 270 RC outpatient 59.4 58.21 All Payors / Plans All Payors / Plans 59.4 other 59.4 59.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RESQPOD CIRCULAT ENHANCER PX-270009066 CDM 270 RC outpatient 112.02 109.78 All Payors / Plans All Payors / Plans 112.02 other 112.02 112.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MORPHEUS CT PICC LINE KIT PX-270009067 CDM 270 RC outpatient 180 176.4 All Payors / Plans All Payors / Plans 180 other 180 180 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC METANEB CIRCUIT KIT PX-270009068 CDM 270 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARAPAC CIRCUIT KIT PX-270009069 CDM 270 RC outpatient 29.4 28.81 All Payors / Plans All Payors / Plans 29.4 other 29.4 29.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VENT CIRCUIT PX-270009070 CDM 270 RC outpatient 27.74 27.19 All Payors / Plans All Payors / Plans 27.74 other 27.74 27.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPTIFLOW NASAL INTERFACE PX-270009071 CDM 270 RC outpatient 26.4 25.87 All Payors / Plans All Payors / Plans 26.4 other 26.4 26.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FRESENIUS DIA STAY SAFE EXT 18 PX-270009072 CDM 270 RC outpatient 22.8 22.34 All Payors / Plans All Payors / Plans 22.8 other 22.8 22.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FRESENIUS DIALYSIS ADAPTER PX-270009073 CDM 270 RC outpatient 14.4 14.11 All Payors / Plans All Payors / Plans 14.4 other 14.4 14.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RESCUSITATION BAG PX-270009074 CDM 270 RC outpatient 23.35 22.88 All Payors / Plans All Payors / Plans 23.35 other 23.35 23.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HYPOTHERMIA WARMING BLANKET PX-270009075 CDM 270 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AIR MATTRESS PX-270009076 CDM 270 RC outpatient 45.6 44.69 All Payors / Plans All Payors / Plans 45.6 other 45.6 45.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STER IRRIG H20 3000 ML PX-270009077 CDM 270 RC outpatient 5.06 4.96 All Payors / Plans All Payors / Plans 5.06 other 5.06 5.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SCLEROTHERAPY NEEDLES PX-270009081 CDM 270 RC outpatient 44.4 43.51 All Payors / Plans All Payors / Plans 44.4 other 44.4 44.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OCCLUSION BALLOONS PX-270009082 CDM 270 RC outpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STENT KITS PX-270009083 CDM 270 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TROCAR REDUCERS PX-270009084 CDM 270 RC outpatient 10.54 10.33 All Payors / Plans All Payors / Plans 10.54 other 10.54 10.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INT.EXT STAPLE SUTURE DEV PX-270009085 CDM 270 RC outpatient 68.68 67.31 All Payors / Plans All Payors / Plans 68.68 other 68.68 68.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INT/EXTER STAPLE/SUTURE DEV. PX-270009086 CDM 270 RC outpatient 134.98 132.28 All Payors / Plans All Payors / Plans 134.98 other 134.98 134.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLEX TORCAR SET PX-270009087 CDM 270 RC outpatient 182.05 178.41 All Payors / Plans All Payors / Plans 182.05 other 182.05 182.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INT EXT STAPLE/SUTURE DEV PX-270009088 CDM 270 RC outpatient 132.68 130.03 All Payors / Plans All Payors / Plans 132.68 other 132.68 132.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INT/EXT STAPLE/ SUTURE DEV PX-270009089 CDM 270 RC outpatient 299.84 293.84 All Payors / Plans All Payors / Plans 299.84 other 299.84 299.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INT/ EXT STAPLE/SUTURE DEVICE PX-270009090 CDM 270 RC outpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HICKMAN INFUS-A-PORT PX-270009091 CDM 270 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROLENE MESH--LARGE (9 X 14) PX-270009092 CDM 270 RC outpatient 114.9 112.6 All Payors / Plans All Payors / Plans 114.9 other 114.9 114.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MARLEX MESH 3X6 PX-270009093 CDM 270 RC outpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HICKMAN DUAL LUMEN CATHETER PX-270009094 CDM 270 RC outpatient 199.49 195.5 All Payors / Plans All Payors / Plans 199.49 other 199.49 199.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRONCHIAL CYTOLOGY BRUSHES PX-270009095 CDM 270 RC outpatient 8.64 8.47 All Payors / Plans All Payors / Plans 8.64 other 8.64 8.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LITHOTRIPTER (ENDO) PX-270009096 CDM 270 RC outpatient 390 382.2 All Payors / Plans All Payors / Plans 390 other 390 390 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLO TIP CATHETER PX-270009097 CDM 270 RC outpatient 45.6 44.69 All Payors / Plans All Payors / Plans 45.6 other 45.6 45.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVACUATOR BOTTLES PX-270009098 CDM 270 RC outpatient 7.37 7.22 All Payors / Plans All Payors / Plans 7.37 other 7.37 7.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ULTRATOME LX PX-270009099 CDM 270 RC outpatient 204 199.92 All Payors / Plans All Payors / Plans 204 other 204 204 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRANSBRONCHIAL/ASPIR NEEDLE PX-270009100 CDM 270 RC outpatient 58.2 57.04 All Payors / Plans All Payors / Plans 58.2 other 58.2 58.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ZEBRA GUIDEWIRE PX-270009102 CDM 270 RC outpatient 129.6 127.01 All Payors / Plans All Payors / Plans 129.6 other 129.6 129.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PEG REPLACEMENT TUBE PX-270009103 CDM 270 RC outpatient 82.8 81.14 All Payors / Plans All Payors / Plans 82.8 other 82.8 82.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BICAP PROBES PX-270009104 CDM 270 RC outpatient 209.24 205.06 All Payors / Plans All Payors / Plans 209.24 other 209.24 209.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DISPOSABLE SNARE/RETRIEVAL PX-270009105 CDM 270 RC outpatient 27.6 27.05 All Payors / Plans All Payors / Plans 27.6 other 27.6 27.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CATHETER/GUIDEWIRE (OR) PX-270009106 CDM 270 RC outpatient 17.27 16.92 All Payors / Plans All Payors / Plans 17.27 other 17.27 17.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MIAMI J COLLAR PX-270009108 CDM 270 RC outpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CERVICAL COLLAR PX-270009109 CDM 270 RC outpatient 4.09 4.01 All Payors / Plans All Payors / Plans 4.09 other 4.09 4.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CERVICAL COLLAR 2 PX-270009110 CDM 270 RC outpatient 12.6 12.35 All Payors / Plans All Payors / Plans 12.6 other 12.6 12.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WRIST SPLINT PX-270009117 CDM 270 RC outpatient 8.82 8.64 All Payors / Plans All Payors / Plans 8.82 other 8.82 8.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KNEE PACK PX-270009119 CDM 270 RC outpatient 210.29 206.08 All Payors / Plans All Payors / Plans 210.29 other 210.29 210.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HIP PACK PX-270009120 CDM 270 RC outpatient 273.78 268.3 All Payors / Plans All Payors / Plans 273.78 other 273.78 273.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLOBAL SHOULDER PACK PX-270009121 CDM 270 RC outpatient 78.82 77.24 All Payors / Plans All Payors / Plans 78.82 other 78.82 78.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SHOULDER TRACTION KIT PX-270009122 CDM 270 RC outpatient 35.4 34.69 All Payors / Plans All Payors / Plans 35.4 other 35.4 35.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KNEE WRAP W/4 COLD PACKS PX-270009123 CDM 270 RC outpatient 26.81 26.27 All Payors / Plans All Payors / Plans 26.81 other 26.81 26.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SHOULDER WRAP W/4 COLD PKS PX-270009124 CDM 270 RC outpatient 30.17 29.57 All Payors / Plans All Payors / Plans 30.17 other 30.17 30.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COLOSTOMY SUPPLIES PX-270009125 CDM 270 RC outpatient 2.92 2.86 All Payors / Plans All Payors / Plans 2.92 other 2.92 2.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLEURAVAC PX-270009126 CDM 270 RC outpatient 133.63 130.96 All Payors / Plans All Payors / Plans 133.63 other 133.63 133.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD REC. SYSTEM PX-270009127 CDM 270 RC outpatient 34.01 33.33 All Payors / Plans All Payors / Plans 34.01 other 34.01 34.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VENA CAVA FILTER SYSTEM PX-270009128 CDM 270 RC outpatient 1174.8 1151.3 All Payors / Plans All Payors / Plans 1174.8 other 1174.8 1174.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SWAN GANTZ PX-270009129 CDM 270 RC outpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SWAN GANTZ-CCO PX-270009130 CDM 270 RC outpatient 148.18 145.22 All Payors / Plans All Payors / Plans 148.18 other 148.18 148.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARSONNET PROBE PX-270009131 CDM 270 RC outpatient 83.69 82.02 All Payors / Plans All Payors / Plans 83.69 other 83.69 83.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC EXTERNAL DRAIN UNIT, 8300" PX-270009132 CDM 270 RC outpatient 153.6 150.53 All Payors / Plans All Payors / Plans 153.6 other 153.6 153.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PORTEX TRACH TUBE PX-270009133 CDM 270 RC outpatient 36.61 35.88 All Payors / Plans All Payors / Plans 36.61 other 36.61 36.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRACEOSTOMY SUPPLIES PX-270009134 CDM 270 RC outpatient 4.63 4.54 All Payors / Plans All Payors / Plans 4.63 other 4.63 4.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TROCAR CATHETER PX-270009135 CDM 270 RC outpatient 17.16 16.82 All Payors / Plans All Payors / Plans 17.16 other 17.16 17.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THORACIC CATHETER PX-270009136 CDM 270 RC outpatient 6.47 6.34 All Payors / Plans All Payors / Plans 6.47 other 6.47 6.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IN LINE SUCTION KIT PX-270009137 CDM 270 RC outpatient 16.62 16.29 All Payors / Plans All Payors / Plans 16.62 other 16.62 16.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SUCTION KIT - DIRECTIONAL TIP PX-270009138 CDM 270 RC outpatient 17.1 16.76 All Payors / Plans All Payors / Plans 17.1 other 17.1 17.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DUAL PRESSURE TRANSDUCER PX-270009139 CDM 270 RC outpatient 27 26.46 All Payors / Plans All Payors / Plans 27 other 27 27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRANSDUCER SET PX-270009140 CDM 270 RC outpatient 13.5 13.23 All Payors / Plans All Payors / Plans 13.5 other 13.5 13.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEIMLICH VALVE PX-270009141 CDM 270 RC outpatient 13.5 13.23 All Payors / Plans All Payors / Plans 13.5 other 13.5 13.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMBOLECTOMY CATHETER PX-270009142 CDM 270 RC outpatient 45.85 44.93 All Payors / Plans All Payors / Plans 45.85 other 45.85 45.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRUITT INHARD SHUNT PX-270009143 CDM 270 RC outpatient 126 123.48 All Payors / Plans All Payors / Plans 126 other 126 126 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEDIASTINAL CATHETER PX-270009144 CDM 270 RC outpatient 14.3 14.01 All Payors / Plans All Payors / Plans 14.3 other 14.3 14.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARGON PAC TRAY PX-270009145 CDM 270 RC outpatient 31.44 30.81 All Payors / Plans All Payors / Plans 31.44 other 31.44 31.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SOFT TISSUE PATCH CV PX-270009146 CDM 270 RC outpatient 144 141.12 All Payors / Plans All Payors / Plans 144 other 144 144 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDOCATCH II PX-270009147 CDM 270 RC outpatient 80.4 78.79 All Payors / Plans All Payors / Plans 80.4 other 80.4 80.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VEIN DISTENTION SYSTEM PX-270009148 CDM 270 RC outpatient 47.84 46.88 All Payors / Plans All Payors / Plans 47.84 other 47.84 47.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CAMINO TRAUMA CATHETER PX-270009149 CDM 270 RC outpatient 96 94.08 All Payors / Plans All Payors / Plans 96 other 96 96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CAMINO VENT DRAIN SYSTEM PX-270009150 CDM 270 RC outpatient 123.6 121.13 All Payors / Plans All Payors / Plans 123.6 other 123.6 123.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URETERAL KITS PX-270009151 CDM 270 RC outpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URETERAL CATHETER PX-270009152 CDM 270 RC outpatient 150 147 All Payors / Plans All Payors / Plans 150 other 150 150 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BILIARY DILATION CATHETER PX-270009153 CDM 270 RC outpatient 63.6 62.33 All Payors / Plans All Payors / Plans 63.6 other 63.6 63.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OXI SENSOR PX-270009154 CDM 270 RC outpatient 10.8 10.58 All Payors / Plans All Payors / Plans 10.8 other 10.8 10.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPRESSION FOOT COVER PX-270009155 CDM 270 RC outpatient 88.8 87.02 All Payors / Plans All Payors / Plans 88.8 other 88.8 88.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRACH TUBE PX-270009156 CDM 270 RC outpatient 50.7 49.69 All Payors / Plans All Payors / Plans 50.7 other 50.7 50.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MITT RESTRAINTS PX-270009157 CDM 270 RC outpatient 13.2 12.94 All Payors / Plans All Payors / Plans 13.2 other 13.2 13.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ABDOMINAL BINDER PX-270009158 CDM 270 RC outpatient 18.59 18.22 All Payors / Plans All Payors / Plans 18.59 other 18.59 18.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESSING PACK PX-270009159 CDM 270 RC outpatient 7.04 6.9 All Payors / Plans All Payors / Plans 7.04 other 7.04 7.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EAR SYRINGE PX-270009160 CDM 270 RC outpatient 5.88 5.76 All Payors / Plans All Payors / Plans 5.88 other 5.88 5.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STERILE SURGICAL SUPPLIES PX-270009161 CDM 270 RC outpatient 64.69 63.4 All Payors / Plans All Payors / Plans 64.69 other 64.69 64.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ABDOMINAL ANEURYSM PACK PX-270009162 CDM 270 RC outpatient 199.13 195.15 All Payors / Plans All Payors / Plans 199.13 other 199.13 199.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FEM-POP PACK PX-270009163 CDM 270 RC outpatient 81.9 80.26 All Payors / Plans All Payors / Plans 81.9 other 81.9 81.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NEURO PACK PX-270009164 CDM 270 RC outpatient 171.24 167.82 All Payors / Plans All Payors / Plans 171.24 other 171.24 171.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NEURO SUPPLEMENTARY PACK PX-270009165 CDM 270 RC outpatient 58.63 57.46 All Payors / Plans All Payors / Plans 58.63 other 58.63 58.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CAROTID PACK PX-270009166 CDM 270 RC outpatient 138.77 135.99 All Payors / Plans All Payors / Plans 138.77 other 138.77 138.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARTHROSCOPY PACK PX-270009167 CDM 270 RC outpatient 64.49 63.2 All Payors / Plans All Payors / Plans 64.49 other 64.49 64.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENT PACK PX-270009168 CDM 270 RC outpatient 31.84 31.2 All Payors / Plans All Payors / Plans 31.84 other 31.84 31.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MINOR EYE PACK ALCON PX-270009169 CDM 270 RC outpatient 49.56 48.57 All Payors / Plans All Payors / Plans 49.56 other 49.56 49.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYSTO PACK PX-270009170 CDM 270 RC outpatient 11.39 11.16 All Payors / Plans All Payors / Plans 11.39 other 11.39 11.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LAP/ABD PACK PX-270009171 CDM 270 RC outpatient 29.86 29.26 All Payors / Plans All Payors / Plans 29.86 other 29.86 29.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LOWER EXTREMITY PACK PX-270009172 CDM 270 RC outpatient 31.14 30.52 All Payors / Plans All Payors / Plans 31.14 other 31.14 31.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UPPER EXTREMITY PACK PX-270009173 CDM 270 RC outpatient 24.95 24.45 All Payors / Plans All Payors / Plans 24.95 other 24.95 24.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN CUSTOM PACK PX-270009174 CDM 270 RC outpatient 334.07 327.39 All Payors / Plans All Payors / Plans 334.07 other 334.07 334.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERITONEAL CLOSURE DEVICE PX-270009175 CDM 270 RC outpatient 23.52 23.05 All Payors / Plans All Payors / Plans 23.52 other 23.52 23.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SUCTION CANNISTER/TUBING PX-270009176 CDM 270 RC outpatient 3 2.94 All Payors / Plans All Payors / Plans 3 other 3 3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SUCTION SUPPLIES (U) PX-270009177 CDM 270 RC outpatient 3.83 3.75 All Payors / Plans All Payors / Plans 3.83 other 3.83 3.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPINAL SURGERY KIT PX-270009178 CDM 270 RC outpatient 44.05 43.17 All Payors / Plans All Payors / Plans 44.05 other 44.05 44.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VESSEL OCCULUDERS PX-270009179 CDM 270 RC outpatient 52.8 51.74 All Payors / Plans All Payors / Plans 52.8 other 52.8 52.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARTERIAL/VENOUS SET PX-270009180 CDM 270 RC outpatient 13.32 13.05 All Payors / Plans All Payors / Plans 13.32 other 13.32 13.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC 9% SODIUM CHLOR. SLUSH PX-270009181 CDM 270 RC outpatient 30 29.4 All Payors / Plans All Payors / Plans 30 other 30 30 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC REPLACEMT CAMION COLLECT BAG PX-270009182 CDM 270 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DURA PREP LARGE PX-270009183 CDM 270 RC outpatient 5.76 5.64 All Payors / Plans All Payors / Plans 5.76 other 5.76 5.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DURA PREP SMALL PX-270009184 CDM 270 RC outpatient 2.96 2.9 All Payors / Plans All Payors / Plans 2.96 other 2.96 2.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COBAN DRESSING PX-270009185 CDM 270 RC outpatient 3.4 3.33 All Payors / Plans All Payors / Plans 3.4 other 3.4 3.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITRECTOMY/RETINAL PACK PX-270009186 CDM 270 RC outpatient 328.8 322.22 All Payors / Plans All Payors / Plans 328.8 other 328.8 328.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITRECTOMY/RETINAL TUBING SET PX-270009187 CDM 270 RC outpatient 48 47.04 All Payors / Plans All Payors / Plans 48 other 48 48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDO SPOT MARKER PX-270009188 CDM 270 RC outpatient 22.8 22.34 All Payors / Plans All Payors / Plans 22.8 other 22.8 22.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDO BAR BALLOON PX-270009189 CDM 270 RC outpatient 106.8 104.66 All Payors / Plans All Payors / Plans 106.8 other 106.8 106.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDO CRE BALLOON PX-270009190 CDM 270 RC outpatient 252 246.96 All Payors / Plans All Payors / Plans 252 other 252 252 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SHOULDER REHAB KIT PX-270009191 CDM 270 RC outpatient 58.8 57.62 All Payors / Plans All Payors / Plans 58.8 other 58.8 58.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C SECTION TRACE PACK PX-270009192 CDM 270 RC outpatient 103.81 101.73 All Payors / Plans All Payors / Plans 103.81 other 103.81 103.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LAP-CHOLE TRACE PACK PX-270009193 CDM 270 RC outpatient 190.84 187.02 All Payors / Plans All Payors / Plans 190.84 other 190.84 190.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CAB TRACE PACK PX-270009194 CDM 270 RC outpatient 341.96 335.12 All Payors / Plans All Payors / Plans 341.96 other 341.96 341.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRISM MIXING BOWLS PX-270009196 CDM 270 RC outpatient 96.55 94.62 All Payors / Plans All Payors / Plans 96.55 other 96.55 96.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VERROUS NEEDLE PX-270009197 CDM 270 RC outpatient 43.52 42.65 All Payors / Plans All Payors / Plans 43.52 other 43.52 43.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN TROCARS PX-270009198 CDM 270 RC outpatient 74.4 72.91 All Payors / Plans All Payors / Plans 74.4 other 74.4 74.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ORIGIN TACKER SYSTEM PX-270009199 CDM 270 RC outpatient 312 305.76 All Payors / Plans All Payors / Plans 312 other 312 312 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ORIGIN TROCAR PX-270009200 CDM 270 RC outpatient 162 158.76 All Payors / Plans All Payors / Plans 162 other 162 162 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD CULTURE KIT PX-270009201 CDM 270 RC outpatient 9.9 9.7 All Payors / Plans All Payors / Plans 9.9 other 9.9 9.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POSEY BED CORDS PX-270009202 CDM 270 RC outpatient 4.62 4.53 All Payors / Plans All Payors / Plans 4.62 other 4.62 4.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LEVEL I TUBING PX-270009203 CDM 270 RC outpatient 77.7 76.15 All Payors / Plans All Payors / Plans 77.7 other 77.7 77.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RESTRAINT FREE SPLINT LG PX-270009204 CDM 270 RC outpatient 13.63 13.36 All Payors / Plans All Payors / Plans 13.63 other 13.63 13.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CATH TRAY PLUS CDC VARIOUS SZ PX-270009212 CDM 270 RC outpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HOYER PATIENT SLING SL-UD513 PX-270009213 CDM 270 RC outpatient 30.48 29.87 All Payors / Plans All Payors / Plans 30.48 other 30.48 30.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SNSR FLO TRAC PX-270009214 CDM 270 RC outpatient 210 205.8 All Payors / Plans All Payors / Plans 210 other 210 210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SHEATH PINNACLE PX-270009215 CDM 270 RC outpatient 9.54 9.35 All Payors / Plans All Payors / Plans 9.54 other 9.54 9.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRIPLE LUMEN KIT PX-270009216 CDM 270 RC outpatient 135.64 132.93 All Payors / Plans All Payors / Plans 135.64 other 135.64 135.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GI CYTOLOGY BRUSHES PX-270009217 CDM 270 RC outpatient 10.5 10.29 All Payors / Plans All Payors / Plans 10.5 other 10.5 10.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COLOSTOMY BAG PX-270009218 CDM 270 RC outpatient 2.2 2.16 All Payors / Plans All Payors / Plans 2.2 other 2.2 2.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PNEUMOSTAT CHEST DRAIN VAL PX-270009219 CDM 270 RC outpatient 37.73 36.98 All Payors / Plans All Payors / Plans 37.73 other 37.73 37.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TITANIUM LIAGATING CLIPS PX-270009220 CDM 270 RC outpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BASIC PACK PX-270009222 CDM 270 RC outpatient 7.56 7.41 All Payors / Plans All Payors / Plans 7.56 other 7.56 7.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THORACENTESIS TRAY PX-270009223 CDM 270 RC outpatient 30.34 29.73 All Payors / Plans All Payors / Plans 30.34 other 30.34 30.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STAPLER LINEAR PX-270009225 CDM 270 RC outpatient 208.98 204.8 All Payors / Plans All Payors / Plans 208.98 other 208.98 208.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STAPLER/RELOAD DEV 2 PX-270009226 CDM 270 RC outpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MINOR ALCON EYE PACK PX-270009227 CDM 270 RC outpatient 240 235.2 All Payors / Plans All Payors / Plans 240 other 240 240 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PADS CLO-SUR #MCP44 PX-270009230 CDM 270 RC outpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CL CLOSURE DEVICE FEMOSTOT PX-270009231 CDM 270 RC outpatient 89.4 87.61 All Payors / Plans All Payors / Plans 89.4 other 89.4 89.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CIRCUMCISION TRAY PX-270009250 CDM 270 RC outpatient 63 61.74 All Payors / Plans All Payors / Plans 63 other 63 63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE MARROW DISPOSABLE PX-270009255 CDM 270 RC outpatient 103.75 101.68 All Payors / Plans All Payors / Plans 103.75 other 103.75 103.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INSTRUMENT TRAY PX-270009300 CDM 270 RC outpatient 58 56.84 All Payors / Plans All Payors / Plans 58 other 58 58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GREEN LIGHT LASER PROCEDURE PX-270010033 CDM 270 RC outpatient 1380 1352.4 All Payors / Plans All Payors / Plans 1380 other 1380 1380 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DAVINCI PACK PX-270010034 CDM 270 RC outpatient 280.8 275.18 All Payors / Plans All Payors / Plans 280.8 other 280.8 280.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APLIGAF-PER 44 SQ CM PX-270041010 CDM Q4101 CPT 270 RC outpatient 1554 1522.92 All Payors / Plans All Payors / Plans 1554 other 1554 1554 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OASIS WOUND MATRIX PX-270041020 CDM Q4102 CPT 270 RC outpatient 113.64 111.37 All Payors / Plans All Payors / Plans 113.64 other 113.64 113.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OASIS WOUND MATRIX 3 X 7 CM PX-270041021 CDM Q4102 CPT 270 RC outpatient 189.4 185.61 All Payors / Plans All Payors / Plans 189.4 other 189.4 189.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DERMAGRAFT PX-270041060 CDM Q4106 CPT 270 RC outpatient 1500 1470 All Payors / Plans All Payors / Plans 1500 other 1500 1500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THERASKIN 2X3 PX-270041210 CDM Q4121 CPT 270 RC outpatient 1530 1499.4 All Payors / Plans All Payors / Plans 1530 other 1530 1530 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THERASKIN 1X2 PX-270041211 CDM Q4121 CPT 270 RC outpatient 1170 1146.6 All Payors / Plans All Payors / Plans 1170 other 1170 1170 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THERASKIN 1X1 PX-270041212 CDM Q4121 CPT 636 RC outpatient 1050 1029 All Payors / Plans All Payors / Plans 1050 other 1050 1050 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THERASKIN 3X6 PX-270041213 CDM Q4121 CPT 270 RC outpatient 3594 3522.12 All Payors / Plans All Payors / Plans 3594 other 3594 3594 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALGIDEX AG 4X4 1/2 IN X 5 YARDS PX-270041311 CDM 270 RC outpatient 8.54 8.37 All Payors / Plans All Payors / Plans 8.54 other 8.54 8.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALGIDEX AG 4X8 1/4 IN X 5 YARDS PX-270041312 CDM 270 RC outpatient 17.18 16.84 All Payors / Plans All Payors / Plans 17.18 other 17.18 17.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MULTIDEX GEL 1/4 OZ PX-270041313 CDM 270 RC outpatient 5.6 5.49 All Payors / Plans All Payors / Plans 5.6 other 5.6 5.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MULTIDEX POWDER 6 GRAM PX-270041314 CDM 270 RC outpatient 6.38 6.25 All Payors / Plans All Payors / Plans 6.38 other 6.38 6.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX TRANSFER 6X8 PX-270041315 CDM 270 RC outpatient 8.74 8.57 All Payors / Plans All Payors / Plans 8.74 other 8.74 8.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX TRANSFER 8X20 PX-270041316 CDM 270 RC outpatient 23.8 23.32 All Payors / Plans All Payors / Plans 23.8 other 23.8 23.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SECURA ANTIFUNGAL CREAM 2OZ TUBE PX-270041317 CDM 270 RC outpatient 4.22 4.14 All Payors / Plans All Payors / Plans 4.22 other 4.22 4.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COVERSITE 4X4 PLUS PX-270041318 CDM 270 RC outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IODOFLEX 5 GRAM PX-270041319 CDM 270 RC outpatient 5.72 5.61 All Payors / Plans All Payors / Plans 5.72 other 5.72 5.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROFORE WRAPS PX-270041320 CDM 270 RC outpatient 13.52 13.25 All Payors / Plans All Payors / Plans 13.52 other 13.52 13.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPITEL ONE 4X7 PX-270041321 CDM 270 RC outpatient 11.89 11.65 All Payors / Plans All Payors / Plans 11.89 other 11.89 11.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VISCOPASTE PX-270041322 CDM 270 RC outpatient 6.77 6.63 All Payors / Plans All Payors / Plans 6.77 other 6.77 6.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COVERSITE PLUS 6X6 PX-270041323 CDM 270 RC outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARGLASE POWDER PX-270041324 CDM 270 RC outpatient 66.77 65.43 All Payors / Plans All Payors / Plans 66.77 other 66.77 66.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CALAZYME PASTE PX-270041325 CDM 270 RC outpatient 5.2 5.1 All Payors / Plans All Payors / Plans 5.2 other 5.2 5.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MED E-KAST KIT PX-270041326 CDM 270 RC outpatient 96 94.08 All Payors / Plans All Payors / Plans 96 other 96 96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEDIHONEY CALC ALG 4X5 PX-270041327 CDM 270 RC outpatient 10.19 9.99 All Payors / Plans All Payors / Plans 10.19 other 10.19 10.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEDIHONEY HCS NON-AD 4.3X4.3 PX-270041328 CDM 270 RC outpatient 10.52 10.31 All Payors / Plans All Payors / Plans 10.52 other 10.52 10.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEDIHONEY GEL 0.5OZ PX-270041329 CDM 270 RC outpatient 4.94 4.84 All Payors / Plans All Payors / Plans 4.94 other 4.94 4.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HYDROFERA BLUE BACTERIO DRESS 4X4 PX-270041330 CDM 270 RC outpatient 7.62 7.47 All Payors / Plans All Payors / Plans 7.62 other 7.62 7.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDOFORM 2X2 FENESTRATED COLLAGEN PX-270041333 CDM 270 RC outpatient 12.97 12.71 All Payors / Plans All Payors / Plans 12.97 other 12.97 12.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST 3 INCH NO BOOT PX-270041334 CDM 270 RC outpatient 122.96 120.5 All Payors / Plans All Payors / Plans 122.96 other 122.96 122.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST 3 IN W/1 BOOT REGULAR PX-270041335 CDM 270 RC outpatient 136.2 133.48 All Payors / Plans All Payors / Plans 136.2 other 136.2 136.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST 3 IN REPLACE NO BOOT PX-270041336 CDM 270 RC outpatient 71.25 69.83 All Payors / Plans All Payors / Plans 71.25 other 71.25 71.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST 4 INCH NO BOOT PX-270041337 CDM 270 RC outpatient 122.96 120.5 All Payors / Plans All Payors / Plans 122.96 other 122.96 122.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST 4 INCH W/XL BOOT PX-270041338 CDM 270 RC outpatient 136.2 133.48 All Payors / Plans All Payors / Plans 136.2 other 136.2 136.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST BOOT REPLACE REGULAR PX-270041339 CDM 270 RC outpatient 80.78 79.16 All Payors / Plans All Payors / Plans 80.78 other 80.78 80.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST BOOT REPLACE LARGE PX-270041340 CDM 270 RC outpatient 96.23 94.31 All Payors / Plans All Payors / Plans 96.23 other 96.23 96.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST BOOT REPLACE XLARGE PX-270041341 CDM 270 RC outpatient 100.98 98.96 All Payors / Plans All Payors / Plans 100.98 other 100.98 100.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHARCOT TCC-EZ BOOT LG 41017 PX-270041342 CDM 270 RC outpatient 223 218.54 All Payors / Plans All Payors / Plans 223 other 223 223 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHARCOT TCC-EZ BOOT XLG 41018 PX-270041343 CDM 270 RC outpatient 249.99 244.99 All Payors / Plans All Payors / Plans 249.99 other 249.99 249.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PURAPLY AM 2 X 2 PX-270041344 CDM Q4196 CPT 761 RC outpatient 710.4 696.19 All Payors / Plans All Payors / Plans 710.4 other 710.4 710.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PURAPLY AM 2 X 4 PX-270041345 CDM Q4196 CPT 761 RC outpatient 1075.2 1053.7 All Payors / Plans All Payors / Plans 1075.2 other 1075.2 1075.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PURAPLY AM 5 X 5 PX-270041346 CDM Q4196 CPT 761 RC outpatient 3360 3292.8 All Payors / Plans All Payors / Plans 3360 other 3360 3360 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PURAPLY AM 6 X 9 PX-270041347 CDM Q4196 CPT 761 RC outpatient 7257.6 7112.45 All Payors / Plans All Payors / Plans 7257.6 other 7257.6 7257.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX 14MM DISC PX-270041363 CDM Q4110 CPT 270 RC outpatient 582 570.36 All Payors / Plans All Payors / Plans 582 other 582 582 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX 18MM DISC PX-270041364 CDM Q4110 CPT 270 RC outpatient 708 693.84 All Payors / Plans All Payors / Plans 708 other 708 708 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX 2X2 PX-270041365 CDM Q4110 CPT 270 RC outpatient 837.6 820.85 All Payors / Plans All Payors / Plans 837.6 other 837.6 837.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX MESHED 3X3 PX-270041366 CDM Q4110 CPT 270 RC outpatient 900 882 All Payors / Plans All Payors / Plans 900 other 900 900 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX FENESTRATED 4X4 PX-270041367 CDM Q4110 CPT 270 RC outpatient 1140 1117.2 All Payors / Plans All Payors / Plans 1140 other 1140 1140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX MESHED 4X4 PX-270041368 CDM Q4110 CPT 270 RC outpatient 1140 1117.2 All Payors / Plans All Payors / Plans 1140 other 1140 1140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX MESHED 5X5 PX-270041369 CDM Q4110 CPT 270 RC outpatient 1380 1352.4 All Payors / Plans All Payors / Plans 1380 other 1380 1380 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX FENESTRATED 6X6 PX-270041370 CDM Q4110 CPT 270 RC outpatient 1560 1528.8 All Payors / Plans All Payors / Plans 1560 other 1560 1560 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT PRIMATRIX MESHED 6X6 PX-270041371 CDM Q4110 CPT 270 RC outpatient 1560 1528.8 All Payors / Plans All Payors / Plans 1560 other 1560 1560 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT OMNIGRAFT/STAPLER 2.5X2.5 PX-270041372 CDM Q4105 CPT 270 RC outpatient 918 899.64 All Payors / Plans All Payors / Plans 918 other 918 918 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALLOGRAFT OMNIGRAFT/STAPLER 4X4 PX-270041373 CDM Q4105 CPT 270 RC outpatient 1350 1323 All Payors / Plans All Payors / Plans 1350 other 1350 1350 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LYOFOAM 3X3.4 PX-270041374 CDM 270 RC outpatient 2.64 2.59 All Payors / Plans All Payors / Plans 2.64 other 2.64 2.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX 4X4 FOAM PX-270041375 CDM 270 RC outpatient 3.65 3.58 All Payors / Plans All Payors / Plans 3.65 other 3.65 3.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX 6X6 PX-270041376 CDM 270 RC outpatient 7.96 7.8 All Payors / Plans All Payors / Plans 7.96 other 7.96 7.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX 3X3 BORDERED FOAM PX-270041377 CDM 270 RC outpatient 2.58 2.53 All Payors / Plans All Payors / Plans 2.58 other 2.58 2.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX 4X4 BORDERED FOAM PX-270041378 CDM 270 RC outpatient 4.68 4.59 All Payors / Plans All Payors / Plans 4.68 other 4.68 4.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX BORDERED SACRUM PX-270041379 CDM 270 RC outpatient 7.6 7.45 All Payors / Plans All Payors / Plans 7.6 other 7.6 7.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX BORDERED HEEL PX-270041380 CDM 270 RC outpatient 11.42 11.19 All Payors / Plans All Payors / Plans 11.42 other 11.42 11.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MELGISORB PLUS PX-270041381 CDM 270 RC outpatient 2.48 2.43 All Payors / Plans All Payors / Plans 2.48 other 2.48 2.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX LITE 6X6 PX-270041382 CDM 270 RC outpatient 5.57 5.46 All Payors / Plans All Payors / Plans 5.57 other 5.57 5.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEFIX 2X11 YD PX-270041383 CDM 270 RC outpatient 4.02 3.94 All Payors / Plans All Payors / Plans 4.02 other 4.02 4.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROMOGRAN/PRISMA 4.34 SQ IN PX-270041384 CDM 270 RC outpatient 9.8 9.6 All Payors / Plans All Payors / Plans 9.8 other 9.8 9.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROMOGRAN/PRISMA 19.1 SQ IN PX-270041385 CDM 270 RC outpatient 29.41 28.82 All Payors / Plans All Payors / Plans 29.41 other 29.41 29.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEDIHONEY HCS 4.3X4.3 PX-270041386 CDM 270 RC outpatient 10.62 10.41 All Payors / Plans All Payors / Plans 10.62 other 10.62 10.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARTRIDGE WOUND SNAP VAC PX-270041388 CDM 270 RC outpatient 151.2 148.18 All Payors / Plans All Payors / Plans 151.2 other 151.2 151.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESSING SNAP FOAM L 10X10 ADVANCE PX-270041389 CDM 270 RC outpatient 53.1 52.04 All Payors / Plans All Payors / Plans 53.1 other 53.1 53.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESSING SNAP L 15X15 FOAM INTERFACE PX-270041390 CDM 270 RC outpatient 56.64 55.51 All Payors / Plans All Payors / Plans 56.64 other 56.64 56.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OASIS 3.5CM X 3.0CM TRIPLE LAYER PX-270041393 CDM Q4124 CPT 270 RC outpatient 187 183.26 All Payors / Plans All Payors / Plans 187 other 187 187 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OASIS 7.0CM X 3.0CM TRIPLE LAYER PX-270041394 CDM Q4124 CPT 270 RC outpatient 337 330.26 All Payors / Plans All Payors / Plans 337 other 337 337 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GRAFIX PL PRIME 1.5X2 PX-270041395 CDM Q4133 CPT 761 RC outpatient 950 931 All Payors / Plans All Payors / Plans 950 other 950 950 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GRAFIX PL PRIME 2X3 PX-270041396 CDM Q4133 CPT 761 RC outpatient 1188 1164.24 All Payors / Plans All Payors / Plans 1188 other 1188 1188 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GRAFIX PL PRIME 3X3 PX-270041397 CDM Q4133 CPT 761 RC outpatient 1350 1323 All Payors / Plans All Payors / Plans 1350 other 1350 1350 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GRAFIX PL PRIME 3X4 PX-270041398 CDM Q4133 CPT 761 RC outpatient 1458 1428.84 All Payors / Plans All Payors / Plans 1458 other 1458 1458 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GRAFIX PL PRIME 5X5 PX-270041399 CDM Q4133 CPT 761 RC outpatient 3240 3175.2 All Payors / Plans All Payors / Plans 3240 other 3240 3240 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KERECIS GRAFT 16MM CIRCULAR PX-270041400 CDM Q4158 CPT 270 RC outpatient 622 609.56 All Payors / Plans All Payors / Plans 622 other 622 622 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KERECIS GRAFT 3X3.5 PX-270041401 CDM Q4158 CPT 270 RC outpatient 1000.8 980.78 All Payors / Plans All Payors / Plans 1000.8 other 1000.8 1000.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KERECIS GRAFT 3X7 PX-270041402 CDM Q4158 CPT 270 RC outpatient 1560 1528.8 All Payors / Plans All Payors / Plans 1560 other 1560 1560 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POLYMEM 4X4 PX-270041403 CDM 270 RC outpatient 7 6.86 All Payors / Plans All Payors / Plans 7 other 7 7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POLYMEM 4X12.5 PX-270041404 CDM 270 RC outpatient 22.1 21.66 All Payors / Plans All Payors / Plans 22.1 other 22.1 22.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPTILOCK NON-ADHESIVE 8X12 PX-270041405 CDM 270 RC outpatient 6.58 6.45 All Payors / Plans All Payors / Plans 6.58 other 6.58 6.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROFORE BANDAGE COMPRESSION PAD PX-270041406 CDM 270 RC outpatient 8.8 8.62 All Payors / Plans All Payors / Plans 8.8 other 8.8 8.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NUSHEILD PLACENTAL MEMBRANE 2.01 SQ CM ALLOGRAFT PX-270041407 CDM Q4160 CPT 270 RC outpatient 474 464.52 All Payors / Plans All Payors / Plans 474 other 474 474 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NUSHEILD L3 CM X W 2 CM ALLOGRAFT PX-270041408 CDM Q4160 CPT 270 RC outpatient 954 934.92 All Payors / Plans All Payors / Plans 954 other 954 954 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NUSHEILD PLACENTAL MEMBRANE 8 SQ CM L 4CM X W 2CM ALLOGRAFT PX-270041409 CDM Q4160 CPT 270 RC outpatient 1140 1117.2 All Payors / Plans All Payors / Plans 1140 other 1140 1140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NUSHEILD PLACENTAL MEMBRANE 12 SQ CM L 4CM X W 3CM ALLOGRAFT PX-270041410 CDM Q4160 CPT 270 RC outpatient 1650 1617 All Payors / Plans All Payors / Plans 1650 other 1650 1650 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NUSHEILD L 4 CM X W 4 CM ALLOGRAFT PX-270041411 CDM Q4160 CPT 270 RC outpatient 1710 1675.8 All Payors / Plans All Payors / Plans 1710 other 1710 1710 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NUSHEILD L 6 CM X W 4CM ALLOGRAFT PX-270041412 CDM Q4160 CPT 270 RC outpatient 2250 2205 All Payors / Plans All Payors / Plans 2250 other 2250 2250 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NUSHEILD L 6 CM X W 6 CM ALLOGRAFT PX-270041413 CDM Q4160 CPT 270 RC outpatient 2988 2928.24 All Payors / Plans All Payors / Plans 2988 other 2988 2988 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEBULIZER MEDICATION BREATH ACTUATED AEROECLIPSE HANDHELD SM PX-270800001 CDM 270 RC outpatient 1.48 1.45 All Payors / Plans All Payors / Plans 1.48 other 1.48 1.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PAIL COMMODE COVER 7QT PX-270800002 CDM 270 RC outpatient 7.66 7.51 All Payors / Plans All Payors / Plans 7.66 other 7.66 7.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PAD DEFIBRILLATOR PX-270800003 CDM 270 RC outpatient 14.25 13.97 All Payors / Plans All Payors / Plans 14.25 other 14.25 14.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PADS HANDS OFF DEFIBILATOR FOR PHILIPS PX-270800004 CDM 270 RC outpatient 19.31 18.92 All Payors / Plans All Payors / Plans 19.31 other 19.31 19.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC POSITIONER ALIGNER BODY FOAM PX-270800005 CDM 270 RC outpatient 6.98 6.84 All Payors / Plans All Payors / Plans 6.98 other 6.98 6.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC TRANSPORT TUBE VIRAL KIT UVT KIT 1ML WITH FLOKED FLEX MINI T PX-270800006 CDM 270 RC outpatient 2.57 2.52 All Payors / Plans All Payors / Plans 2.57 other 2.57 2.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC STATLOCK 2 WAY FOLEY PX-270800007 CDM 270 RC outpatient 3.52 3.45 All Payors / Plans All Payors / Plans 3.52 other 3.52 3.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC SET IV NITROGLYCERIN 60CTT 103""L PVC TUBING DUO-VENT" PX-270800008 CDM 270 RC outpatient 7.21 7.07 All Payors / Plans All Payors / Plans 7.21 other 7.21 7.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC TEGADERM I.V. ADVANCED PX-270800009 CDM 270 RC outpatient 1.27 1.24 All Payors / Plans All Payors / Plans 1.27 other 1.27 1.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PUREWICK FEMALE EXTERNAL CATHETER PX-270800012 CDM 270 RC outpatient 7.8 7.64 All Payors / Plans All Payors / Plans 7.8 other 7.8 7.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC ELECTRODE EKG RADIOLUCENT PUPPYDOG NEONATAL PEDIATRIC PX-270800016 CDM 270 RC outpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BOARD WRIST REUSABLE CHILD IV 3.5 X 9.0IN PX-270800019 CDM 270 RC outpatient 1.39 1.36 All Payors / Plans All Payors / Plans 1.39 other 1.39 1.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BAG ENEMA SLIDE CLAMP PRE LUBRICATED KIT DISPOSABLE INDIVIDU PX-270800020 CDM 270 RC outpatient 1.37 1.34 All Payors / Plans All Payors / Plans 1.37 other 1.37 1.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC RESUS MNL ADLT BVM STAT CK CO2 PX-270800021 CDM 270 RC outpatient 9.34 9.15 All Payors / Plans All Payors / Plans 9.34 other 9.34 9.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SOLUTION SCRUB POVIDONE IODINE 2OZ PX-270800022 CDM 270 RC outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER URINARY EXTERNAL EXTENDED WEAR MEDIUM 26MM PX-270800024 CDM 270 RC outpatient 1.36 1.33 All Payors / Plans All Payors / Plans 1.36 other 1.36 1.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER EXTERNAL INTERMEDIATE 32MM PX-270800025 CDM 270 RC outpatient 1.36 1.33 All Payors / Plans All Payors / Plans 1.36 other 1.36 1.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC OPTICHAMBER DIAMOND WITHOUT MASK WITH RECLOSABLE BAG PX-270800027 CDM 270 RC outpatient 5.66 5.55 All Payors / Plans All Payors / Plans 5.66 other 5.66 5.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC COLLECTOR SPECIMEN STOOL PX-270800034 CDM 270 RC outpatient 1.27 1.24 All Payors / Plans All Payors / Plans 1.27 other 1.27 1.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BAG COLLECTION URINARY LEG WITH STRAP TWIST VALVE BOTTOM MED PX-270800035 CDM 270 RC outpatient 2.09 2.05 All Payors / Plans All Payors / Plans 2.09 other 2.09 2.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC TUBE NASAL GASTRIC ARGYLE SALEM SUMP WITH IRRIGATION FUNNEL PX-270800036 CDM 270 RC outpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEB AERS THERA-MST 36-95 FIO2 40/CS PX-270800038 CDM 270 RC outpatient 5.13 5.03 All Payors / Plans All Payors / Plans 5.13 other 5.13 5.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC HUMIDIFIER PREFILLED WITH ADAPTER PLASTIC 500ML PX-270800039 CDM 270 RC outpatient 1.56 1.53 All Payors / Plans All Payors / Plans 1.56 other 1.56 1.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC KIT IV START STERILE PX-270800040 CDM 270 RC outpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SKIN PREP TRAY MISSION/STJOE 20/CS PX-270800041 CDM 270 RC outpatient 12.3 12.05 All Payors / Plans All Payors / Plans 12.3 other 12.3 12.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC KIT ARTERIAL BLOOD GAS SAMPLE LATEX FREE PX-270800042 CDM 270 RC outpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CUP COLLECTION URINE MIDSTREAM CATCH PLASTIC STRAW TUBE 5.0M PX-270800043 CDM 270 RC outpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC LINER CANISTER SUCTION THIN WALL FLEX ADVANTAGE WITH FILTER PX-270800044 CDM 270 RC outpatient 1.36 1.33 All Payors / Plans All Payors / Plans 1.36 other 1.36 1.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC MASK OXYGEN AEROSOL UNDER THE CHIN WITHOUT TUBING ELONGATED PX-270800045 CDM 270 RC outpatient 1.29 1.26 All Payors / Plans All Payors / Plans 1.29 other 1.29 1.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC MASK NON REBREATHING W SAFETY VENT PX-270800046 CDM 270 RC outpatient 1.18 1.16 All Payors / Plans All Payors / Plans 1.18 other 1.18 1.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC FASTENER NASAL GASTRIC TUBE NON LATEX ADULT PX-270800048 CDM 270 RC outpatient 1.17 1.15 All Payors / Plans All Payors / Plans 1.17 other 1.17 1.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SENSOR PULSE OXIMETER FINGER DISPOSABLE NEONATAL 18IN PX-270800049 CDM 270 RC outpatient 13.24 12.98 All Payors / Plans All Payors / Plans 13.24 other 13.24 13.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SENSOR PULSE OXIMETER WITH ADHESIVE STRAP DISPOSABLE PEDIATR PX-270800050 CDM 270 RC outpatient 10.18 9.98 All Payors / Plans All Payors / Plans 10.18 other 10.18 10.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SENSOR PULSE OXIMETER FINGER DISPOSABLE ADULT 18IN PX-270800051 CDM 270 RC outpatient 10.18 9.98 All Payors / Plans All Payors / Plans 10.18 other 10.18 10.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC METER PEAK FLOW FULL RANGE WITH ZONE MANAGEMENT SINGLE PATIE PX-270800052 CDM 270 RC outpatient 9.81 9.61 All Payors / Plans All Payors / Plans 9.81 other 9.81 9.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SPLINT ELBOW ARM WRAP FREEDOM MEDIUM PX-270800055 CDM 270 RC outpatient 20.35 19.94 All Payors / Plans All Payors / Plans 20.35 other 20.35 20.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC STRAINER URINE CALCULLI KIDNEY STONE WITH FUNNEL FILTER SCRE PX-270800056 CDM 270 RC outpatient 1.26 1.23 All Payors / Plans All Payors / Plans 1.26 other 1.26 1.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC TRAY PROCEDURE CATHETER URETHRAL STRAIGHT 15FR PX-270800057 CDM 270 RC outpatient 2.33 2.28 All Payors / Plans All Payors / Plans 2.33 other 2.33 2.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC TRAY SUTURE REMOVAL PX-270800059 CDM 270 RC outpatient 1.15 1.13 All Payors / Plans All Payors / Plans 1.15 other 1.15 1.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CONTAINER SPECIMEN MUCOUS TRAP WITH SCREW ON LID 40CC PX-270800060 CDM 270 RC outpatient 1.62 1.59 All Payors / Plans All Payors / Plans 1.62 other 1.62 1.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC TUBE RECTAL COLON PLASTIC WITH LUBRICANT ADULT 24FR X 20IN PX-270800063 CDM 270 RC outpatient 3.13 3.07 All Payors / Plans All Payors / Plans 3.13 other 3.13 3.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC VALVE NASOGASTRIC ANTI REFLUX FOR ARGYLE SALEM SUMP STERILE PX-270800067 CDM 270 RC outpatient 4.12 4.04 All Payors / Plans All Payors / Plans 4.12 other 4.12 4.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC VALVE LOPEZ ENTERAL FEEDING PX-270800068 CDM 270 RC outpatient 1.7 1.67 All Payors / Plans All Payors / Plans 1.7 other 1.7 1.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SET IV ADMINISTRATION BLOOD CONTINUOUS FLOW WITH DUO TYPE Y PX-270800070 CDM 270 RC outpatient 7.79 7.63 All Payors / Plans All Payors / Plans 7.79 other 7.79 7.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC SET SECONDARY MED 37""" PX-270800071 CDM 270 RC outpatient 1.2 1.18 All Payors / Plans All Payors / Plans 1.2 other 1.2 1.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EXTENSION IV CATHETER EXTENSION STANDARD BORE LUER LOCK SET PX-270800072 CDM 270 RC outpatient 2.14 2.1 All Payors / Plans All Payors / Plans 2.14 other 2.14 2.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC VALVE LUER ACTIVATED WITH MALE LUER LOCK ADAPTER STERILE MIC PX-270800073 CDM 270 RC outpatient 1.3 1.27 All Payors / Plans All Payors / Plans 1.3 other 1.3 1.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC SET IV PRIMARY CONTINUOUS FLO WITH DUO-VENT 105""" PX-270800074 CDM 270 RC outpatient 3.81 3.73 All Payors / Plans All Payors / Plans 3.81 other 3.81 3.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC ADAPTER LUER VENOJECT MULTI SAMPLE PX-270800075 CDM 270 RC outpatient 29.34 28.75 All Payors / Plans All Payors / Plans 29.34 other 29.34 29.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER IV VASCULAR PERIPHERAL RADIOPAQUE PROTECTIVE PLUS S PX-270800076 CDM 270 RC outpatient 90.03 88.23 All Payors / Plans All Payors / Plans 90.03 other 90.03 90.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER IV VASCULAR PERIPHERAL RADIOPAQUE PROTECTIVE PLUS 2 PX-270800077 CDM 270 RC outpatient 90.03 88.23 All Payors / Plans All Payors / Plans 90.03 other 90.03 90.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER IV VASCULAR PERIPHERAL RADIOPAQUE PROTECTIVE PLUS S PX-270800078 CDM 270 RC outpatient 90.03 88.23 All Payors / Plans All Payors / Plans 90.03 other 90.03 90.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER IV VASCULAR PERIPHERAL RADIOPAQUE PROTECTIVE PLUS S PX-270800079 CDM 270 RC outpatient 90.03 88.23 All Payors / Plans All Payors / Plans 90.03 other 90.03 90.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC ELECTRODE ECG RESTING TAB ADHESIVE VINYL QTRACE 5400 ADULT PX-270800080 CDM 270 RC outpatient 21.66 21.23 All Payors / Plans All Payors / Plans 21.66 other 21.66 21.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SYRINGE HYPODERMIC WITHOUT NEEDLE WITH LUER LOCK TIP PLASTIC PX-270800081 CDM 270 RC outpatient 12.9 12.64 All Payors / Plans All Payors / Plans 12.9 other 12.9 12.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SYRINGE BD 60ML LUER-LOK TIP GRADUATION PX-270800082 CDM 270 RC outpatient 14.11 13.83 All Payors / Plans All Payors / Plans 14.11 other 14.11 14.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC RAIL PROTECTOR SPLIT SIDE PX-270800083 CDM 270 RC outpatient 36.36 35.63 All Payors / Plans All Payors / Plans 36.36 other 36.36 36.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC RESTRAINT BELT SAFETY ROLL WITH TIE COTTON ONE SIZE 17.5 X 6 PX-270800084 CDM 270 RC outpatient 24.3 23.81 All Payors / Plans All Payors / Plans 24.3 other 24.3 24.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PROTECTOR SKIN SLEEVE ARM LATEX FREE LIGHT TONE STANDARD PX-270800085 CDM 270 RC outpatient 18.49 18.12 All Payors / Plans All Payors / Plans 18.49 other 18.49 18.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PAD BED WITH SENSOR PX-270800086 CDM 270 RC outpatient 17.1 16.76 All Payors / Plans All Payors / Plans 17.1 other 17.1 17.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC HYPERTHERMIA COOLING BLANKET 24'X60""""" PX-270800087 CDM 270 RC outpatient 20.4 19.99 All Payors / Plans All Payors / Plans 20.4 other 20.4 20.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BAG DRAINAGE URINARY UROLOGY ANTI REFLUX INFECTION CONTROL 2 PX-270800090 CDM 270 RC outpatient 4.05 3.97 All Payors / Plans All Payors / Plans 4.05 other 4.05 4.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC RESUSCITATOR BABY BLUE II WITH MASK INFANT PX-270800091 CDM 270 RC outpatient 20.31 19.9 All Payors / Plans All Payors / Plans 20.31 other 20.31 20.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BAGS PEDIATRIC BLUE PX-270800092 CDM 270 RC outpatient 20.62 20.21 All Payors / Plans All Payors / Plans 20.62 other 20.62 20.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER MULTIMED PENINSULA 5/CS PX-270800095 CDM 270 RC outpatient 78 76.44 All Payors / Plans All Payors / Plans 78 other 78 78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER KIT TRIPLE PX-270800096 CDM 270 RC outpatient 138.52 135.75 All Payors / Plans All Payors / Plans 138.52 other 138.52 138.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SYSTEM CULTURE COLLECTION TRANSPORT ANAEROBIC SPECIMEN VACUT PX-270800097 CDM 270 RC outpatient 6.44 6.31 All Payors / Plans All Payors / Plans 6.44 other 6.44 6.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BAG SPECIMEN COLLECTION URINARY STERILE NEWBORN PX-270800098 CDM 270 RC outpatient 1.6 1.57 All Payors / Plans All Payors / Plans 1.6 other 1.6 1.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BAG SPECIMEN URINARY COLLECTION WITH MICROPOROUS ADHESIVE RE PX-270800099 CDM 270 RC outpatient 1.67 1.64 All Payors / Plans All Payors / Plans 1.67 other 1.67 1.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CONTAINER FORMALIN NT PREFILLED 10% 6OZ PX-270800103 CDM 270 RC outpatient 1.36 1.33 All Payors / Plans All Payors / Plans 1.36 other 1.36 1.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC LBL ORNG MED AD 1 ROLL = 500 EA PX-270800104 CDM 270 RC outpatient 12.91 12.65 All Payors / Plans All Payors / Plans 12.91 other 12.91 12.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SENSOR PULSE OXIMETER FINGER DISPOSABLE INFANT PX-270800105 CDM 270 RC outpatient 14.74 14.45 All Payors / Plans All Payors / Plans 14.74 other 14.74 14.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC TRAY PROCEDURE LUMBAR PUNCTURE DIAMOND POINT MANOMETER 4 SPE PX-270800107 CDM 270 RC outpatient 7.94 7.78 All Payors / Plans All Payors / Plans 7.94 other 7.94 7.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC TRAY LUMBAR PUNCTURE 3 WAY STOPCOCK STERILE WITH MANOMETER P PX-270800108 CDM 270 RC outpatient 6.56 6.43 All Payors / Plans All Payors / Plans 6.56 other 6.56 6.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BAG DRAINAGE UROLOGY WITH URINE METER INFECTION CONTROL 350M PX-270800109 CDM 270 RC outpatient 8.46 8.29 All Payors / Plans All Payors / Plans 8.46 other 8.46 8.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CONTAINER IV INFUSION EMPTY VIAFLEX PLASTIC BAG 1000ML PX-270800110 CDM 270 RC outpatient 2.62 2.57 All Payors / Plans All Payors / Plans 2.62 other 2.62 2.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC FILTER BLOOD SQ40SK PX-270800111 CDM 270 RC outpatient 11.14 10.92 All Payors / Plans All Payors / Plans 11.14 other 11.14 11.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SOLUTION IV INJECTION LACTATED RINGER PLASTIC BAG 500ML PX-270800112 CDM 270 RC outpatient 1.6 1.57 All Payors / Plans All Payors / Plans 1.6 other 1.6 1.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SOLUTION IV INJECTION LACTATED RINGER PLASTIC BAG 1000ML PX-270800113 CDM 270 RC outpatient 1.92 1.88 All Payors / Plans All Payors / Plans 1.92 other 1.92 1.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BIOPATCH PX-270800114 CDM 270 RC outpatient 65.85 64.53 All Payors / Plans All Payors / Plans 65.85 other 65.85 65.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CUROS CAPS PX-270800115 CDM 270 RC outpatient 62.18 60.94 All Payors / Plans All Payors / Plans 62.18 other 62.18 62.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER IV VASCULAR PERIPHERAL RADIOPAQUE PROTECTED PLUS 14 PX-270800116 CDM 270 RC outpatient 90.23 88.43 All Payors / Plans All Payors / Plans 90.23 other 90.23 90.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CATHETER IV VASCULAR PERIPHERAL RADIOPAQUE PROTECTIVE PLUS S PX-270800117 CDM 270 RC outpatient 90.37 88.56 All Payors / Plans All Payors / Plans 90.37 other 90.37 90.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SET EXT WITH MICROCLAVE CLAMP 7 INCHES PX-270800123 CDM 270 RC outpatient 3.79 3.71 All Payors / Plans All Payors / Plans 3.79 other 3.79 3.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SET EXT WITH MICROCLAVE CLAMP 60 INCHES PX-270800124 CDM 270 RC outpatient 5.92 5.8 All Payors / Plans All Payors / Plans 5.92 other 5.92 5.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BRACE ANKLE SPLINT BILATERAL REGULAR GREEN PX-270800125 CDM 270 RC outpatient 11.58 11.35 All Payors / Plans All Payors / Plans 11.58 other 11.58 11.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CANNULA NASAL CURVED TIP INFANT 7FT PX-270800126 CDM 270 RC outpatient 2.11 2.07 All Payors / Plans All Payors / Plans 2.11 other 2.11 2.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CONNECTOR 22MM OD X 22MM OD PX-270800128 CDM 270 RC outpatient 1.59 1.56 All Payors / Plans All Payors / Plans 1.59 other 1.59 1.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC IMMOBILIZER KNEE 3PANEL ADJUSTABLE UNIVERAL COTTON FOAM BLUE PX-270800129 CDM 270 RC outpatient 16.8 16.46 All Payors / Plans All Payors / Plans 16.8 other 16.8 16.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC IMMOBILIZER SHOULDER DELUXE MEDIUM PX-270800130 CDM 270 RC outpatient 4.84 4.74 All Payors / Plans All Payors / Plans 4.84 other 4.84 4.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC IMMOBILIZER SHOULDER DELUXE LARGE PX-270800131 CDM 270 RC outpatient 4.84 4.74 All Payors / Plans All Payors / Plans 4.84 other 4.84 4.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC MEDIA BLOOD CULTURE BOTTLE AUTO PEDIATRIC PLUS MEDIUM FOR BA PX-270800132 CDM 270 RC outpatient 3.65 3.58 All Payors / Plans All Payors / Plans 3.65 other 3.65 3.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PACESETTER II CLOSED HEEL BLK PX-270800133 CDM 270 RC outpatient 28.5 27.93 All Payors / Plans All Payors / Plans 28.5 other 28.5 28.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PACESETTER II CLOSED HEEL BLK MEDIUM/LARGE PX-270800134 CDM 270 RC outpatient 28.5 27.93 All Payors / Plans All Payors / Plans 28.5 other 28.5 28.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PACESETTER II CLOSED HEEL BLK PX-270800135 CDM 270 RC outpatient 28.5 27.93 All Payors / Plans All Payors / Plans 28.5 other 28.5 28.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SPLINT CASTING FIBERGLASS SCOTCHCAST CUSTOM LENGTH ROLL 5.0I PX-270800152 CDM 270 RC outpatient 86.53 84.8 All Payors / Plans All Payors / Plans 86.53 other 86.53 86.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC DRESSING WOUND HEMOSTAT ABSORBABLE STERILE SURGICEL 2 X 3IN PX-270800153 CDM 270 RC outpatient 41.62 40.79 All Payors / Plans All Payors / Plans 41.62 other 41.62 41.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC DRESSING WOUND HEMOSTAT ABSORBABLE STERILE SURGICEL 4.0 X 8. PX-270800154 CDM 270 RC outpatient 77.05 75.51 All Payors / Plans All Payors / Plans 77.05 other 77.05 77.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SOLUTION IV INJECTION DEXTROSE 10% IN WATER 1000ML PX-270800155 CDM 270 RC outpatient 2.35 2.3 All Payors / Plans All Payors / Plans 2.35 other 2.35 2.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SOLUTION IV INJECTION DEXTROSE 5% LACTATED RINGERS VISIV PLA PX-270800156 CDM 270 RC outpatient 1.75 1.72 All Payors / Plans All Payors / Plans 1.75 other 1.75 1.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC 24G X 5/8 CATHERTER PROTECTIVE PLUS PX-270800157 CDM 270 RC outpatient 96.25 94.33 All Payors / Plans All Payors / Plans 96.25 other 96.25 96.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PADDING UNDERCAST WEBRIL NON STERILE REGULAR FINISH COTTON 2 PX-270800158 CDM 270 RC outpatient 15.26 14.95 All Payors / Plans All Payors / Plans 15.26 other 15.26 15.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PADDING UNDERCAST WEBRIL NON STERILE REGULAR FINISH COTTON 3 PX-270800159 CDM 270 RC outpatient 8.22 8.06 All Payors / Plans All Payors / Plans 8.22 other 8.22 8.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PADDING UNDERCAST WEBRIL NON STERILE REGULAR FINISH COTTON 4 PX-270800160 CDM 270 RC outpatient 10.71 10.5 All Payors / Plans All Payors / Plans 10.71 other 10.71 10.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PADDING UNDERCAST WEBRIL NON STERILE REGULAR FINISH COTTON 6 PX-270800161 CDM 270 RC outpatient 7.6 7.45 All Payors / Plans All Payors / Plans 7.6 other 7.6 7.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SPLINT FINGER PLASTALUME STRAIGHT 1.25IN PX-270800162 CDM 270 RC outpatient 7.18 7.04 All Payors / Plans All Payors / Plans 7.18 other 7.18 7.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SPLINT CASTING FIBERGLASS SCOTCHCAST CUSTOM LENGTH ROLL 3.0I PX-270800163 CDM 270 RC outpatient 62.27 61.02 All Payors / Plans All Payors / Plans 62.27 other 62.27 62.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SPLINT CASTING FIBERGLASS SCOTCHCAST CUSTOM LENGTH ROLL 4.0I PX-270800164 CDM 270 RC outpatient 71.48 70.05 All Payors / Plans All Payors / Plans 71.48 other 71.48 71.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTRAOCULAR LENS MED SURG PX-276000000 CDM 276 RC outpatient 180 176.4 All Payors / Plans All Payors / Plans 180 other 180 180 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTRAOCULAR LENS PX-276023100 CDM V2631 CPT 276 RC outpatient 150 147 All Payors / Plans All Payors / Plans 150 other 150 150 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTEROCULAR LENS ALCON PX-276027880 CDM V2788 CPT 276 RC outpatient 1074 1052.52 All Payors / Plans All Payors / Plans 1074 other 1074 1074 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CAB TEST PX-300000033 CDM 300 RC outpatient 272 266.56 All Payors / Plans All Payors / Plans 272 other 272 272 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PSA SCREEN (PSAS) PX-300001030 CDM G0103 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROSEQ PX-3000026U0 CDM 0026U CPT 300 RC outpatient 2228 2183.44 All Payors / Plans All Payors / Plans 2228 other 2228 2228 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC EXON 12-15 SEQUENCING, REFLEX" PX-300002700 CDM 0027U CPT 300 RC outpatient 465 455.7 All Payors / Plans All Payors / Plans 465 other 465 465 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC JAK2 EXON 12 & OTHER NON V617F MUTATION DETECT BLOOD (JAKXB,JACXM)" PX-300002701 CDM 0027U CPT 300 RC outpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TPMT AND NUDT15 GENOTYPE PX-300003400 CDM 0034U CPT 300 RC outpatient 557 545.86 All Payors / Plans All Payors / Plans 557 other 557 557 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IG PARAPROTEIN QUAL BLD/UR PX-3000077U0 CDM 0077U CPT 300 RC outpatient 32 31.36 All Payors / Plans All Payors / Plans 32 other 32 32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFCT DS BCT/VIR RESP 22 TARGETS ARS/COV2 PX-3000202U0 CDM 0202U CPT 300 RC outpatient 437 428.26 All Payors / Plans All Payors / Plans 437 other 437 437 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SENTOSA SQ HIV-1 GENOTYPING ASSAY PX-3000219U0 CDM 0219U CPT 300 RC outpatient 557 545.86 All Payors / Plans All Payors / Plans 557 other 557 557 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFECTIOUS DETECTION SARS-COV2,INFLUENZA A/B, RSV" PX-300024100 CDM 0241U CPT 300 RC outpatient 150 147 All Payors / Plans All Payors / Plans 150 other 150 150 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BETA AMYLOID Aβ40&Aβ42 LC-MS/MS RATIO PLASMA PX-3000346U0 CDM 0346U CPT 300 RC outpatient 267 261.66 All Payors / Plans All Payors / Plans 267 other 267 267 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NEURO ALYS β-AMYL 1-42&1-40 PX-3000358U0 CDM 0358U CPT 300 RC outpatient 834 817.32 All Payors / Plans All Payors / Plans 834 other 834 834 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEGLYCEROLIZED RBC (DRBC) PX-300090220 CDM P9022 CPT 300 RC outpatient 914 895.72 All Payors / Plans All Payors / Plans 914 other 914 914 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PF CO-OX ANALYSIS (PCABG) PX-300366001 CDM 36600 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEM8(BASIC METABOLIC) PX-300800480 CDM 80048 CPT 301 RC outpatient 32 31.36 All Payors / Plans All Payors / Plans 32 other 32 32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ELECTROLYTES (LYTE) PX-300800510 CDM 80051 CPT 301 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMP METABOLIC PANEL (CMP) PX-300800530 CDM 80053 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRENATAL PROFILE (PNP) PX-300800550 CDM 80055 CPT 300 RC outpatient 217 212.66 All Payors / Plans All Payors / Plans 217 other 217 217 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LIPID PROFILE (LIPD) PX-300800610 CDM 80061 CPT 301 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FITNESS PLUS PROFILE (FPP) PX-300800611 CDM 80061 CPT 300 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RENAL PROFILE (RENAL) PX-300800690 CDM 80069 CPT 301 RC outpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXPOSURE PROFILE (EXP) PX-300800740 CDM 80074 CPT 300 RC outpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VIRAL HEPATITIS STUDY PX-300800741 CDM 80074 CPT 300 RC outpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEPATIC PANEL (LIVR) PX-300800760 CDM 80076 CPT 301 RC outpatient 32 31.36 All Payors / Plans All Payors / Plans 32 other 32 32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRENATAL PROFILE INC HIV PX-300800810 CDM 80081 CPT 300 RC outpatient 289 283.22 All Payors / Plans All Payors / Plans 289 other 289 289 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ADALIMUMAB QN WITH REFLEX TO AB, S" PX-300801450 CDM 80145 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMIKACIN PX-300801500 CDM 80150 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CAFFEINE (CAF) PX-300801550 CDM 80155 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARBAMAZEPINE (TEG) PX-300801560 CDM 80156 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYCLOSPORIN (CYCLO) PX-300801580 CDM 80158 CPT 301 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CLOZAPINE PX-300801590 CDM 80159 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DIGOXIN, SERUM (DIG)" PX-300801620 CDM 80162 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEPAKENE (DEPK)(VA) PX-300801640 CDM 80164 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRUG SCREEN QUANT DIPROPYLACETIC ACID FREE PX-300801650 CDM 80165 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ETHXOSUX-ZARONTIN (ZAR) PX-300801680 CDM 80168 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GENTAMICIN PX-300801700 CDM 80170 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NEURONTIN,GABAPENTIN(GABA)" PX-300801710 CDM 80171 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LAMOTRIGINE (LAMO) PX-300801750 CDM 80175 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LIDOCAINE (LIDO) PX-300801760 CDM 80176 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LEVETIRACETAM (LEVE) PX-300801770 CDM 80177 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC LITHIUM,SERUM (LI)" PX-300801780 CDM 80178 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OXCARBAZEPINE PX-300801830 CDM 80183 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PHENOBARBITAL (PHEN) PX-300801840 CDM 80184 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DILANTIN (PTN) PX-300801850 CDM 80185 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FREE DILANTIN (FPTNB) PX-300801860 CDM 80186 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRIMIDONE PX-300801880 CDM 80188 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROCAINAMIDE (PRO)(PRON) PX-300801900 CDM 80190 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHG ASSAY OF PROCAINAMIDE W METABOLITES PX-300801920 CDM 80192 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC QUINIDINE (QUID) PX-300801940 CDM 80194 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RAPAMYCIN (RAPA) PX-300801950 CDM 80195 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FK506(TACROLIMUS) PX-300801970 CDM 80197 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMINOPHYLLINE (THEO)(AMFN) PX-300801980 CDM 80198 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TOBRAMYCIN PX-300802000 CDM 80200 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TOPIRAMATE (TOPI) PX-300802010 CDM 80201 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VANCOMYCIN PX-300802020 CDM 80202 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFLIXIMAB QN WITH REFLEX TO AB, S" PX-300802300 CDM 80230 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC LACOSAMIDE, S" PX-300802350 CDM 80235 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VEDOLIZUMAB QN WITH ANTIBODIES, S" PX-300802800 CDM 80280 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC THIOPURINE METABOLITES, WHOLE BLOOD" PX-300802989 CDM 80299 CPT 300 RC outpatient 372 364.56 All Payors / Plans All Payors / Plans 372 other 372 372 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NORPACE (NRPC) PX-300802990 CDM 80299 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CLOMIPRAMINE (CLOM) PX-300802991 CDM 80299 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLECAINIDE (FLEC) PX-300802992 CDM 80181 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUOXETINE (FLUOX) PX-300802993 CDM 80299 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC 5-FLUCYTOSINE, SERUM" PX-300802994 CDM 80299 CPT 300 RC outpatient 37 36.26 All Payors / Plans All Payors / Plans 37 other 37 37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMIODARONE LEVEL PX-300802995 CDM 80151 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFLIXIMAB QUANTIFIC W/ REFLEX TO ANTIBODIES TO INFLIXIMAB SERUM PX-300802996 CDM 80299 CPT 300 RC outpatient 314 307.72 All Payors / Plans All Payors / Plans 314 other 314 314 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC LACOSAMIDE, SERUM" PX-300802997 CDM 80299 CPT 300 RC outpatient 209 204.82 All Payors / Plans All Payors / Plans 209 other 209 209 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VEDOLIZUMBA QN WITH ABS, SERUM" PX-300802998 CDM 80299 CPT 300 RC outpatient 197 193.06 All Payors / Plans All Payors / Plans 197 other 197 197 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ADALIMUMAB QN W/RFLX TO AB, SERUM (ADALX)" PX-300802999 CDM 80299 CPT 300 RC outpatient 515 504.7 All Payors / Plans All Payors / Plans 515 other 515 515 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DRUG SCRN,URINE,NURSERY ONLY(OPDS" PX-300803010 CDM 80307 CPT 300 RC outpatient 206 201.88 All Payors / Plans All Payors / Plans 206 other 206 206 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DRUG SCREEN, ABBREV. (ADRUG)" PX-300803011 CDM 80307 CPT 300 RC outpatient 206 201.88 All Payors / Plans All Payors / Plans 206 other 206 206 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRUG SCREEN MECONIUM PX-300803012 CDM 80307 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INITIAL DRUG SCREEN AT PRMC PX-300803013 CDM 80307 CPT 300 RC outpatient 206 201.88 All Payors / Plans All Payors / Plans 206 other 206 206 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PAIN CLINIC DRUG SCREEN PX-300803014 CDM 80307 CPT 300 RC outpatient 160 156.8 All Payors / Plans All Payors / Plans 160 other 160 160 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRENATAL DRUG SCRN. (PNDS) PX-300803015 CDM 80307 CPT 300 RC outpatient 183 179.34 All Payors / Plans All Payors / Plans 183 other 183 183 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BENZODIAZEPINE URINE SCREEN PX-300803016 CDM 80307 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BUPRENORPHINE, URINE" PX-300803017 CDM 80307 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CANNABINOIDS SCREEN PX-300803018 CDM 80307 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COCAINE METABOLITE URINE SCREEN PX-300803019 CDM 80307 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SALICYLATE SERUM (SALI) PX-300803020 CDM 80179 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACETAMINOPHEN (ACE) PX-300803021 CDM 80143 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ABBREV DRUG SCREEN, ACETEMINOPHEN & SALICYLATE" PX-300803022 CDM 80307 CPT 300 RC outpatient 291 285.18 All Payors / Plans All Payors / Plans 291 other 291 291 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PRENATAL DRUG SCREEN & BUPRENORPHINE,URINE" PX-300803023 CDM 80307 CPT 300 RC outpatient 206 201.88 All Payors / Plans All Payors / Plans 206 other 206 206 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DRUG SCREEN URINE, NURSERY & MECONIUM" PX-300803024 CDM 80307 CPT 300 RC outpatient 320 313.6 All Payors / Plans All Payors / Plans 320 other 320 320 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ABBREV DRUG SCREEN &ACETEMOPHIN/SALICYLATE PX-300803025 CDM 80307 CPT 300 RC outpatient 249 244.02 All Payors / Plans All Payors / Plans 249 other 249 249 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD & URINE ALCOHOL PX-300803026 CDM 80320 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CONTROLLED SUBSTANCE MONITORING PANEL, URINE" PX-300803027 CDM 80307 CPT 300 RC outpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRUG SCREEN (DRUS)(DRUSU) PX-300803040 CDM 80307 CPT 300 RC outpatient 534 523.32 All Payors / Plans All Payors / Plans 534 other 534 534 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRUG SCREEN PRESCRIPTION/OTC U PX-300803041 CDM 80307 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRUG SCREEN W/ REFLEX PX-300803042 CDM 80307 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC URINE DRUG SCREEN, INSTRUMENT CHEM ANALYZER" PX-300803043 CDM 80307 CPT 300 RC outpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URINE DRUG SCREEN VISUAL OBSERVATION PX-300803050 CDM 80305 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URINE DRUG SCREEN INSTRUMENT ASSISTED DIRECT OBSERV PX-300803060 CDM 80307 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRUG SCREEEN FENTANYL PX-300803070 CDM 80307 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD ALCOHOL (ALCO) PX-300803200 CDM 80320 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VOLATILE SCREEN (MEOH) PX-300803201 CDM 80320 CPT 300 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ALCOHOL, URINE (ALCOU)" PX-300803202 CDM 80320 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ETHYLENE GLYCOL, SERUM (ETGL)" PX-300803203 CDM 80320 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DRUG SCREEN, QUANT ALCOHOL BIOMARKERS 1 OR 2" PX-300803210 CDM 80321 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMPHETAMINE CONF PX-300803240 CDM 80324 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRUG SCREEN QUANT AMPHETAMINES 3 OR 4 PX-300803250 CDM 80325 CPT 300 RC outpatient 37 36.26 All Payors / Plans All Payors / Plans 37 other 37 37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC AMPHETAMINES CONFIRMATION, FLUID (CSMP)" PX-300803260 CDM 80326 CPT 300 RC outpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ANTIDEPRESSANTS, TRICYCLIC, OTHER CYCLICALS, 1 OR 2" PX-300803350 CDM 80335 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMIPRAMINE (TOF) PX-300803351 CDM 80335 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DESIPRAMINE (DSIPB) PX-300803352 CDM 80335 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NORTRIPTYLENE (NOR)(ELV) PX-300803353 CDM 80335 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMIODARONE (AMID) PX-300803450 CDM 80151 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BARBITURATE CONFIRMATION URINE PX-300803451 CDM 80345 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CLONOPIN (CLNN) PX-300803460 CDM 80346 CPT 300 RC outpatient 48 47.04 All Payors / Plans All Payors / Plans 48 other 48 48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIAZEPAM/NORDIAZEPAM (DIAZ) PX-300803461 CDM 80346 CPT 300 RC outpatient 51 49.98 All Payors / Plans All Payors / Plans 51 other 51 51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BENZODIAZIPINE CONFIRMATION URINE PX-300803462 CDM 80346 CPT 301 RC outpatient 37 36.26 All Payors / Plans All Payors / Plans 37 other 37 37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CLONAZEPAM LEVEL PX-300803463 CDM 80346 CPT 300 RC outpatient 48 47.04 All Payors / Plans All Payors / Plans 48 other 48 48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BENZODIAZEPINES CONFIRMATION, RANDOM, URINE" PX-300803470 CDM 80347 CPT 300 RC outpatient 51 49.98 All Payors / Plans All Payors / Plans 51 other 51 51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEFINITIVE DURG BENZODIAZEPINES (CSMP) PX-300803471 CDM 80347 CPT 300 RC outpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BUPRENOR & NORBUPRENOR URINE PX-300803480 CDM 80348 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CANNABINOID (THC) CONF.,MECONIUM" PX-300803490 CDM 80349 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TETRAHYDROCANNABINOL CONF URINE PX-300803491 CDM 80349 CPT 300 RC outpatient 46 45.08 All Payors / Plans All Payors / Plans 46 other 46 46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC COCAINE CONFIRMATION, MECONIUM" PX-300803530 CDM 80353 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COCAINE CONFIRMATION URINE PX-300803531 CDM 80353 CPT 300 RC outpatient 37 36.26 All Payors / Plans All Payors / Plans 37 other 37 37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DRUG SCREENING, FENTANYL" PX-300803540 CDM 80354 CPT 300 RC outpatient 372 364.56 All Payors / Plans All Payors / Plans 372 other 372 372 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC METHADONE PX-300803580 CDM 80358 CPT 300 RC outpatient 103 100.94 All Payors / Plans All Payors / Plans 103 other 103 103 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC METHADONE CONFIRMATION URINE PX-300803581 CDM 80358 CPT 300 RC outpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC METHYLENEDIOXYAMPHETAMINES PX-300803590 CDM 80359 CPT 300 RC outpatient 20 19.6 All Payors / Plans All Payors / Plans 20 other 20 20 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC OPIATE CONFIRMATION, MECONIUM" PX-300803610 CDM 80361 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPIATE CONFIRMATION URINE PX-300803611 CDM 80361 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRUG SCREEN OPIODS AND OPIATE ANALOGS 1 OR 2 PX-300803621 CDM 80326 CPT 300 RC outpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC OPIATES, 5 OR MORE" PX-300803640 CDM 80364 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEFINITIVE DRUG OPOIDS/ANALOGS (CSMP) PX-300803641 CDM 80364 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OXYCODONE W METABOLITE PX-300803650 CDM 80365 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEXAMETHASONE LEVEL PX-300803750 CDM 80375 CPT 300 RC outpatient 200 196 All Payors / Plans All Payors / Plans 200 other 200 200 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEXAMETHSONE LEVEL(DEXA) PX-300803990 CDM 80299 CPT 300 RC outpatient 180 176.4 All Payors / Plans All Payors / Plans 180 other 180 180 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ADRENOCORTICOTROPHIC HORMONE (ACTH) STIM PANEL PX-300804000 CDM 80400 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URINE DIPSTICK TEST(URDIP) PX-300810000 CDM 81000 CPT 300 RC outpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URINE W/MICROSCOPIC (UWM) PX-300810010 CDM 81001 CPT 307 RC outpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC REFRACTOMETER SPECIFIC GRAVITY PX-300810020 CDM 81002 CPT 300 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URINALYSIS ROUTINE PX-300810030 CDM 81003 CPT 307 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC URINALYSIS, QUALIT OR SEMIQUNAT;EXCEPT IMMUNOASSAY" PX-300810050 CDM 81005 CPT 300 RC outpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URINE MICROSCOPIC PX-300810150 CDM 81015 CPT 300 RC outpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UCG SPOT TEST (UCG) PX-300810250 CDM 81025 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRCA1/BRCA2 GENE ANALYSIS PX-300811620 CDM 81162 CPT 300 RC outpatient 2428 2379.44 All Payors / Plans All Payors / Plans 2428 other 2428 2428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC APC GENE, FULL GENE ANALYSIS" PX-300812010 CDM 81201 CPT 300 RC outpatient 3313 3246.74 All Payors / Plans All Payors / Plans 3313 other 3313 3313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BCR ABL P210 MRNA QUANT PX-300812060 CDM 81206 CPT 300 RC outpatient 460 450.8 All Payors / Plans All Payors / Plans 460 other 460 460 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BCR/ABL, RNA,QUAL, DIAGNOSTIC" PX-300812061 CDM 81206 CPT 300 RC outpatient 131 128.38 All Payors / Plans All Payors / Plans 131 other 131 131 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BCR ABL P190 MRNA QUANT PX-300812070 CDM 81207 CPT 300 RC outpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BCR/ABL,RNA, QUAL MINOR QUAL, DIAGNOSTIC" PX-300812071 CDM 81207 CPT 300 RC outpatient 118 115.64 All Payors / Plans All Payors / Plans 118 other 118 118 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BCR ABL TRANSLOCATION ANALY OTH PX-300812080 CDM 81208 CPT 300 RC outpatient 560 548.8 All Payors / Plans All Payors / Plans 560 other 560 560 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BCR/ABL, RNA, OTHER, QUAL, DIAGNOSTIC" PX-300812081 CDM 81208 CPT 300 RC outpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRAF ANALYSIS PX-300812103 CDM 81210 CPT 300 RC outpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CALR MUTATION ANALYSIS, MYELOPROLIFERATIVE NEOPLASM" PX-300812190 CDM 81219 CPT 300 RC outpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CALR MUTATION ANAL, MYELOPROLIFERATIVE NEOPLASM, REFLEX" PX-300812191 CDM 81219 CPT 300 RC outpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MYELOPROLIFETATIVE NEOPLASM, CALR W REFLEX MPL" PX-300812192 CDM 81219 CPT 300 RC outpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYSTIC FIB.CARRIER AND DETECTION PX-300812200 CDM 81220 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CFTR GENE ANALYSIS DUPLICATION/DELETION VARIANTS PX-300812220 CDM 81222 CPT 300 RC outpatient 151 147.98 All Payors / Plans All Payors / Plans 151 other 151 151 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOGENOMIC CONSTITUTIONAL MICROARRAY ANAL PX-300812280 CDM 81228 CPT 300 RC outpatient 1342 1315.16 All Payors / Plans All Payors / Plans 1342 other 1342 1342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOGENOMIC CHROM MICROARRAY CONGEN PX-300812290 CDM 81229 CPT 300 RC outpatient 1642 1609.16 All Payors / Plans All Payors / Plans 1642 other 1642 1642 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHROMOSOMAL MICROARRAY,AUTOPSY, PROD CONCEPTION,STILLBIRTH" PX-300812291 CDM 81229 CPT 300 RC outpatient 1856 1818.88 All Payors / Plans All Payors / Plans 1856 other 1856 1856 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIHYDROPYRIMIDINE DEHYDROGENASE FULL GENE SEQU PX-300812320 CDM 81232 CPT 300 RC outpatient 1285 1259.3 All Payors / Plans All Payors / Plans 1285 other 1285 1285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HYPERCOAGULABILITY CONSULT.(CCHC) PX-300812400 CDM 81240 CPT 300 RC outpatient 151 147.98 All Payors / Plans All Payors / Plans 151 other 151 151 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROTHROMBIN 20210 MUTATION (PTGM) PX-300812401 CDM 81240 CPT 300 RC outpatient 148 145.04 All Payors / Plans All Payors / Plans 148 other 148 148 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FACTOR V LEIDEN (F5DNA) PX-300812410 CDM 81241 CPT 302 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FMR1(FRAGILE 1 MENTAL RETARDATION) GENE ANALYSIS,EVAL ABNORMAL ALLELES" PX-300812430 CDM 81243 CPT 300 RC outpatient 320 313.6 All Payors / Plans All Payors / Plans 320 other 320 320 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FMRI GENE ANALYSIS, CHARAC OF ALLELES" PX-300812440 CDM 81244 CPT 300 RC outpatient 160 156.8 All Payors / Plans All Payors / Plans 160 other 160 160 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEMOCHROMATOSIS HFE GENE ANALYSIS PX-300812560 CDM 81256 CPT 300 RC outpatient 200 196 All Payors / Plans All Payors / Plans 200 other 200 200 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGH@ REARRANGE ABNORMAL CLONAL POP AMPLIFIED PX-300812610 CDM 81261 CPT 300 RC outpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IGH SOMATIC HYPERMUT ANALYSIS, B-CELL CHRONIC LYMPHCYTIC LEUKEMIA" PX-300812630 CDM 81263 CPT 300 RC outpatient 697 683.06 All Payors / Plans All Payors / Plans 697 other 697 697 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGK@GENE REARRANGE DETECT ABNORMAL CLONAL POP PX-300812640 CDM 81264 CPT 300 RC outpatient 249 244.02 All Payors / Plans All Payors / Plans 249 other 249 249 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPARITIVE ANALYSIS SHORT TANDEM REPEAT PX-300812650 CDM 81265 CPT 300 RC outpatient 702 687.96 All Payors / Plans All Payors / Plans 702 other 702 702 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ADD'L COMP ANALYSIS W/STR (STR2) PX-300812660 CDM 81266 CPT 300 RC outpatient 329 322.42 All Payors / Plans All Payors / Plans 329 other 329 329 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALPHA-GLOBULIN GENE ANALYSIS PX-300812690 CDM 81269 CPT 300 RC outpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC JAK2 V617F MUTATION PX-300812700 CDM 81270 CPT 310 RC outpatient 148 145.04 All Payors / Plans All Payors / Plans 148 other 148 148 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC JAK2 V167F MUTATION DETECTION, BONE MARROW" PX-300812701 CDM 81270 CPT 300 RC outpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MYELOPROLIFERATIVE NEOPLASM,JAK2 V617F W REFLEX" PX-300812702 CDM 81270 CPT 300 RC outpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HUNTINGTON DISEASE ANALYSIS PX-300812710 CDM 81271 CPT 300 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC KIT ASP816VAL MUTATION ANALYSIS, BLOOD" PX-300812730 CDM 81273 CPT 300 RC outpatient 1277 1251.46 All Payors / Plans All Payors / Plans 1277 other 1277 1277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MGMT PROMOTER METHYLATION, TUMOR" PX-300812870 CDM 81287 CPT 300 RC outpatient 885 867.3 All Payors / Plans All Payors / Plans 885 other 885 885 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MLH1 HYPERMETHYLATION ANALYSIS PX-300812880 CDM 81288 CPT 300 RC outpatient 643 630.14 All Payors / Plans All Payors / Plans 643 other 643 643 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MTHFR MUTATION ANALYSIS, COMMON VARIANTS" PX-300812910 CDM 81291 CPT 300 RC outpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYD88 L265P GENE MUTATION ANALYSIS (MYD88) PX-300813050 CDM 81305 CPT 300 RC outpatient 820 803.6 All Payors / Plans All Payors / Plans 820 other 820 820 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PML/RARA QUANT, PCR" PX-300813150 CDM 81315 CPT 300 RC outpatient 600 588 All Payors / Plans All Payors / Plans 600 other 600 600 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SMA CARRIER BY DEL/DUP (SMNCS) PX-300813290 CDM 81329 CPT 300 RC outpatient 852 834.96 All Payors / Plans All Payors / Plans 852 other 852 852 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HLA CLASS I MOLECULAR TYPING DISEASE ASSOCIATION PX-300813720 CDM 81372 CPT 300 RC outpatient 271 265.58 All Payors / Plans All Payors / Plans 271 other 271 271 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HLA CLASS II MOLECULAR TYPING DISEASE ASSOCIATION PX-300813750 CDM 81375 CPT 300 RC outpatient 791 775.18 All Payors / Plans All Payors / Plans 791 other 791 791 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ONE LOCUS (EG, HLA-DRB1,DRB3/4/5-DQB1,DQA1,DPB1,OR DPA1)EACH" PX-300813760 CDM 81376 CPT 300 RC outpatient 217 212.66 All Payors / Plans All Payors / Plans 217 other 217 217 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CELIAC DISEASE GLUTEN-FREE CASCADE PX-300813761 CDM 81376 CPT 300 RC outpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NARCOLEPSY ASSOC ANTIGEN, HLA-DQB1 TYPE, BLOOD" PX-300813762 CDM 81376 CPT 300 RC outpatient 440 431.2 All Payors / Plans All Payors / Plans 440 other 440 440 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HLA-B 5701 GENOTYPE,ABACAVIR HYPERSENSIT, BLOOD" PX-300813810 CDM 81381 CPT 300 RC outpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROMETHEUS LACTOTYPE PX-300814000 CDM 81400 CPT 300 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROMETHEUS TPMT GENETICS PX-300814010 CDM 81401 CPT 300 RC outpatient 557 545.86 All Payors / Plans All Payors / Plans 557 other 557 557 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPINAL MUSCULAR ATROPHY CARRIER SCREEN DELETE/DUPLICAT PX-300814011 CDM 81401 CPT 300 RC outpatient 557 545.86 All Payors / Plans All Payors / Plans 557 other 557 557 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HUNTINGTON DISEASE, MOLECULAR ANALYSIS" PX-300814012 CDM 81401 CPT 300 RC outpatient 940 921.2 All Payors / Plans All Payors / Plans 940 other 940 940 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MUTYH GENE ANALYSIS, Y165C AND G382D" PX-300814013 CDM 81401 CPT 300 RC outpatient 940 921.2 All Payors / Plans All Payors / Plans 940 other 940 940 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MPL EXON 10 MUTATION DETECTION, BLOOD" PX-300814031 CDM 81339 CPT 300 RC outpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MPL EXON 10 MUTATION DETECTION, REFLEX" PX-300814032 CDM 81339 CPT 300 RC outpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MPL EXON 10 SEQUENCING, REFLEX" PX-300814033 CDM 81339 CPT 300 RC outpatient 463 453.74 All Payors / Plans All Payors / Plans 463 other 463 463 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VERY LONG CHAIN ACLY-COA DEHYDROGENASE DEFICIENCY PX-300814060 CDM 81406 CPT 300 RC outpatient 1714 1679.72 All Payors / Plans All Payors / Plans 1714 other 1714 1714 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MUTYH GENE, FULL GENE ANALYSIS (MYHZ)" PX-300814061 CDM 81406 CPT 300 RC outpatient 1285 1259.3 All Payors / Plans All Payors / Plans 1285 other 1285 1285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UDP-GLUCURONOSYL TRANSFERASE 1A1 FULL GENE SEQU PX-300814791 CDM 81479 CPT 300 RC outpatient 1428 1399.44 All Payors / Plans All Payors / Plans 1428 other 1428 1428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MYD88, L265P, SOMATIC GENE MUTATION, SNA ALLELE-PCR" PX-300814792 CDM 81479 CPT 300 RC outpatient 817 800.66 All Payors / Plans All Payors / Plans 817 other 817 817 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHG FETAL CONGENITAL ABNOR ASSAY TWO PROTEINS PX-300815080 CDM 81508 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AFP MATERNAL 4 MARKER PX-300815110 CDM 81511 CPT 300 RC outpatient 223 218.54 All Payors / Plans All Payors / Plans 223 other 223 223 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFECTIOUS DISEASE, BACTERIAL VAGINOSIS, QUANT REAL TIME AMP" PX-300815130 CDM 81513 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FIBRO TEST ACTI TEST, S (FIBRO)" PX-300815960 CDM 81596 CPT 300 RC outpatient 372 364.56 All Payors / Plans All Payors / Plans 372 other 372 372 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NASH FIBROSURE PX-300815990 CDM 81599 CPT 300 RC outpatient 191 187.18 All Payors / Plans All Payors / Plans 191 other 191 191 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC KETONE BODIES SERUM, QUALITATIVE" PX-300820090 CDM 82009 CPT 301 RC outpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BETA HYDROXYBUTYRATE (BHOB) PX-300820100 CDM 82010 CPT 300 RC outpatient 37 36.26 All Payors / Plans All Payors / Plans 37 other 37 37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACETYLCHOLINESTERASE PX-300820130 CDM 82013 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACTH (ACTH) PX-300820240 CDM 82024 CPT 301 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ALBUMIN;SERUM, PLASMA OR WHOLE BLOOD" PX-300820400 CDM 82040 CPT 301 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ALBUMIN, URINE/OTHER SOURCE QUANTITATIVE EA." PX-300820420 CDM 82042 CPT 301 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC URINE,MICROALBUMIN" PX-300820430 CDM 82043 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALDOLASE (ALSE) PX-300820850 CDM 82085 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALDOSTERONE PX-300820880 CDM 82088 CPT 301 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALPHA-1-ANTITRYPSIN (ALA) PX-300821030 CDM 82103 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHG ALPHA-1-ANTITRYPSIN, PHENO" PX-300821040 CDM 82104 CPT 301 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALPHA-FETOPROTEIN (AFP) SERUM PX-300821050 CDM 82105 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALPHA FETOPROTEIN PX-300821051 CDM 82105 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC AFP,AMNIOTIC FLUID (AFPAF)" PX-300821060 CDM 82106 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALUMINUM (ALMU) PX-300821080 CDM 82108 CPT 300 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC AMINOLEVULINIC ACID(ALA),RAND,UR" PX-300821350 CDM 82135 CPT 300 RC outpatient 75 73.5 All Payors / Plans All Payors / Plans 75 other 75 75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC AMINO ACIDS, 2-5 QUANTITATIVE" PX-300821360 CDM 82136 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMINO ACID SCREEN BLD. (ACCB) PX-300821390 CDM 82139 CPT 300 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMMONIA PX-300821400 CDM 82140 CPT 301 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMYLASE PX-300821500 CDM 82150 CPT 301 RC outpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANDROSTENEDIONE (ANDRS) PX-300821570 CDM 82157 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANGIOTENSIN I CONVERT ENZYME PX-300821640 CDM 82164 CPT 301 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ASSAY ANTI-MULLERIAN HORM PX-300821660 CDM 82166 CPT 301 RC outpatient 133 130.34 All Payors / Plans All Payors / Plans 133 other 133 133 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHG ASSAY OF ALPOLIPOPROTEIN PX-300821720 CDM 82172 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARSENIC (ARSU) PX-300821750 CDM 82175 CPT 300 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHG ASSAY OF ASCORBIC ACID PX-300821800 CDM 82180 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BETA 2 MICROGLOBULIN (B2M) PX-300822320 CDM 82232 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BILIRUBIN TOTAL PX-300822470 CDM 82247 CPT 301 RC outpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIRECT BILIRUBIN(DBIL) PX-300822480 CDM 82248 CPT 301 RC outpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OCCULT BLD FECES (OCB) PX-300822700 CDM 82270 CPT 300 RC outpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OCCULT BLOOD X2 PX-300822702 CDM 82270 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OCCULT BLOOD X3 PX-300822703 CDM 82270 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BLOOD, OCCULT, QUAL, FECES, SINGLE SPECIMEN" PX-300822720 CDM 82272 CPT 301 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FECAL OCCULT BLOOD IMMUNO PX-300822740 CDM 82274 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHG ASSAY OF CADMIUM PX-300823000 CDM 82300 CPT 300 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITAMIN D -25 HYDROXY PX-300823060 CDM 82306 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CALCITONIN (CALTN) PX-300823080 CDM 82308 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CALCIUM TOTAL PX-300823100 CDM 82310 CPT 301 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CALCIUM IONIZED PX-300823300 CDM 82330 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CALCIUM RANDOM URINE PX-300823400 CDM 82340 CPT 301 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STONE ANALYSIS (STONE) PX-300823650 CDM 82365 CPT 301 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CO2 (CO2) PX-300823740 CDM 82374 CPT 300 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RT CO-OX ANALYSIS PX-300823750 CDM 82375 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CEA (CEAM) PX-300823780 CDM 82378 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CARNITINE(TOTAL AND FREE) QUANT., EACH SPEC" PX-300823790 CDM 82379 CPT 300 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BETA CAROTENE PX-300823800 CDM 82380 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CATECHOLAMINES FRACT. PX-300823840 CDM 82384 CPT 300 RC outpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CERULOPLASMIN (CERMN) PX-300823900 CDM 82390 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMILUMINESCENT ASSAY PX-300823970 CDM 82397 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHLORIDE BLOOD PX-300824350 CDM 82435 CPT 300 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHLORIDE URINE PX-300824360 CDM 82436 CPT 301 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHLORIDE, OTHER SOURCE" PX-300824380 CDM 82438 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHOLESTEROL (CHOL) PX-300824650 CDM 82465 CPT 301 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHOLINESTERASE, SERUM" PX-300824800 CDM 82480 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ACETYLCHOLINESTERASE,RBC (ACHS)" PX-300824820 CDM 82482 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC URINE,CITRATE 24HR (CITU)" PX-300825070 CDM 82507 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC COLLAGEN CROSS LINKS, ANY METHOD" PX-300825230 CDM 82523 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COPPER PX-300825250 CDM 82525 CPT 301 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CORTISOL FREE PX-300825300 CDM 82530 CPT 301 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CORTISOL TOTAL PX-300825330 CDM 82533 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC COLUMN CHROMATOGRAPHY, EACH SPECIMIN" PX-300825420 CDM 82542 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPK (CPK) PX-300825500 CDM 82550 CPT 301 RC outpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPK-MB (CKMB) PX-300825530 CDM 82553 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CREATININE BLOOD PX-300825650 CDM 82565 CPT 301 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CREATININE OTHER SOURCE PX-300825700 CDM 82570 CPT 301 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CREAT CLEAR 24 HR (CRCL) PX-300825750 CDM 82575 CPT 301 RC outpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CRYOGLOBULIN (CRY) PX-300825950 CDM 82595 CPT 300 RC outpatient 40 39.2 All Payors / Plans All Payors / Plans 40 other 40 40 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC B-12 (B12) PX-300826071 CDM 82607 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYSTATIN C PX-300826100 CDM 82610 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DHEA,UNCONJUGATED (DHEA)" PX-300826260 CDM 82626 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC DHEA, SULFATE (DHEAS)" PX-300826270 CDM 82627 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIBUCAINE (DIBC) PX-300826380 CDM 82638 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITAMIN D - DIHYDROXY (VITDD) PX-300826520 CDM 82652 CPT 301 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ELASTASE, PANCREATIC FECAL" PX-300826560 CDM 82656 CPT 300 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ENZYME ACTIVITY IN CELLS,NOS, NON RADIOACTIVE" PX-300826570 CDM 82657 CPT 300 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ERTHROPOIETIN (ERYTP) PX-300826680 CDM 82668 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ESTRADIOL PX-300826700 CDM 82670 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ESTROGENS FRACTIONATED PX-300826710 CDM 82671 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ESTROGENS,TL (ESTB)" PX-300826720 CDM 82672 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ESTRONE PX-300826790 CDM 82679 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ETHYLENE GLYCOL PX-300826930 CDM 82693 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FECAL FAT QUANTITATIVE PX-300827100 CDM 82710 CPT 300 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FERRITIN (FER) PX-300827280 CDM 82728 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FETAL FIBRONECTIN (FFN) PX-300827310 CDM 82731 CPT 301 RC outpatient 500 490 All Payors / Plans All Payors / Plans 500 other 500 500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FOLIC ACID (FOL) PX-300827460 CDM 82746 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOGLOBULIN IGA,IGD,IGC,IGM EACH" PX-300827840 CDM 82784 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGA (IGA) PX-300827841 CDM 82784 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG (IGG) PX-300827842 CDM 82784 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGM (IGM) PX-300827843 CDM 82784 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CELIAC DISEASE SEROLOGY CASCADE PX-300827844 CDM 82784 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGE (IGE) PX-300827850 CDM 82785 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG SUBGLASS (IGGS) PX-300827870 CDM 82787 CPT 301 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RT VENOUS BG-ANALYSIS-ONLY (ABGA) PX-300828000 CDM 82800 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RT BLOOD GAS ANALYSIS PX-300828030 CDM 82803 CPT 300 RC outpatient 88 86.24 All Payors / Plans All Payors / Plans 88 other 88 88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PF BLOOD GAS ANALYSIS PX-300828031 CDM 82803 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GASTRIN AFTER SECRETIN STIMULATION PX-300829380 CDM 82938 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GASTRIN (GASN) PX-300829410 CDM 82941 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLUCOSE FLUID PX-300829450 CDM 82945 CPT 301 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLUCOSE QUANTITATIVE BLOOD PX-300829470 CDM 82947 CPT 301 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC GLUCOSE, POST GLUC. DOSE(INCLUDES GLUC)" PX-300829500 CDM 82950 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLUC. CHALLENGE SCREEN (GLUC) PX-300829501 CDM 82950 CPT 300 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POST GLUCOSE TEST PX-300829505 CDM 82952 CPT 301 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLUCOSE TOL 5 HR (OGT5) PX-300829510 CDM 82951 CPT 300 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLUCOSE TOLERANCE TEST 3 SPECIMENS PX-300829511 CDM 82951 CPT 300 RC outpatient 88 86.24 All Payors / Plans All Payors / Plans 88 other 88 88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LACTOSE TOL. TEST (LATT) PX-300829512 CDM 82951 CPT 300 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC G6PD QUANTITATIVE (G6PDQ) PX-300829550 CDM 82955 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD GLUCOSE CHECK PX-300829620 CDM 82962 CPT 300 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GGTP (GT) PX-300829770 CDM 82977 CPT 301 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FRUCTOSAMINE, SERUM" PX-300829850 CDM 82985 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FSH (FSH) PX-300830010 CDM 83001 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LH (LH) PX-300830021 CDM 83002 CPT 301 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GROWTH HORMONE (HGH) PX-300830030 CDM 83003 CPT 300 RC outpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HAPTOGLOBIN, BLD. (HAP)" PX-300830100 CDM 83010 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC H. PYLORI UREA BREATH TEST (UBT) PX-300830130 CDM 83013 CPT 301 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEAVY METAL QUANTITATIVE EACH PX-300830180 CDM 83018 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HGB INVESTIGATION (HIN)(HELEC) PX-300830200 CDM 83020 CPT 300 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEMOGLOBIN F FETAL QUALITATIVE PX-300830330 CDM 83033 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEMOGLOBIN A1C (A1C) PX-300830360 CDM 83036 CPT 301 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLASMA HGB (PHGB) PX-300830510 CDM 83051 CPT 300 RC outpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEMOSIDERIN URINE (HSID) PX-300830700 CDM 83070 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HOMOCYSTEINE, TL PLASMA (HCP)" PX-300830900 CDM 83090 CPT 301 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC 5-HIAA (HIAA) PX-300834970 CDM 83497 CPT 301 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC 17 HYDROXY PROGESTERONE (17HPG) PX-300834980 CDM 83498 CPT 301 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOASSAY,NON INFECTIOUS DISEASE;MULTI, STEP" PX-300835160 CDM 83516 CPT 301 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-NEUTRO. CYTO. AB. (ANCAB) PX-300835161 CDM 83516 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLIADIN ANTIBODY (GLIAB) PX-300835162 CDM 83516 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARIETAL CELL ANTIBODIES (PCABS) PX-300835163 CDM 83516 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TISSUE TRANSGLUTAMINASE (TTG) PX-300835164 CDM 83516 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC GLIADIN (DEAMINATED) AB, IGA" PX-300835165 CDM 83516 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TISSUE TRANSGLUTAMINASE, IGG" PX-300835166 CDM 83516 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC GLIADIN (DEAMINATED) AB, IGG" PX-300835167 CDM 83516 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOASSAY FOR ANALYTE, MULTIPLE STEP" PX-300835168 CDM 83516 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMMUNOASSAY ANALYTE QUANTITATIVE BY RADIOIMMUNOASSAY PX-300835190 CDM 83519 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACETYCHOLINE RECEPTOR AB (ACEAB) PX-300835192 CDM 83519 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC METHOTREXATE, SERUM" PX-300835200 CDM 80204 CPT 300 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARANEOPLASTIC AUTOANTIBODY EVAL. PX-300835201 CDM 83520 CPT 300 RC outpatient 782 766.36 All Payors / Plans All Payors / Plans 782 other 782 782 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MANNOSE BINDING LECTIN(MANBL) PX-300835202 CDM 83520 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CQ ESTERASE INHIBITOR,FUNCTIONAL" PX-300835203 CDM 83520 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRYPTASE (TRYPT) PX-300835204 CDM 83520 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C-1 ESTERASE INHIBITOR (C1EST) PX-300835205 CDM 83520 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STRIATED MUSCLE AB (MUSAB) PX-300835206 CDM 83520 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLOM.BASEMENT AB (AGBM) PX-300835207 CDM 83520 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SULFATIDE AUTOANTIBODY (SLFAB) PX-300835208 CDM 83520 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFLAM BOWEL SEROLOGY PANEL SERUM PX-300835209 CDM 83520 CPT 300 RC outpatient 114.5 112.21 All Payors / Plans All Payors / Plans 114.5 other 114.5 114.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOASSAY FOR ANALYTE, QUANTITATIVE NOT SPECIFIED" PX-300835210 CDM 83520 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROMETHEUS FIBROSPECT II PX-300835211 CDM 83520 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTIMULLERIAN HORMONE (AMH) PX-300835212 CDM 83520 CPT 300 RC outpatient 134 131.32 All Payors / Plans All Payors / Plans 134 other 134 134 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INSULIN LIKE GROWTH FACTOR-BINDING PROTEIN 3 (IGFBP-3) PX-300835213 CDM 83520 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC RNA POLYMERASE III ANTIBODIES, IGG, SERUM" PX-300835214 CDM 83520 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SOLUBLE LIVER ANTIGEN (SLA) AUTOANTIBODY PX-300835215 CDM 83520 CPT 300 RC outpatient 126 123.48 All Payors / Plans All Payors / Plans 126 other 126 126 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC THYROTROPIN RECEPTOR ANTIBODY,SERUM(THYRO)" PX-300835216 CDM 83520 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC 14-3-3 PROTEIN, SPINAL FLUID" PX-300835217 CDM 83520 CPT 300 RC outpatient 138 135.24 All Payors / Plans All Payors / Plans 138 other 138 138 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PROMETHEUS IBD IMMUNOASSAY, NOT OTHERWISE SPEC(FIBDD)" PX-300835218 CDM 83520 CPT 300 RC outpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ADALIMUMAB AB, S (ADLAB)" PX-300835219 CDM 83520 CPT 300 RC outpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PANCREATIC ELASTASE, FECES" PX-300835220 CDM 83520 CPT 300 RC outpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NEURON SPECIFIC ENOLASE (NSE), SPINAL FLUID" PX-300835221 CDM 83520 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ALZHEIMER DISEASE EVAL, SPINAL FLUID" PX-300835222 CDM 83520 CPT 300 RC outpatient 571 559.58 All Payors / Plans All Payors / Plans 571 other 571 571 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PHOSPHO TAU 217 PX-300835223 CDM 83520 CPT 300 RC outpatient 525 514.5 All Payors / Plans All Payors / Plans 525 other 525 525 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INSULIN (INLN) PX-300835250 CDM 83525 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IRON,SERUM (FEE)" PX-300835400 CDM 83540 CPT 301 RC outpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IRON BINDING CAPACITY PX-300835501 CDM 83550 CPT 300 RC outpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LACTIC ACID (LACT) PX-300836050 CDM 83605 CPT 301 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LACTATE RESPIRATORY PX-300836051 CDM 83605 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LDH PX-300836150 CDM 83615 CPT 301 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FECAL LACTOFERRIN PX-300836300 CDM 83630 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LEAD PX-300836550 CDM 83655 CPT 301 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEAVY METALS (METAL) PX-300836551 CDM 83655 CPT 300 RC outpatient 372 364.56 All Payors / Plans All Payors / Plans 372 other 372 372 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC LIPASE, SERUM (LPSE)" PX-300836900 CDM 83690 CPT 301 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LIPOPROTEIN A (LPA) PX-300836950 CDM 83695 CPT 300 RC outpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VAP PX-300837010 CDM 83701 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHG LIPOPROTEIN, BLOOD,BY NMR SPECT" PX-300837040 CDM 83704 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WELLNESS PROFILE (WP) PX-300837180 CDM 83718 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HDL CHOLESTEROL (HDL) PX-300837181 CDM 83718 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEART CHECK PROFILE (HCK) PX-300837182 CDM 83718 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIRECT LOW DENSITY LIPOPROTEIN PX-300837210 CDM 83721 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MAGNESIUM PX-300837350 CDM 83735 CPT 301 RC outpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MASS SPECTROMETRY & TANDEM MASS SPECTR NON DRUG ANALYTES NOT SPEC. PX-300837890 CDM 83789 CPT 300 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MERCURY (HGU) PX-300838250 CDM 83825 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC METANEPHRINES PX-300838350 CDM 83835 CPT 301 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYOGLOBIN PX-300838740 CDM 83874 CPT 301 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC B TYPE NATURIURETIC PEPTIDE PX-300838800 CDM 83880 CPT 301 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NEPHELOMETRY, EA ANALYTE NOT ELSEWHERE SPECIFIED" PX-300838830 CDM 83883 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOGLOB.TL LT.CHAINS, URINE" PX-300838831 CDM 83883 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROMETHEUS FIBROSPECT II PX-300838832 CDM 83883 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OLIGOCLONAL IMMUNE(OLIGOCLONAL BANDS) PX-300839160 CDM 83916 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CSF. NEUROLOGIGAL PROF. (SPFN) PX-300839161 CDM 83916 CPT 300 RC outpatient 405 396.9 All Payors / Plans All Payors / Plans 405 other 405 405 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ORGANIC ACID SCREEN, UR. (OASU)" PX-300839190 CDM 83919 CPT 300 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC METHYLALONIC ACID, SERUM(MMAS)" PX-300839210 CDM 83921 CPT 301 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SERUM OSMOLALITY (OSM) PX-300839300 CDM 83930 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC OSMOLALITY,URINE (UOSM)" PX-300839350 CDM 83935 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OSTEOCALCIN PX-300839370 CDM 83937 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CA OXALATE, URINE (OXU)" PX-300839450 CDM 83945 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARATHORMONE PX-300839700 CDM 83970 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PH, BODY FLUID, EXCEPT BLOOD" PX-300839860 CDM 83986 CPT 301 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PHENCYCLIDINE PX-300839920 CDM 83992 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CALPROTECTIN, FECAL" PX-300839930 CDM 83993 CPT 301 RC outpatient 300 294 All Payors / Plans All Payors / Plans 300 other 300 300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROSTATIC ACID PHOSPHATASE (PACP) PX-300840660 CDM 84066 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALK PHOSPHATASE (ALKP) PX-300840750 CDM 84075 CPT 301 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALKALINE PHOS. ISOENZYMES (APISO) PX-300840800 CDM 84080 CPT 300 RC outpatient 77 75.46 All Payors / Plans All Payors / Plans 77 other 77 77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PHOSPHORUS INORGANIC (PHOSPHATE) PX-300841000 CDM 84100 CPT 301 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PHOSPHORUS, URINE 24HR." PX-300841050 CDM 84105 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PQNU PX-300841100 CDM 84110 CPT 300 RC outpatient 37 36.26 All Payors / Plans All Payors / Plans 37 other 37 37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PORPHYRINS, URINE, QUANTIFICATION, FRACTIONATION" PX-300841200 CDM 84120 CPT 300 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POTASSIUM (K) PX-300841320 CDM 84132 CPT 301 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POTASSIUM URINE PX-300841330 CDM 84133 CPT 301 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRE-ALBUMIN PX-300841340 CDM 84134 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PREGNENOLONE PX-300841400 CDM 84140 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROGESTERONE (PROG) PX-300841440 CDM 84144 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROCALCITONIN (PCT) PX-300841450 CDM 84145 CPT 300 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROLACTIN (PROL) PX-300841460 CDM 84146 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PROLACTIN, DILUTED" PX-300841461 CDM 84146 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PSA TOTAL PX-300841530 CDM 84153 CPT 301 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FREE PSA PX-300841540 CDM 84154 CPT 301 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC A/G RATIO (AG) PX-300841550 CDM 84155 CPT 300 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROTEIN (TP) PX-300841551 CDM 84155 CPT 301 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROTEIN TOTAL URINE PX-300841560 CDM 84156 CPT 301 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROTEIN URINE (UP24) PX-300841561 CDM 84156 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUID T. PROTEIN (FPRO) PX-300841570 CDM 84157 CPT 301 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUID T. PROTEIN (FPRO) PX-300841571 CDM 84157 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERITONEAL FLD. ANALYSIS (PERTFA) PX-300841572 CDM 84157 CPT 300 RC outpatient 151 147.98 All Payors / Plans All Payors / Plans 151 other 151 151 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EFFUSION FLD. ANALYSIS (EFFA) PX-300841573 CDM 84157 CPT 300 RC outpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROTEIN E'PHORES (PE) PX-300841650 CDM 84165 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PROTEIN ELECTROPHORETIC, OTHE FLUIDS" PX-300841660 CDM 84166 CPT 301 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WESTERN BLOT W/INTERP AND REPORT;BLOOD/OTHER FLUID PX-300841820 CDM 84182 CPT 300 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PROTOPORPHYRINS,FRAC,RBC (PFE)" PX-300842020 CDM 84202 CPT 300 RC outpatient 154 150.92 All Payors / Plans All Payors / Plans 154 other 154 154 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PYRIDOXAL PHOSPHATE (VITAMIN B6) PX-300842070 CDM 84207 CPT 301 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PYRUVIC ACID (PYRV) PX-300842100 CDM 84210 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SOLUBLE TRANSFERRIN RECEPTOR PX-300842380 CDM 84238 CPT 300 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RENIN (REN) PX-300842440 CDM 84244 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RIBOFLAVIN (VITAMIN B-2) PX-300842520 CDM 84252 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SELENIUM PX-300842550 CDM 84255 CPT 300 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SEROTONIN,BLOOD (SRTNB)" PX-300842600 CDM 84260 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SEX HORMONE BINDING GLOBULIN (SHBG) PX-300842700 CDM 84270 CPT 301 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SODIUM (NA) PX-300842950 CDM 84295 CPT 301 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SODIUM URINE PX-300843000 CDM 84300 CPT 301 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SODIUM, OTHER SOURCE" PX-300843020 CDM 84302 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SOMATOMEDIN C (SOMC) PX-300843050 CDM 84305 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SPECTOPHOTOTOMETRY, ANALYTE" PX-300843110 CDM 84311 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC REFRACTOMETER SG BODY FLUID PX-300843150 CDM 84315 CPT 300 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FECAL REDUCING SUB (FRS) PX-300843760 CDM 84376 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFANT URINE RED SUB (IURS) PX-300843761 CDM 84376 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SUGARS,SINGLE QUANTITATIVE EA SPECIMIN" PX-300843780 CDM 84378 CPT 300 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SULFATE, URINE" PX-300843920 CDM 84392 CPT 300 RC outpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TESTOSERONE, FREE" PX-300844020 CDM 84402 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TESTOSTERONE (TES) PX-300844030 CDM 84403 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITAMIN B-1 (VITB1) PX-300844250 CDM 84425 CPT 301 RC outpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROGLOBULIN (TG) PX-300844320 CDM 84432 CPT 301 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NEWBORN SCREEN ONE(NBSCR1) PX-300844370 CDM 84437 CPT 300 RC outpatient 523 512.54 All Payors / Plans All Payors / Plans 523 other 523 523 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROXINE FREE PX-300844390 CDM 84439 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYR BINDING GLOB (TBG) PX-300844420 CDM 84442 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TSH PX-300844430 CDM 84443 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROID STIMULATING IG (TSIG) PX-300844450 CDM 84445 CPT 301 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITAMIN E (VITE) PX-300844460 CDM 84446 CPT 301 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AST (SGOT) PX-300844500 CDM 84450 CPT 301 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALT (SGPT) PX-300844600 CDM 84460 CPT 301 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRANSFERRIN (TRANF) PX-300844660 CDM 84466 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRIGLYCERIDES PX-300844780 CDM 84478 CPT 301 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC T3 BY RIA (T3R) PX-300844800 CDM 84480 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FREE T3 (FT3) PX-300844810 CDM 84481 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRIODOTHYRONINE T3, REVERSE" PX-300844820 CDM 84482 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TROPONIN-I(TNI) PX-300844840 CDM 84484 CPT 301 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BUN (BUN) PX-300845200 CDM 84520 CPT 301 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UREA NITROGEN RANDOM PX-300845400 CDM 84540 CPT 301 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URIC ACID (URIC) PX-300845500 CDM 84550 CPT 301 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URIC ACID OTHER SOURCE PX-300845600 CDM 84560 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VMA (VMA) PX-300845850 CDM 84585 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VAS INTS POLYPEPTIDE (VIP) PX-300845860 CDM 84586 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHG ASSAY OF VASOPRESSIN PX-300845880 CDM 84588 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITAMIN A (VITA) PX-300845900 CDM 84590 CPT 301 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VITAMIN, NOT OTHERWISE SPECIFIED" PX-300845910 CDM 84591 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC XYLOSE ABSORPTION TEST, BLOOD AND/OR URINE" PX-300846200 CDM 84620 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ZINC PX-300846300 CDM 84630 CPT 301 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ZINC, BLD. (ZN)" PX-300846301 CDM 84630 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C-PEPTIDE (CPEP) PX-300846810 CDM 84681 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC GONADOTROPIN, CHORIONIC(HCG);QUANTITATIVE" PX-300847020 CDM 84702 CPT 301 RC outpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FIRST TRIMESTER MATERNAL SCREEN PX-300847021 CDM 84702 CPT 300 RC outpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUID CHOLESTEROL (FCHOL) PX-300849991 CDM 84999 CPT 300 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STOOL OSMALITY PX-300849993 CDM 84999 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STOOL POTASSIUM PX-300849994 CDM 84999 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MANUAL DIFFERENTIAL PX-300850070 CDM 85007 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BLOOD COUNT, MANUAL EXAM W/O DIFF" PX-300850080 CDM 85008 CPT 300 RC outpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEMATOCRIT (HCT) PX-300850140 CDM 85014 CPT 305 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEMOGLOBIN (HGB) PX-300850180 CDM 85018 CPT 305 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CBC W/DIFF (CBCD) PX-300850250 CDM 85025 CPT 305 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CBC (CBC) PX-300850270 CDM 85027 CPT 305 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EOSINOPHIL COUNT (EOCT) PX-300850320 CDM 85032 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RETICULOCYTE CT (RET) PX-300850450 CDM 85045 CPT 305 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLATELET COUNT PX-300850490 CDM 85049 CPT 305 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHROMOGENIC SUBSTRATE ASSAY PX-300851300 CDM 85130 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COAG FACTOR II ASSAY (F2ASY) PX-300852100 CDM 85210 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COAG FACTOR V ASSAY (F5ASY) PX-300852200 CDM 85220 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COAG FACTOR VII ASSAY (F7ASY) PX-300852300 CDM 85230 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FACTOR VIII ANTIGEN (F8AG) PX-300852400 CDM 85240 CPT 305 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RISTOCETIN COFACTOR PX-300852450 CDM 85245 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VONWILLEBRAND FACTOR AG PX-300852460 CDM 85246 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BLEEDING DIATH PROF, LIMITED" PX-300852461 CDM 85246 CPT 300 RC outpatient 771 755.58 All Payors / Plans All Payors / Plans 771 other 771 771 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VON WILLEBRAND FACTOR PX-300852470 CDM 85247 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COAG FACTOR IX ASSAY (F9ASY) PX-300852500 CDM 85250 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COAG FACTOR X ASSAY (F10ASY) PX-300852600 CDM 85260 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COAG FACTOR XI ASSAY(F11ASY) PX-300852700 CDM 85270 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COAG FACTOR XII ASSAY (F12ASY) PX-300852800 CDM 85280 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHG ANTITHROMBIN II TEST, ACTIV" PX-300853000 CDM 85300 CPT 305 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-THROMBIN III (ANTI3) PX-300853010 CDM 85301 CPT 300 RC outpatient 48 47.04 All Payors / Plans All Payors / Plans 48 other 48 48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROTEIN C (PROTC) PX-300853020 CDM 85302 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHG CLOT INHIB PROTEIN C, ACTIV" PX-300853030 CDM 85303 CPT 305 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PROTEIN S AG, TL" PX-300853050 CDM 85305 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROTEIN S FREE PX-300853060 CDM 85306 CPT 305 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACTIVATED PROTEIN C RESISTENCE PX-300853070 CDM 85307 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FACTOR INHIBITOR TEST PX-300853350 CDM 85335 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FIBRIN(OGEN) DEGRADATION (SPLIT) PRODUCTS (FDP) (FSP) PARACOAGULATION PX-300853660 CDM 85366 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC D DIMER QUANTITATIVE PX-300853790 CDM 85379 CPT 305 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FIBRINOGEN ACTIVITY PX-300853840 CDM 85384 CPT 305 RC outpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FIBRINOGEN ANTIGEN PX-300853850 CDM 85385 CPT 300 RC outpatient 46 45.08 All Payors / Plans All Payors / Plans 46 other 46 46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPECIAL COAGULATION INTERPRETATION PX-300853900 CDM 85390 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FACTOR VIII PROFILE (F8BAT) PX-300853970 CDM 85397 CPT 300 RC outpatient 200 196 All Payors / Plans All Payors / Plans 200 other 200 200 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALPHA-2 PLASMIN INHIBITOR P PX-300854100 CDM 85410 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FIBRINOLYTIC PLASMINOGEN ACTIVATOR PX-300854150 CDM 85415 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLASMINOGEN ACTIVITY PX-300854200 CDM 85420 CPT 300 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FETALDEX SCREEN (FEDXS) PX-300854600 CDM 85460 CPT 305 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HEMOGLOBIN, FETAL, ROSETTE" PX-300854610 CDM 85461 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEPARIN ASSAY PX-300855200 CDM 85520 CPT 305 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE MARROW SMEAR PX-300855400 CDM 85540 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MURAMIDASE PX-300855490 CDM 85549 CPT 300 RC outpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLATELET FUNCTION PX-300855760 CDM 85576 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLATELET NEUTRALIZATION PX-300855970 CDM 85597 CPT 305 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PHOSPHOLIPID, HEXAGONAL" PX-300855980 CDM 85598 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROTHROMBIN TIME (PROT)(PROS) PX-300856100 CDM 85610 CPT 305 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PTMIX 1 TO 1 PX-300856110 CDM 85611 CPT 300 RC outpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RUSSELL VIPER VENOM TIME DILUTED PX-300856130 CDM 85613 CPT 305 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC REPTILASE PX-300856350 CDM 85635 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SED RATE (ESR) PX-300856510 CDM 85651 CPT 300 RC outpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SICKLE CELL PREP (SIKL) PX-300856600 CDM 85660 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC THROMBIN TIME, PLASMA" PX-300856700 CDM 85670 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PTT SCREENING PX-300857300 CDM 85730 CPT 305 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANT-PHOSPHOLIPID ABS. (APSAB) PX-300857301 CDM 85730 CPT 300 RC outpatient 88 86.24 All Payors / Plans All Payors / Plans 88 other 88 88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APTT MIX 1 TO 1 PX-300857320 CDM 85732 CPT 300 RC outpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VISCOSITY, SERUM (VSC)" PX-300858100 CDM 85810 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FEBRILE AGGLUTININS (FEB) PX-300860000 CDM 86000 CPT 300 RC outpatient 571 559.58 All Payors / Plans All Payors / Plans 571 other 571 571 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ALLERGAN SPEC IGG QUANT, EACH X8" PX-300860010 CDM 86001 CPT 302 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RAST (RST1) PX-300860030 CDM 86003 CPT 302 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RAST N E REGION (RAST) PX-300860033 CDM 86003 CPT 300 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ALLERGEN SPECIFIC IGE;QUANT OR SEMIQUANT, RECOMBINANT OR PURIFED COMPONENT, EACH" PX-300860080 CDM 86008 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLATELET ANTIBODIES PX-300860220 CDM 86022 CPT 302 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI NUCLEAR ANTIBODY PX-300860380 CDM 86038 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ASTO TITER (ASTO) PX-300860600 CDM 86060 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTISTREPTOLYSIN O SCREEN PX-300860630 CDM 86063 CPT 300 RC outpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC C-REACTIVE PROTEIN, INFLAMMATORY" PX-300861400 CDM 86140 CPT 302 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HSCRP, CARDIAC" PX-300861410 CDM 86141 CPT 302 RC outpatient 46 45.08 All Payors / Plans All Payors / Plans 46 other 46 46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BETA 2 GLYCOPROTEIN 1 ANTIBODY EACH PX-300861460 CDM 86146 CPT 306 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CARDIOLIPIN ANTIBODY, EA IG CLASS" PX-300861470 CDM 86147 CPT 302 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC COLD AGGLUTININ, TITER" PX-300861570 CDM 86157 CPT 300 RC outpatient 75 73.5 All Payors / Plans All Payors / Plans 75 other 75 75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPLEMENT;ANTIGEN EACH COMPONENT PX-300861600 CDM 86160 CPT 302 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPLEMENT C4 (C4) PX-300861601 CDM 86160 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPLEMENT C3 (C3) PX-300861602 CDM 86160 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MANNAN BINDING LECTIN COMPLEMENT PATHWAY, FUNCTIONAL, SERUM" PX-300861610 CDM 86161 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPLEMENT-TL (TCMP) PX-300861620 CDM 86162 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYCLIC CITRULLINATED PEPTIDE PX-300862000 CDM 86200 CPT 302 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-DNA ANTIBODY (ADNA) PX-300862250 CDM 86225 CPT 300 RC outpatient 88 86.24 All Payors / Plans All Payors / Plans 88 other 88 88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AB TO EXTRACTABLE NUCLEAR AG(ENA) PX-300862350 CDM 86235 CPT 300 RC outpatient 719 704.62 All Payors / Plans All Payors / Plans 719 other 719 719 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AUTOANTIBODIES TO SS-A/RO PX-300862351 CDM 86235 CPT 300 RC outpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AUTOANTIBODIES TO SS-B/LA PX-300862352 CDM 86235 CPT 300 RC outpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AUTOANTIBODIES TO SCL 70 PX-300862353 CDM 86235 CPT 300 RC outpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AUTOANTIBODIES TO SM PX-300862354 CDM 86235 CPT 300 RC outpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AUTOANTIBODIES TO U1RNP PX-300862355 CDM 86235 CPT 300 RC outpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AUTOANTIBODIES TO JO 1 PX-300862356 CDM 86235 CPT 300 RC outpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CENTROMERE ANTIBODY (CMA) PX-300862357 CDM 86235 CPT 300 RC outpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HISTONE ANTIBODY (HISTA) PX-300862358 CDM 86235 CPT 300 RC outpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NUCLEAR ANTIGEN ANTIBODY X8 PX-300862359 CDM 86235 CPT 300 RC outpatient 639 626.22 All Payors / Plans All Payors / Plans 639 other 639 639 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FLUORESCENT NONINFECTIOUS AGENT ANTIBODY, SCREEN EA" PX-300862550 CDM 86255 CPT 302 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-SMOOTH MUSCLE AB (ASMUS) PX-300862551 CDM 86255 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NMO/AQP4-IGG CBA PX-300862552 CDM 86255 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUORESCENT NONINFECTIOUS AGENT ANTIBODY;TITER EA. PX-300862560 CDM 86256 CPT 302 RC outpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PANCREATIC ELASTASE-1 PX-300862651 CDM 82656 CPT 300 RC outpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMMUNOASSAY TUMOR ANTIGEN PX-300863000 CDM 86300 CPT 302 RC outpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CA 199 (CA199) PX-300863010 CDM 86301 CPT 300 RC outpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CA 125 AG (C125) PX-300863040 CDM 86304 CPT 300 RC outpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MONO TEST (MONO) PX-300863080 CDM 86308 CPT 302 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHROMOGRANIN A PX-300863160 CDM 86316 CPT 300 RC outpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMMUNOASSAY INFECTIOUS AGENT ANTIBODY QUANTITATIVE PX-300863170 CDM 86317 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOASSAY INFECTIOUS AGENT ANTIBODY(IES), QUALIT/SEMIQUANT, SINGLE STEP COVID-19" PX-300863280 CDM 86328 CPT 300 RC outpatient 47 46.06 All Payors / Plans All Payors / Plans 47 other 47 47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMUNODIFFUSION OUCHTEROLOGY X5 PX-300863310 CDM 86331 CPT 302 RC outpatient 271 265.58 All Payors / Plans All Payors / Plans 271 other 271 271 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOFIXATION, BLOOD" PX-300863340 CDM 86334 CPT 300 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MONOCLONAL PROTEIN STUDY, BLOOD" PX-300863341 CDM 86334 CPT 300 RC outpatient 191 187.18 All Payors / Plans All Payors / Plans 191 other 191 191 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOFIXATION ELECTROPHORESIS, OTHER FLUID" PX-300863350 CDM 86335 CPT 302 RC outpatient 126 123.48 All Payors / Plans All Payors / Plans 126 other 126 126 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INSULIN ANTIBODIES (INAB) PX-300863370 CDM 86337 CPT 300 RC outpatient 106 103.88 All Payors / Plans All Payors / Plans 106 other 106 106 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTRINSIC FACTOR ANTIBODIES PX-300863400 CDM 86340 CPT 300 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ISLET CELL ANTIBODY PX-300863410 CDM 86341 CPT 302 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC B CELLS, TOTAL COUNT" PX-300863550 CDM 86355 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NATURAL KILLER CELLS, TOTAL COUNT" PX-300863570 CDM 86357 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC T CELLS, TOTAL COUNT" PX-300863590 CDM 86359 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC T CELLS, ABSOLUTE CD4 &CD8, INCLUDE RATIO" PX-300863600 CDM 86360 CPT 300 RC outpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MICROSOMAL ANTIBODIES(THYROID/KIDNEY/LIVER) EA. PX-300863760 CDM 86376 CPT 302 RC outpatient 63 61.74 All Payors / Plans All Payors / Plans 63 other 63 63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHG NEUTRALIZATION TEST, VIRAL" PX-300863820 CDM 86382 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CRYPTOCOCCAL ANTIGEN (CRAG) PX-300864030 CDM 86403 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BACTERIAL ANTIGEN DETECT (BAAG) PX-300864031 CDM 86403 CPT 300 RC outpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CRYPTOCOCCAL ANTIGEN SER. (SCRAG) PX-300864032 CDM 86403 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RA TEST (RA) PX-300864300 CDM 86430 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RHEUMATOID FACTOR; QUANTITATIVE PX-300864310 CDM 86431 CPT 302 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC M TUBERCULOSIS BY QUANTIFERON PX-300864800 CDM 86480 CPT 302 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SYPHILIS TEST, NON TREPONEMAL ANTIBODY, QUALIT(VDRL,RPR,ART)" PX-300865920 CDM 86592 CPT 302 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SYPHILLIS, NON-TREPONEMAL ANTIBODY,QUALIT, QUANTIT" PX-300865930 CDM 86593 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ASPERGILLUS, ANTIBODY" PX-300866060 CDM 86606 CPT 302 RC outpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BACTERIUM, ANTIBODY" PX-300866090 CDM 86609 CPT 300 RC outpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BARTONELLA AB PANEL PX-300866110 CDM 86611 CPT 300 RC outpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BORDATELLA PX-300866150 CDM 86615 CPT 300 RC outpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC LYME DISEASE, CONF. (LYMWB)" PX-300866170 CDM 86617 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BORRELIA BURGDORFERI(LYME DISEASE) PX-300866180 CDM 86618 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRUCELLA AGGLUTINATION PX-300866220 CDM 86622 CPT 300 RC outpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHLAMYDIA SEROLOGY PX-300866310 CDM 86631 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOMEGALOVIRUS(CMV) PX-300866440 CDM 86644 CPT 302 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TORCH TEST (TORT) PX-300866441 CDM 86644 CPT 300 RC outpatient 229 224.42 All Payors / Plans All Payors / Plans 229 other 229 229 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTIBODY CYTOMEGALOVIRUS (CMV) PX-300866450 CDM 86645 CPT 302 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENCEPHALITIS CALIFORN ANTBDY PX-300866510 CDM 86651 CPT 300 RC outpatient 133 130.34 All Payors / Plans All Payors / Plans 133 other 133 133 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARBOVIRUS PX-300866520 CDM 86652 CPT 300 RC outpatient 269 263.62 All Payors / Plans All Payors / Plans 269 other 269 269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENCEPHALTIS ST LOUIS ANTBODY PX-300866530 CDM 86653 CPT 300 RC outpatient 133 130.34 All Payors / Plans All Payors / Plans 133 other 133 133 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ENCEPHALITIS, WESTERN EQUINE" PX-300866540 CDM 86654 CPT 300 RC outpatient 134 131.32 All Payors / Plans All Payors / Plans 134 other 134 134 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EB VIRUS SEROLOGY (EBVS) PX-300866630 CDM 86663 CPT 302 RC outpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTIBODY EHRLICHIA PX-300866660 CDM 86666 CPT 302 RC outpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FRANCISELLA TURLARENSIS AB PX-300866680 CDM 86668 CPT 300 RC outpatient 134 131.32 All Payors / Plans All Payors / Plans 134 other 134 134 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHG FUNGUS, ANTIBODY" PX-300866710 CDM 86671 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HELICOBACTER PYLORI PX-300866770 CDM 86677 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC H PYLORI AB, IGG, IGM, IGA" PX-300866771 CDM 86677 CPT 300 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HTLV I/II AB (HTLV12) PX-300866870 CDM 86790 CPT 300 RC outpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HTLV OR HIV ANTIBODY, CONFIRMATORY TEST(EG. WESTERN BLOT)" PX-300866890 CDM 86689 CPT 300 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STATE HIV CONF TEST (SHIV) PX-300866891 CDM 86689 CPT 300 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HERPES SIMPLEX, NONSPEC TYPE, ANTIBODY" PX-300866940 CDM 86694 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HERPES SEROLOGY (HESE) PX-300866941 CDM 86694 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HSV AB,IGM BY IRA(HSVIGM)" PX-300866942 CDM 86694 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TORCH PROFILE LGM 1 PX-300866943 CDM 86694 CPT 300 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HERPES SIMPLEX, TYPE 1, ANTIBODY" PX-300866950 CDM 86695 CPT 302 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HERPES SIMPLEX, TYPE 2, ANTIBODY" PX-300866960 CDM 86696 CPT 302 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HISTOPLASMA PX-300866980 CDM 86698 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-HB CORE (CORE) PX-300867040 CDM 86704 CPT 302 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-CORE IGM (COREM) PX-300867050 CDM 86705 CPT 302 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-HBSAG (HAB) PX-300867060 CDM 86706 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-HBE (EAB) PX-300867070 CDM 86707 CPT 302 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEPATITIS A ANTIBODY (HAAB) PX-300867080 CDM 86708 CPT 302 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ANTI-HAV, IGM (HAV)" PX-300867090 CDM 86709 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LEGIONAIRES SEROLOGY (LGSE) PX-300867130 CDM 86713 CPT 300 RC outpatient 56 54.88 All Payors / Plans All Payors / Plans 56 other 56 56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LEPTOSPIRA SEROLOGY (LPS) PX-300867200 CDM 86720 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MUMPS TITER (MUSE) PX-300867350 CDM 86735 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYCOPLASMA SEROLOGY (MYSE) PX-300867380 CDM 86738 CPT 302 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARVOVIRUS PX-300867470 CDM 86747 CPT 302 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ANTIBODY PROTOZOA, NOT ELSEWHERE SPECIFIED" PX-300867530 CDM 86753 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RICKETTSIA PX-300867570 CDM 86757 CPT 302 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ROCKY MTN SPOTTED FEVER (RMSF) PX-300867590 CDM 86759 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RUBELLA TEST (RUBE) PX-300867620 CDM 86762 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RUBEOLA SCREEN (RBOLA) PX-300867650 CDM 86765 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHG SALMONELLA PX-300867680 CDM 86768 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOASSAY INFECTIOUS AGENT ANTIBODY(IES), QUALIT/SEMIQUANT, MULTI-STEP COVID-19" PX-300867691 CDM 86769 CPT 300 RC outpatient 44 43.12 All Payors / Plans All Payors / Plans 44 other 44 44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TOXOPLASMA SEROLOGY (TOSE) PX-300867770 CDM 86777 CPT 302 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHG TOXOPLASMA, IGM" PX-300867780 CDM 86778 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FTA (FTA) PX-300867800 CDM 86780 CPT 300 RC outpatient 48 47.04 All Payors / Plans All Payors / Plans 48 other 48 48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VARICELLA-ZOSTER PX-300867870 CDM 86787 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VARICELLA ZOSTER IMMUNE (VZI) PX-300867871 CDM 86787 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HUMAN T-CELL LYMPHOTROPIC VIRUS I&II (HTLVI) PX-300867900 CDM 86790 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTI-THYROGLOBULIN AB (ATHYR) PX-300868000 CDM 86800 CPT 302 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANT-HEPATITITS C (AHCV) PX-300868030 CDM 86803 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HLA B27 (HLA) PX-300868120 CDM 86812 CPT 302 RC outpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CELIAC DISEASE COMP CASCADE PX-300868160 CDM 86816 CPT 300 RC outpatient 372 364.56 All Payors / Plans All Payors / Plans 372 other 372 372 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTIBODY SCREEN (ABST) PX-300868500 CDM 86850 CPT 300 RC outpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ANTIBODY ELUTION, RBC, EA ELUTION" PX-300868600 CDM 86860 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTIBODY IDENTIFICATION PX-300868700 CDM 86870 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIRECT COOMBS PX-300868800 CDM 86880 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTIBODY TITER (ABTI) PX-300868860 CDM 86886 CPT 302 RC outpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PATIENT BLOOD TYPE (BTY) PX-300869000 CDM 86900 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BLOOD TYPING, ABO" PX-300869001 CDM 86900 CPT 300 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RHIG STUDIES (RHG) PX-300869002 CDM 86900 CPT 300 RC outpatient 146 143.08 All Payors / Plans All Payors / Plans 146 other 146 146 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD TYPING RH (D) PX-300869010 CDM 86901 CPT 300 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANTIGEN TYPING PX-300869020 CDM 86902 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AHG PHASE CROSSMATCH INCUBATION PX-300869210 CDM 86921 CPT 300 RC outpatient 3 2.94 All Payors / Plans All Payors / Plans 3 other 3 3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AHG PHASE CROSSMATCH ANTIGLOBULIN PX-300869220 CDM 86922 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CROSSMATCH (XM) PX-300869230 CDM 86923 CPT 300 RC outpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONCENTRATION(ANY TYPE)INFECTIOUS AGENTS PX-300870150 CDM 87015 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CULTURE BLOOD (BLC) PX-300870400 CDM 87040 CPT 306 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CULT LOWER G I (STLC) PX-300870450 CDM 87045 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CAMPY PLATE PX-300870460 CDM 87046 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SM CULT RESPIR (RESC) PX-300870700 CDM 87070 CPT 300 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SM CULT GENITAL (GESC) PX-300870701 CDM 87070 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SM CULT CSF (SFSC) PX-300870702 CDM 87070 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CULT THROAT (THRC) PX-300870703 CDM 87070 CPT 300 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CULT NASO (NASO) PX-300870704 CDM 87070 CPT 300 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SM CULT MISC (MISC) PX-300870705 CDM 87070 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BODY FLUID SMEAR AND CULTURE PX-300870706 CDM 87070 CPT 300 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC QUANT AEROBIC W ISOLATION PRESUMP ID ISOLATES SOURCE EXC UR BLD STL PX-300870710 CDM 87071 CPT 300 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRESUMPTIVE ANAEROBIC ID PX-300870750 CDM 87075 CPT 300 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CULTURE,BACTERIAL,ANAEROBIC ISOLATE, ADD, ID EA ISOLATE" PX-300870760 CDM 87076 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CULTURE,BACTERIAL,AEROBIC ISOLATE. ADD ID EA ISOLATE" PX-300870770 CDM 87077 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BACTERIAL IDENTIFICATION X 1 PX-300870771 CDM 87077 CPT 306 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GENITAL CULTURE-GC ONLY (GCCU) PX-300870810 CDM 87081 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CULT BETA STREP (BETA) PX-300870811 CDM 87081 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CLO TEST (CLO) PX-300870812 CDM 87081 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GROUP B STREP SCREEN (GBST) PX-300870813 CDM 87081 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BORDETELLA PERTUSSIS CULT (BPEC) PX-300870814 CDM 87081 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VRE SCREEN CULTURE (VRSC) PX-300870815 CDM 87081 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRSA SCREEN CULTURE(MRSAC) PX-300870816 CDM 87081 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STAPH. AUREUS SCREEN ORTHO PX-300870817 CDM 87081 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CRE SCREEN PX-300870818 CDM 87081 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CULT URINE (URNC) PX-300870860 CDM 87086 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRESUMPTIVE IDENTIFICATION X 1 PX-300870880 CDM 87088 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FUNGUS SM AND CULT (FUSC) PX-300871020 CDM 87102 CPT 300 RC outpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC YEAST IDENTIFICATION X 1 PX-300871060 CDM 87106 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CULTURE,FUNGI, DEFINITIVE ID, EA ORGANISM,MOLD" PX-300871070 CDM 87107 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYCOPLASA PX-300871090 CDM 87109 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CULTURE,TUBERCLE,AFB, ANY SOURCE W/ISOL&PRESUMP" PX-300871160 CDM 87116 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACID FAST CULT BLOOD (AFBLC) PX-300871161 CDM 87116 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CULTURE MYCOBACTERIAL, DEFINITIVE ID, EA ISOLATE" PX-300871180 CDM 87118 CPT 300 RC outpatient 217 212.66 All Payors / Plans All Payors / Plans 217 other 217 217 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SERO TYPING X 1 PX-300871470 CDM 87147 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PBP2A TEST PX-300871472 CDM 87147 CPT 306 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD CULTURE GRAM POSITIVE PX-300871490 CDM 87149 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD CULTURE GRAM NEGATIVE PX-300871491 CDM 87149 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD CULTURE GRAM NEGATIVE 6 PX-300871492 CDM 87149 CPT 300 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD CULTURE GRAM NEGATIVE 7 PX-300871493 CDM 87149 CPT 300 RC outpatient 500 490 All Payors / Plans All Payors / Plans 500 other 500 500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD CULTURE GRAM POSITIVE 11 PX-300871494 CDM 87149 CPT 300 RC outpatient 785 769.3 All Payors / Plans All Payors / Plans 785 other 785 785 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD CULTURE GRAM POSITIVE 2 PX-300871495 CDM 87149 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLOOD CULTURE GRAM POSITIVE 1 PX-300871496 CDM 87149 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CULTURE TYPING, ID NUCLEIC ACID(DNA OR RNA)PROBE" PX-300871500 CDM 87150 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CULTURE REFER FOR ID, FUNGUS&CULTURE ID (FUNID(DSF)" PX-300871530 CDM 87153 CPT 300 RC outpatient 183 179.34 All Payors / Plans All Payors / Plans 183 other 183 183 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ORGANISM REFERRED FOR ID, AEROBIC BACTERIA" PX-300871531 CDM 87153 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ORGANISM REFERRED FOR ID, ANAEROBIC BACTERIA(ISAN,ISAE)" PX-300871532 CDM 87153 CPT 300 RC outpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CULTURE TYPING, OTHER METHODS" PX-300871580 CDM 87158 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MACROSCOPIC EXAM, ARTHROPOD" PX-300871680 CDM 87168 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MACROSCOPIC EXAM, PARASITE" PX-300871690 CDM 87169 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PINWORM PREP PX-300871720 CDM 87172 CPT 300 RC outpatient 17 16.66 All Payors / Plans All Payors / Plans 17 other 17 17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TISSUE GRINDING PX-300871760 CDM 87176 CPT 300 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SENSITIVITY TESTING PX-300871860 CDM 87186 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUID WBC (FLDWBC) PX-300872050 CDM 87205 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUID RBC (FLDRBC) PX-300872051 CDM 87205 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URINE FOR EOSINOPHILS (UREOS) PX-300872052 CDM 87205 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GC SMEAR (GCSM) PX-300872053 CDM 87205 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GRAM STAIN (GRAM) PX-300872054 CDM 87205 CPT 306 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SMEAR, FLUORES AND/OR ACID FAST BACTERIA,FUNGI, PARASITES,VIRUS OR CELL TYPES" PX-300872060 CDM 87206 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MALARIA SMEAR (MAL) PX-300872070 CDM 87207 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OVA AND PARASITES COMPLEX SMEAR PX-300872090 CDM 87209 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SMEAR, WET MOUNT, SIMPLE STAIN" PX-300872100 CDM 87210 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WET MOUNT (WTMT) PX-300872101 CDM 87210 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KOH PREP PX-300872200 CDM 87220 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VIRUS ISOLATION TISSUE CULTURE INOCULATION, PRESUMP ID CYTOPATHIC EFFECT" PX-300872520 CDM 87252 CPT 300 RC outpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VIRUS ISOLATION, TISSUE CULT, ADD STUDIES OR ID, EA ISOLATE" PX-300872530 CDM 87253 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VIRUS INOCULATION, SHELL VIA, INCL ID, EA VIRUS" PX-300872540 CDM 87254 CPT 300 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GIARDIA PX-300872690 CDM 87269 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CRYPTOSPORDIUM PX-300872720 CDM 87272 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ASPERGILUS, ANTIGEN, BRONCHOALEVOLAR LAVAGE" PX-300873050 CDM 87305 CPT 302 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CL DIFFICILE LATEX TEST (CDT) PX-300873240 CDM 87324 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC H.PYLORI ANTIGEN, STOOL" PX-300873380 CDM 87338 CPT 306 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEPATITIS B SURFACE ANTIGEN PX-300873400 CDM 87340 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEP B. SURFACE AG NEUTRALIZATION PX-300873410 CDM 87341 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEPATITIS BE ANTIGEN (EAG) PX-300873500 CDM 87350 CPT 306 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HIV-Q ANTIGEN(S) W HIV-1/HIV-2 ANTIBODIES,SIMPLE" PX-300873890 CDM 87389 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RSV ANTIGEN (RSVA) PX-300874200 CDM 87420 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ROTOVIRUS (ROTO) PX-300874250 CDM 87425 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENTEROHEMORAGIC E. COLI ASSYS PX-300874270 CDM 87427 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LEGIONELLA URINARY ANTIGEN PX-300874490 CDM 87449 CPT 306 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FUNGITELL, BAL" PX-300874491 CDM 87449 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IADNA ANAPLASMA PHAGOCYTOPHILUM AMPLIFIED PRB TQ PX-300874680 CDM 87468 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BORRELIA BURGDORFERI, AMPLIFIED PROBE TECHNIQUE" PX-300874760 CDM 87476 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CANDIDA SPECIES AMPLIFIED PROBE PX-300874810 CDM 87481 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA) PX-300874830 CDM 87483 CPT 300 RC outpatient 1148 1125.04 All Payors / Plans All Payors / Plans 1148 other 1148 1148 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IADNA EHRLICHIA CHAFFEENSIS AMPLIFIED PROBE TQ PX-300874840 CDM 87484 CPT 300 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHLAMYDIA PNEUMONIAE, DNA, AMP PROBE" PX-300874860 CDM 87486 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE" PX-300874910 CDM 87491 CPT 306 RC outpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CMV BY RAPID PCR (CMVPCR) PX-300874960 CDM 87496 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CYTOMEGALOVIRUS, AMPLIFIED PROBE" PX-300874965 CDM 87496 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CMV, QUANT, PCR, PLASMA" PX-300874970 CDM 87497 CPT 306 RC outpatient 457 447.86 All Payors / Plans All Payors / Plans 457 other 457 457 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENTEROVIRUS BY PCR (PCRENT) PX-300874980 CDM 87498 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ENTEROVIRUS, AMPLIFIED PROBE, INCLUDE REVERSE TRANSCRIPTION" PX-300874985 CDM 87498 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ENTERIC BACTERIAL PANEL, STOOL" PX-300875060 CDM 87506 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HEPATITIS B VIRAL DNA,QNT(QHBV)" PX-300875170 CDM 87517 CPT 300 RC outpatient 457 447.86 All Payors / Plans All Payors / Plans 457 other 457 457 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HEPATITIS C, REVERSE TRANSCRIPTION & QUANTIFICATION" PX-300875220 CDM 87522 CPT 306 RC outpatient 457 447.86 All Payors / Plans All Payors / Plans 457 other 457 457 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HERPES BY PCR (HSVPCR) PX-300875290 CDM 87529 CPT 306 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HERPES SIMPLEX VIRUS, AMPLIFIED PROBE" PX-300875295 CDM 87529 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HERPES VIRUS-6, AMPLIFIED PROBE" PX-300875320 CDM 87532 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HIV-1 DNA BY PCR, PLASMA" PX-300875350 CDM 87535 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HIV RNA BY PCR (PCRHIV) PX-300875360 CDM 87536 CPT 306 RC outpatient 457 447.86 All Payors / Plans All Payors / Plans 457 other 457 457 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYCOPLASMA GENITALIUM AMPLIFIED PROBE PX-300875630 CDM 87563 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYCOPLASMA GENITALIUM PCR PX-300875631 CDM 87563 CPT 300 RC outpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MYCOPLASMA PNEUMONIAE, AMP PROBE" PX-300875810 CDM 87581 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC N. GONO, AMPLIFIED PROBE" PX-300875910 CDM 87591 CPT 300 RC outpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HUMAN PAPILLOMAVIRUS(HPV) PX-300876240 CDM 87624 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HPV GENOTYPES 16&18 PX-300876250 CDM 87625 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "RESPIRATORY VIRUS, INFLUENZA TYPE A&BM 3-5 TARGETS" PX-300876310 CDM 87631 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC RESP VIRUS,MULTIPLEX, REVERSE TRANS/AMP, 12-25 TARGETS" PX-300876330 CDM 87633 CPT 300 RC outpatient 515 504.7 All Payors / Plans All Payors / Plans 515 other 515 515 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFECTIOUS AGENT DETECTION BY NUCLEIC ACID, RESPIRATORY SYNDROME" PX-300876350 CDM U0002 CPT 300 RC outpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFECTIOUS AGENT DETECTION BY NUCLEIC ACID, HIGH THROUGHPUT TECH" PX-300876351 CDM U0003 CPT 300 RC outpatient 79 77.42 All Payors / Plans All Payors / Plans 79 other 79 79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFEC AGENT DETECTION AMPLIFIED PROBE PX-300876352 CDM U0005 CPT 300 RC outpatient 26 25.48 All Payors / Plans All Payors / Plans 26 other 26 26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SURGEY MRSA SCREEN (SXMR) PX-300876410 CDM 87641 CPT 306 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC STREPTOCOCCUS,GROUP B, AMPLIFIED PROBE" PX-300876530 CDM 87653 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRICHOMONAS VAGINALIS PX-300876610 CDM 87661 CPT 300 RC outpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFECTIOUS AGENT AMPLIFIED PROBE, EA ORGANISM" PX-300877980 CDM 87798 CPT 306 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CLOSTRIDIUM DIFFICILE PCR(CDTPCR) PX-300877981 CDM 87798 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC EHRLICHIA/ANAPLASMA PCR,B" PX-300877982 CDM 87798 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC AMPLIFIED PROBE, EA. ORGANISM" PX-300877985 CDM 87798 CPT 300 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ORTHOPOXVIRUS(MONKEYPOX) DNA, PCR" PX-300877986 CDM 87798 CPT 300 RC outpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFECTIOUS AGENT QUANTIFICATION, EA ORGANISM" PX-300877990 CDM 87799 CPT 300 RC outpatient 457 447.86 All Payors / Plans All Payors / Plans 457 other 457 457 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFECTIOUS AGENT, MULTIPLE ORGS, AMPLIFIED PROBE" PX-300878010 CDM 87801 CPT 302 RC outpatient 599 587.02 All Payors / Plans All Payors / Plans 599 other 599 599 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFLUENZA ANTIGEN (FLUAG) PX-300878040 CDM 87804 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HIV AG/AB PX-300878060 CDM 87806 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC STREPTOCOCCUS, GROUP A" PX-300878800 CDM 87880 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFECTIOUS AGENT IMMUNOASSAY NOT SPECIFIED PX-300878990 CDM 87899 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HIV-1 GENOTYPIC PR RT-RESISTANCE,P" PX-300879010 CDM 87901 CPT 300 RC outpatient 971 951.58 All Payors / Plans All Payors / Plans 971 other 971 971 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC GENOTYPE BY NUCLEIC ACID,HEPATITIS C" PX-300879020 CDM 87902 CPT 300 RC outpatient 971 951.58 All Payors / Plans All Payors / Plans 971 other 971 971 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CYTOPATH, INSITU HYBRID URINE SPEC 3-5 PROBES, EA. MANUAL" PX-300881200 CDM 88120 CPT 300 RC outpatient 571 559.58 All Payors / Plans All Payors / Plans 571 other 571 571 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FLOW CYTOMETRY, CELL SFC,CYTOPLASMIC OR NUCLEAR MARKER" PX-300881840 CDM 88184 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLOW CYTO CELL SURF 1 (BILL ONLY) PX-300881841 CDM 88184 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLOW CYTOMETRY EACH ADD'L MARKER PX-300881850 CDM 88185 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLOW CYTO CELL SURF 1 ADD BILL ON PX-300881851 CDM 88185 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLOW CYTOMETRY EACH ADD'L MARKER PX-300881855 CDM 88185 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLOW CYTO INTERP 2 TO 8 MARKERS PX-300881870 CDM 88187 CPT 300 RC outpatient 44 43.12 All Payors / Plans All Payors / Plans 44 other 44 44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLOW CYTO INTERP 9 TO 15 MARKERS PX-300881880 CDM 88188 CPT 300 RC outpatient 122 119.56 All Payors / Plans All Payors / Plans 122 other 122 122 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLOW CYTOMETRY 9 TO 15 MARKERS PX-300881888 CDM 88188 CPT 300 RC outpatient 122 119.56 All Payors / Plans All Payors / Plans 122 other 122 122 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLOW CYTO INTERP 16 OR GREAT MARK PX-300881890 CDM 88189 CPT 300 RC outpatient 147 144.06 All Payors / Plans All Payors / Plans 147 other 147 147 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TISSUE CULTURE NON-NEOPLACTIC DISORDERS,LYMPHOCYTE" PX-300882300 CDM 88230 CPT 300 RC outpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TISSUE CULTURE NON-NEOPLASTIC DISORDERS,SKIN/OTHER SOLID TISSUE BIOPSY" PX-300882330 CDM 88233 CPT 300 RC outpatient 571 559.58 All Payors / Plans All Payors / Plans 571 other 571 571 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHG TISSUE CULTURE, PLACENTA" PX-300882350 CDM 88235 CPT 300 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TISSUE CULTURE NEOPLASTIC DISORDERS;BONE MARROW, BLOOD CELLS" PX-300882370 CDM 88237 CPT 300 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHG CELL CRYOPRESERVE/STORAGE PX-300882400 CDM 88240 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC METAPHASES, 1-14 (BILL ONLY)" PX-300882623 CDM 88262 CPT 300 RC outpatient 914 895.72 All Payors / Plans All Payors / Plans 914 other 914 914 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC METAPHASES, 15-20 (BILL ONLY)" PX-300882624 CDM 88262 CPT 300 RC outpatient 914 895.72 All Payors / Plans All Payors / Plans 914 other 914 914 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHROMOSOME ANALYSIS 20-25 CELLS PX-300882640 CDM 88264 CPT 300 RC outpatient 1142 1119.16 All Payors / Plans All Payors / Plans 1142 other 1142 1142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC METAPHASES, 20-25 (BILL ONLY" PX-300882641 CDM 88264 CPT 300 RC outpatient 1142 1119.16 All Payors / Plans All Payors / Plans 1142 other 1142 1142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC METAPHASES, 1-19 (BILL ONLY)" PX-300882642 CDM 88264 CPT 300 RC outpatient 1142 1119.16 All Payors / Plans All Payors / Plans 1142 other 1142 1142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHROMOSOME ANAL,AMN FL OR CHORION VIL,15 CELLS" PX-300882670 CDM 88267 CPT 300 RC outpatient 857 839.86 All Payors / Plans All Payors / Plans 857 other 857 857 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHROMOSOME ANAL, IN SITU FOR AMN FLUID 6-12 COLONIES" PX-300882690 CDM 88269 CPT 300 RC outpatient 857 839.86 All Payors / Plans All Payors / Plans 857 other 857 857 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MOLECULAR CYTOGENETICS;DNA PROBE EACH PX-300882710 CDM 88271 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PROBE, +2 (BILL ONLY)" PX-300882711 CDM 88271 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ANEUPLOIDY DETECTION,POC,FISH" PX-300882712 CDM 88271 CPT 300 RC outpatient 800 784 All Payors / Plans All Payors / Plans 800 other 800 800 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FISH,BCR/ABL FUSION (BCRABL)" PX-300882713 CDM 88271 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INTERPHASES, 25-99 (BILL ONLY)" PX-300882740 CDM 88274 CPT 300 RC outpatient 571 559.58 All Payors / Plans All Payors / Plans 571 other 571 571 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INTERPHASES, <25 (BILL ONLY)" PX-300882741 CDM 88274 CPT 300 RC outpatient 571 559.58 All Payors / Plans All Payors / Plans 571 other 571 571 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INTERPHASES, >=100 (BILL ONLY)" PX-300882750 CDM 88275 CPT 300 RC outpatient 657 643.86 All Payors / Plans All Payors / Plans 657 other 657 657 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC KARYOTYPES, >2 (BILL ONLY)" PX-300882800 CDM 88280 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AG-NOR/CBL STAIN (BILL ONLY) PX-300882830 CDM 88283 CPT 300 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC METAPHASES ADD'L CELLS (BILL ONLY PX-300882850 CDM 88285 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOGENIC AND MOLECULAR INTERP/ REPORT PX-300882910 CDM 88291 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PEROXIDASE STAIN HEMO (POD) PX-300883190 CDM 88319 CPT 300 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CONSULT, OUTSIDE SLIDE(COSPC)" PX-300883210 CDM 88321 CPT 300 RC outpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CONSULT, W/SLIDE PREP(CSPPC)" PX-300883230 CDM 88323 CPT 300 RC outpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CONSULT, W/COMP RVW OF HIS (CRHPC)" PX-300883250 CDM 88325 CPT 300 RC outpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMMUNO SENDOUT ADDL PX-300883410 CDM 88341 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMMUNO SENDOUT PX-300883420 CDM 88342 CPT 300 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MORPHOMETRIC ANAL,IN SITU HYBRID,MANU,PER SPEC,EACH MULTI PROBE STAIN" PX-300883770 CDM 88377 CPT 300 RC outpatient 832 815.36 All Payors / Plans All Payors / Plans 832 other 832 832 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MORPHOMETRIC IN SITU MULTIPLEX PROB STAI PX-300883771 CDM 88377 CPT 300 RC outpatient 706 691.88 All Payors / Plans All Payors / Plans 706 other 706 706 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MICRODISSECTION, MANUAL" PX-300883810 CDM 88381 CPT 301 RC outpatient 106 103.88 All Payors / Plans All Payors / Plans 106 other 106 106 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MLH1 HYPERMEHTYLATION,BRAF MUTATION ANALYS, TUMOR" PX-300883811 CDM 88381 CPT 300 RC outpatient 108 105.84 All Payors / Plans All Payors / Plans 108 other 108 108 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUID CELL COUNT (FCC) PX-300890500 CDM 89050 CPT 300 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CSF, ROUTINE ANALYSIS (SPFR)" PX-300890501 CDM 89050 CPT 300 RC outpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUID CELL COUNT W/DIFFERENTIAL (FDIF) PX-300890510 CDM 89051 CPT 300 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SYNOVIAL FLD. ANALYSIS (SYNA) PX-300890511 CDM 89051 CPT 300 RC outpatient 126 123.48 All Payors / Plans All Payors / Plans 126 other 126 126 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STOOL FOR POLYS (STSM) PX-300890550 CDM 89055 CPT 300 RC outpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUID CRYSTALS (FLDC) PX-300890600 CDM 89060 CPT 300 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EOSINOPHIL SMEAR (EOSM) PX-300891900 CDM 89190 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPUTUM COLLECTED PX-300892200 CDM 89220 CPT 300 RC outpatient 37 36.26 All Payors / Plans All Payors / Plans 37 other 37 37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SWEAT CHLORIDE, CONDUCTIVITY(SWT)" PX-300892300 CDM 89230 CPT 300 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPERM COUNT (SPCT) PX-300893200 CDM 89320 CPT 300 RC outpatient 83 81.34 All Payors / Plans All Payors / Plans 83 other 83 83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPERM POST VAS (SPCK) PX-300893210 CDM 89321 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRAW AND HOLD (DH) PX-300990010 CDM 99001 CPT 300 RC outpatient 23 22.54 All Payors / Plans All Payors / Plans 23 other 23 23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GASTRIC OCCULT BLOOD PX-301822711 CDM 82271 CPT 301 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHROMIUM PX-301824951 CDM 82495 CPT 301 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NEPHELOMETRY, EA ANALYTE (FLCP)" PX-301835210 CDM 83521 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NEPHELOMETRY, EA ANALYTE (MSP3)" PX-301835211 CDM 83521 CPT 301 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IRON BINDING CAPACITY, % SAT" PX-301835501 CDM 83550 CPT 301 RC outpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITAMIN K Q 36585 PX-301845971 CDM 84597 CPT 301 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HCG, QUALITATIVE" PX-301847031 CDM 84703 CPT 301 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BILICHECK TRANSCUTANEOUS - EACH TIME PX-301887201 CDM 88720 CPT 301 RC outpatient 12 11.76 All Payors / Plans All Payors / Plans 12 other 12 12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PANCREATIC ELASTASE, FECES" PX-302826530 CDM 82653 CPT 300 RC outpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INTERLEUKIN-6 (IL-6), SERUM" PX-302835290 CDM 83529 CPT 302 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SMOOTH MUSCLE FLUORESCENT AB, SCREEN EA (SMA)" PX-302860150 CDM 86015 CPT 302 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ANTICYTOPLASMIC NEUT FLUORESCENT AB, SCREEN EA (ANCA)" PX-302860360 CDM 86036 CPT 302 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INFLAMMATORY BOWEL DISEASE PANEL FLUORESCENT AB, SCREEN EA (IBDPT)" PX-302860361 CDM 86036 CPT 302 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACETYLCHOLN RCPTR BNDNG ANTB PX-302860410 CDM 86041 CPT 302 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACETYLCHOLN RCPTR MODLG ANTB PX-302860430 CDM 86043 CPT 302 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NMO/AQP4 FACS FLUORESCENT NONINFECTIOUS AB, SCREEN EA (NMOFS/NMOFC)" PX-302860530 CDM 86053 CPT 302 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ENDOMYSIAL FLUORESCENT AB, SCREEN EA (EMA)" PX-302862310 CDM 86231 CPT 302 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLIADIN (DEAMINATED) ANTIBODY PX-302862580 CDM 86258 CPT 302 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FLUORESCENT NONINFECTIOUS AGENT AB, SCREEN EA (FACS)" PX-302863630 CDM 86363 CPT 302 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TISSUE TRANSGLUTAMINASE (TTG) AB PX-302863640 CDM 86364 CPT 302 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MUSCLE-SPECIFIC KINASE ANTB PX-302863660 CDM 86366 CPT 302 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MITOCHONDRIAL AB, IMMUNOASSAY;MULTI, STEP (AMA)" PX-302863810 CDM 86381 CPT 302 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PPD SKIN TEST PX-302865800 CDM 86580 CPT 302 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC P/Q TYPE CALCIUM CHANNEL AB QUANT BY RADIOIMMUNOASSAY PX-302865960 CDM 86596 CPT 302 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EPSTEIN BARR NUCLEAR ANTIGEN PX-302866641 CDM 86664 CPT 302 RC outpatient 95 93.1 All Payors / Plans All Payors / Plans 95 other 95 95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EPSTEIN-BARR VIRUS VCA IGG AB PX-302866651 CDM 86665 CPT 302 RC outpatient 134 131.32 All Payors / Plans All Payors / Plans 134 other 134 134 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SED RATE ERYTHROCYTE, AUTOMATED" PX-305856521 CDM 85652 CPT 305 RC outpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IAAD IA CRYPTOSPORIDIUM PX-306873280 CDM 87328 CPT 306 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC GIARDIA ANTIGEN, BRUSHING" PX-306873291 CDM 87329 CPT 306 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES PX-306875020 CDM 87502 CPT 306 RC outpatient 457 447.86 All Payors / Plans All Payors / Plans 457 other 457 457 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GARDNER VAG DNA QUANT PX-306875121 CDM 87512 CPT 306 RC outpatient 457 447.86 All Payors / Plans All Payors / Plans 457 other 457 457 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MSSA BY PCR PX-306876401 CDM 87640 CPT 306 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STREP A BY PCR PX-306876511 CDM 87651 CPT 306 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPUTUM COLLECTED PX-309892200 CDM 89220 CPT 309 RC outpatient 37 36.26 All Payors / Plans All Payors / Plans 37 other 37 37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LIVER DISEASE 10 BIOCHEMICAL ASSAYS PX-310003M00 CDM 0003M CPT 310 RC outpatient 412 403.76 All Payors / Plans All Payors / Plans 412 other 412 412 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGA IMMUNOFLUOR STAIN RENAL PX-310183461 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG IMMUNOFLUOR STAIN RENAL PX-310183462 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGM IMMUNOFLUOR STAIN RENAL PX-310183463 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LAMBDA IMMUNOFLUOR STAIN RENAL PX-310183464 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KAPPA IMMUNOFLUOR STAIN RENAL PX-310183465 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C3 IMMUNOFLUOR STAIN RENAL PX-310183467 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ALBUMIN IMMUNOFLUOR STAIN RENAL PX-310183468 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FIBRINOGEN IMMUNOFLUO STAIN RENAL PX-310183469 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C1Q IMMUNOFLUOR STAIN RENAL PX-310188346 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRCA 1/2 MUTATION ANALYSIS FOR TUMORS PX-310811630 CDM 81163 CPT 310 RC outpatient 3555 3483.9 All Payors / Plans All Payors / Plans 3555 other 3555 3555 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRAF MUTATION ANALYSIS (MELANOMA) PX-310812100 CDM 81210 CPT 310 RC outpatient 372 364.56 All Payors / Plans All Payors / Plans 372 other 372 372 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRAF MUTATION ANAL (OTH SOLID TUM PX-310812101 CDM 81210 CPT 310 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BRAF, GENE ALALYSIS, V60E VARIANT" PX-310812102 CDM 81210 CPT 310 RC outpatient 183 179.34 All Payors / Plans All Payors / Plans 183 other 183 183 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EGFR GENE MUTATION ANALYSIS TUMOR PX-310812350 CDM 81235 CPT 310 RC outpatient 1571 1539.58 All Payors / Plans All Payors / Plans 1571 other 1571 1571 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GENE TARGETED SEQUENCE ANALYSIS PX-310812720 CDM 81272 CPT 310 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KRAS GENE MUTATION ANALYSIS PX-310812750 CDM 81275 CPT 310 RC outpatient 329 322.42 All Payors / Plans All Payors / Plans 329 other 329 329 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC KRAS GENE ANALYSIS, VARIANTS IN CONDONS 12 13" PX-310812751 CDM 81275 CPT 310 RC outpatient 606 593.88 All Payors / Plans All Payors / Plans 606 other 606 606 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NRAS, GENE ANALYSIS, VARIANTS IN EXON 2,3" PX-310813110 CDM 81311 CPT 310 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TPMG THIOPURINE S-METHYLTRANS GENE ANALYSIS TPNUV PX-310813350 CDM 81335 CPT 310 RC outpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UGT1A1 GENE POLYMORPHISM PX-310813500 CDM 81350 CPT 310 RC outpatient 1086 1064.28 All Payors / Plans All Payors / Plans 1086 other 1086 1086 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TP53(TUMOR PROTEIN 53), TARGETED SEQUENCE ANALYSIS" PX-310813520 CDM 81352 CPT 310 RC outpatient 1599 1567.02 All Payors / Plans All Payors / Plans 1599 other 1599 1599 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MOLECULAR PATHOLOGY PROCEDURE, LEVEL 4" PX-310814030 CDM 81403 CPT 310 RC outpatient 389 381.22 All Payors / Plans All Payors / Plans 389 other 389 389 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC Y CHROMOSOME MICRODELETION DNA ANALYSIS PX-310814034 CDM 81403 CPT 310 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MOLECULAR PATHOLOGY PROCEDURE, LEVEL 5" PX-310814040 CDM 81404 CPT 310 RC outpatient 822 805.56 All Payors / Plans All Payors / Plans 822 other 822 822 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NGS COLORECTAL CANCER PANEL PX-310814450 CDM 81445 CPT 310 RC outpatient 1000 980 All Payors / Plans All Payors / Plans 1000 other 1000 1000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TARGET GENOMIC SEQU ANALYSIS PANEL, SOLID ORGAN NEOPL 5-50 GENES" PX-310814451 CDM 81445 CPT 310 RC outpatient 1280 1254.4 All Payors / Plans All Payors / Plans 1280 other 1280 1280 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NGS MELANOMA PANEL PX-310814452 CDM 81445 CPT 310 RC outpatient 1000 980 All Payors / Plans All Payors / Plans 1000 other 1000 1000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SOLID TUMOR PANEL PX-310814453 CDM 81445 CPT 310 RC outpatient 1423 1394.54 All Payors / Plans All Payors / Plans 1423 other 1423 1423 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TGSAP SOLID ORGAN NEOPLASM 5-50 DNA/DNA & ARNA ALYS PX-310814454 CDM 81445 CPT 310 RC outpatient 1956 1916.88 All Payors / Plans All Payors / Plans 1956 other 1956 1956 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TARGET GENOMIC SEQUENCE ANALYSIS PX-310814501 CDM 81450 CPT 310 RC outpatient 2155 2111.9 All Payors / Plans All Payors / Plans 2155 other 2155 2155 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UNLISTED MOLECULAR PATH PROCEDURE PX-310814791 CDM 81479 CPT 310 RC outpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MONOCLNAL PROTEIN STUD. 24HR URIN PX-310863350 CDM 86335 CPT 310 RC outpatient 126 123.48 All Payors / Plans All Payors / Plans 126 other 126 126 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IADNA ORTHOPOXVIRUS AMPLIFIED PROBE TECHNIQUE EA PX-310875931 CDM 87593 CPT 310 RC outpatient 123 120.54 All Payors / Plans All Payors / Plans 123 other 123 123 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CYTOLOGY WASHING, SMEARS" PX-310881040 CDM 88104 CPT 310 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CYTOLOGY, CYTOSPINS" PX-310881080 CDM 88108 CPT 310 RC outpatient 200 196 All Payors / Plans All Payors / Plans 200 other 200 200 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FINE NEEDLE ASPIRATION PX-310881720 CDM 88172 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FNA, INTERPRETATION]" PX-310881730 CDM 88173 CPT 310 RC outpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FNA, EA ADDL IMMEDIATE INTERP SAME SITE" PX-310881770 CDM 88177 CPT 310 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DNA PLOIDY PX-310881820 CDM 88182 CPT 310 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC FLOW CYTOMETRY, CELL CYCLE OR DNA ANALYSIS" PX-310881821 CDM 88182 CPT 310 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SURG PATH, LEVEL I" PX-310883040 CDM 88300 CPT 310 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SURG PATH, LEVEL II" PX-310883050 CDM 88302 CPT 310 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SURG PATH, LEVEL III" PX-310883051 CDM 88304 CPT 310 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SURG PATH, LEVEL IV" PX-310883052 CDM 88305 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SURG PATH PROSTATE PX-310883053 CDM 88305 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RENAL PATH LEVEL IV WET TS PX-310883054 CDM 88305 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SURG PATH, LEVEL V" PX-310883070 CDM 88307 CPT 310 RC outpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SURG PATH, LEVEL VI" PX-310883071 CDM 88309 CPT 310 RC outpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SURGICAL PATH C7 PX-310883090 CDM 88309 CPT 310 RC outpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DECAL PX-310883110 CDM 88311 CPT 310 RC outpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPECIAL STAIN I PX-310883120 CDM 88312 CPT 310 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GROCOTTS METH SILVER ST FOR FUNGI PX-310883121 CDM 88312 CPT 310 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ZIEHL NIELSEN ST FOR AF BACT PX-310883122 CDM 88312 CPT 310 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPECIAL STAIN II PX-310883130 CDM 88313 CPT 310 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERIODIC ACID-SCHIFF (PAS) ST PX-310883131 CDM 88313 CPT 310 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MASSONS TRICHROME ST FOR CONN TS PX-310883132 CDM 88313 CPT 310 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC JONES METHENAMINE SILVE ST PX-310883133 CDM 88313 CPT 310 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PUCHTLERS MOD BENNHOLDS ST PX-310883134 CDM 88313 CPT 310 RC outpatient 28 27.44 All Payors / Plans All Payors / Plans 28 other 28 28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FROZEN SECTION PX-310883310 CDM 88331 CPT 310 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ADD'L FROZEN SECTION PX-310883320 CDM 88332 CPT 310 RC outpatient 15 14.7 All Payors / Plans All Payors / Plans 15 other 15 15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TOUCH PREP PX-310883330 CDM 88333 CPT 310 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ADDITIONAL TOUCH PREP PX-310883340 CDM 88334 CPT 310 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMMUNOPEROXIDASE STAIN ADDL PX-310883410 CDM 88341 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG1 IMMUNOFLUO STAIN RENAL PX-310883411 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMMUNOPEROXIDASE STAIN PX-310883420 CDM 88342 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG IMMUNOSTAIN PX-310883421 CDM 88342 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC IMMUNOHISTOCHEMISTRY, EACH ANTIBODY" PX-310883422 CDM 88342 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMMUNOFLUORESCENCE PX-310883460 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG2 IMMUNOFLUO STAIN RENAL PX-310883461 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG3 IMMUNOFLUO STAIN RENAL PX-310883462 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG4 IMMUNOFLUO STAIN RENAL PX-310883463 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C1Q PARAFFIN IMMUNOFLUO STAIN PX-310883464 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGA PARAFFIN IMMUNOFLUO STAIN PX-310883465 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGG PARAFFIN IMMUNOFLUO STAIN PX-310883466 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IGM PARAFFIN IMMUNOFLUO STAIN PX-310883467 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KAPPA PARAFFIN IMMUNOFLUO STAIN PX-310883468 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LAMBDA PARAFFIN IMMUNOFLUOR STAIN PX-310883469 CDM 88346 CPT 310 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RENAL BIOPSY ELECTRON MICROSCOPY PX-310883480 CDM 88348 CPT 310 RC outpatient 1142 1119.16 All Payors / Plans All Payors / Plans 1142 other 1142 1142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EACH ADD'L SINGLE ANTIBODY STAIN PX-310883500 CDM 88350 CPT 310 RC outpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MUSCLE BIOPSY PX-310883550 CDM 88355 CPT 310 RC outpatient 1142 1119.16 All Payors / Plans All Payors / Plans 1142 other 1142 1142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NERVE BX PX-310883560 CDM 88356 CPT 310 RC outpatient 1142 1119.16 All Payors / Plans All Payors / Plans 1142 other 1142 1142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TUMOR IHC QUANT OR SEMI QUANT, EA ANTIBODY" PX-310883600 CDM 88360 CPT 312 RC outpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IHC ANTIBODY VIA IMAGE ANALYSIS PX-310883610 CDM 88361 CPT 310 RC outpatient 257 251.86 All Payors / Plans All Payors / Plans 257 other 257 257 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IN SITU HYBIRD (FISH) EA ADD SING PROBE PX-310883641 CDM 88364 CPT 310 RC outpatient 914 895.72 All Payors / Plans All Payors / Plans 914 other 914 914 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TISSUE IN-SITU HYBRIDIZATION PX-310883650 CDM 88365 CPT 312 RC outpatient 914 895.72 All Payors / Plans All Payors / Plans 914 other 914 914 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HER-2 FISH BY CLARIENT PX-310883740 CDM 88374 CPT 310 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC M/PHMTRC ALSY ISH QUANT/SEMIQ CPTR EA MULTIPRB PX-310883741 CDM 88374 CPT 310 RC outpatient 729 714.42 All Payors / Plans All Payors / Plans 729 other 729 729 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MICRODISSECTION MANUAL-GLOB PX-310883814 CDM 88381 CPT 310 RC outpatient 158 154.84 All Payors / Plans All Payors / Plans 158 other 158 158 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MICRODISSECTION MANUAL-INTER PX-310883815 CDM 88381 CPT 310 RC outpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOLOGY THIN PREP SCREENING PX-311001230 CDM G0123 CPT 311 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOLOGY SELECT ENHANCEMENT PX-311881120 CDM 88112 CPT 311 RC outpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOLOGY THIN PREP MANUAL PX-311881420 CDM 88142 CPT 311 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOLOGY PX-311881640 CDM 88164 CPT 311 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYTOLOGY AUTO THIN PREP SCREEN PX-311881750 CDM 88175 CPT 311 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CUTANEOUS IMMUNOFLUORESCE BIOPSY PX-314883460 CDM 88346 CPT 314 RC outpatient 857 839.86 All Payors / Plans All Payors / Plans 857 other 857 857 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SI JOINT INJECT W ANESTH PX-320270960 CDM 27096 CPT 320 RC outpatient 682 668.36 All Payors / Plans All Payors / Plans 682 other 682 682 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INJECT CONTRAST KNEE ARTHORGR PX-320273700 CDM 27369 CPT 320 RC outpatient 682 668.36 All Payors / Plans All Payors / Plans 682 other 682 682 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR FL NG TUBE PLACEMENT PX-320437520 CDM 43752 CPT 320 RC outpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC T-TUBE CHOLANGIOGRAM PX-320475310 CDM 47531 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR T TUBE CHOLANGIOG NEW ACCESS PX-320475320 CDM 47532 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR FL CECUM TUBE PLACEMENT PX-320494420 CDM 49442 CPT 320 RC outpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ORBIT-FOREIGN BODY PX-320700300 CDM 70030 CPT 320 RC outpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MANDIBLE PX-320701100 CDM 70110 CPT 320 RC outpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FACIAL BONES PX-320701400 CDM 70140 CPT 320 RC outpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FACIAL BONES PX-320701500 CDM 70150 CPT 320 RC outpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NOSE-NASAL BONES PX-320701600 CDM 70160 CPT 320 RC outpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ORBIT-FRACTURE PX-320702000 CDM 70200 CPT 320 RC outpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SINUSES PX-320702100 CDM 70210 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SINUSES PX-320702200 CDM 70220 CPT 320 RC outpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SELLA TURCICA PX-320702400 CDM 70240 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SKULL < 4 VIEWS PX-320702500 CDM 70250 CPT 320 RC outpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SKULL - COMPLETE MIN 4 VIEWS PX-320702600 CDM 70260 CPT 320 RC outpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR TEETH SINGLE VIEW PX-320703000 CDM 70300 CPT 320 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR TEETH PARTIAL < FULL MOUTH PX-320703100 CDM 70310 CPT 320 RC outpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR TEETH COMPLETE FULL MOUTH PX-320703200 CDM 70320 CPT 320 RC outpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TM JOINTS - UNILATERAL PX-320703280 CDM 70328 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TM JOINTS - BILATERAL PX-320703300 CDM 70330 CPT 320 RC outpatient 284 278.32 All Payors / Plans All Payors / Plans 284 other 284 284 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PANOREX PX-320703550 CDM 70355 CPT 320 RC outpatient 85 83.3 All Payors / Plans All Payors / Plans 85 other 85 85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SOFT TISSUES OF NECK PX-320703600 CDM 70360 CPT 320 RC outpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SIALIOGRAM PX-320703900 CDM 70390 CPT 320 RC outpatient 3285 3219.3 All Payors / Plans All Payors / Plans 3285 other 3285 3285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEST SINGLE AP VIEW PX-320710100 CDM 71045 CPT 320 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEST 2 VIEWS PX-320710200 CDM 71046 CPT 320 RC outpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APICAL LORDOTIC CHEST PX-320710210 CDM 71021 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEST & OBLIQUES PX-320710220 CDM 71022 CPT 324 RC outpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEST-DECUBITUS PX-320710350 CDM 71048 CPT 320 RC outpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RIBS PX-320711000 CDM 71100 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RIBS WITH CHEST PX-320711010 CDM 71101 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RIBS BILATERAL WITH CHEST PX-320711110 CDM 71111 CPT 320 RC outpatient 256 250.88 All Payors / Plans All Payors / Plans 256 other 256 256 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STERNUM PX-320711200 CDM 71120 CPT 320 RC outpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STERNO-CLAVICULAR JT PX-320711300 CDM 71130 CPT 320 RC outpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPINE 1 VIEW PX-320720200 CDM 72020 CPT 320 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR C SPINE 3 VIEWS OR LESS PX-320720400 CDM 72040 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR C SPINE 4 OR 5 VIEWS PX-320720500 CDM 72050 CPT 320 RC outpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR C-SPINE 6 OR MORE VIEWS PX-320720520 CDM 72052 CPT 320 RC outpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THORACIC SPINE 2 VIEWS PX-320720700 CDM 72070 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THORACIC SPINE 3 VIEWS PX-320720720 CDM 72072 CPT 320 RC outpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPINE-THORACOLUMBAR PX-320720800 CDM 72080 CPT 320 RC outpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SCOLIOSIS SERIES PX-320720810 CDM 72081 CPT 320 RC outpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR THOR & LUM SPINE PORT 1 VIEW PX-320720811 CDM 72081 CPT 320 RC outpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR SCOLIOSIS SERIES 2-3 VIEW PX-320720820 CDM 72082 CPT 320 RC outpatient 370 362.6 All Payors / Plans All Payors / Plans 370 other 370 370 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR PORT THOR/LUMB SPINE 2-3 VIEW PX-320720821 CDM 72082 CPT 320 RC outpatient 370 362.6 All Payors / Plans All Payors / Plans 370 other 370 370 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR SCOLIOSIS SERIES 4-5 VIEW PX-320720830 CDM 72083 CPT 320 RC outpatient 398 390.04 All Payors / Plans All Payors / Plans 398 other 398 398 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR SCOLIOSIS SERIES MIN 6 VIEW PX-320720840 CDM 72084 CPT 320 RC outpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LUMBAR SPINE 2 VIEWS PX-320721000 CDM 72100 CPT 320 RC outpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LUMBAR SPINE MIN 4 VIEWS PX-320721100 CDM 72110 CPT 320 RC outpatient 256 250.88 All Payors / Plans All Payors / Plans 256 other 256 256 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LUMBAR SPINE 6 VIEW W BEND PX-320721140 CDM 72114 CPT 320 RC outpatient 370 362.6 All Payors / Plans All Payors / Plans 370 other 370 370 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LUMB SPINE BENDING VIEWS 2 OR 3 PX-320721200 CDM 72120 CPT 320 RC outpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PELVIS PX-320721700 CDM 72170 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SACRO-ILIAC JOINTS PX-320722020 CDM 72202 CPT 320 RC outpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SACRUM AND/OR COCCYX PX-320722200 CDM 72220 CPT 320 RC outpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CERVICAL MYELOGRAM PX-320722400 CDM 62302 CPT 361 RC outpatient 3796 3720.08 All Payors / Plans All Payors / Plans 3796 other 3796 3796 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THORACIC MYELOGRAM PX-320722550 CDM 72255 CPT 320 RC outpatient 3796 3720.08 All Payors / Plans All Payors / Plans 3796 other 3796 3796 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LUMBAR MYELOGRAM PX-320722650 CDM 62304 CPT 361 RC outpatient 3358 3290.84 All Payors / Plans All Payors / Plans 3358 other 3358 3358 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MYELOGRAM, COMPLETE" PX-320722700 CDM 72270 CPT 320 RC outpatient 6497 6367.06 All Payors / Plans All Payors / Plans 6497 other 6497 6497 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR EPIDUROGRAPHY PX-320722750 CDM 72275 CPT 320 RC outpatient 365 357.7 All Payors / Plans All Payors / Plans 365 other 365 365 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CLAVICLE PX-320730000 CDM 73000 CPT 320 RC outpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SCAPULA PX-320730100 CDM 73010 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SHOULDER PX-320730300 CDM 73030 CPT 320 RC outpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SHOULDER ARTHROGRAM PX-320730400 CDM 73040 CPT 322 RC outpatient 1095 1073.1 All Payors / Plans All Payors / Plans 1095 other 1095 1095 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACROMIO-CLAV JOINTS PX-320730500 CDM 73050 CPT 320 RC outpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HUMERUS PX-320730600 CDM 73060 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ELBOW PX-320730700 CDM 73070 CPT 320 RC outpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ELBOW 3 VIEWS PX-320730800 CDM 73080 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ELBOW ARTHROGRAM PX-320730850 CDM 73085 CPT 320 RC outpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FOREARM PX-320730900 CDM 73090 CPT 320 RC outpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WRIST W 20 DEGREE ELEVATION 2 VIE PX-320731000 CDM 73100 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WRIST 3 VIEW PX-320731100 CDM 73110 CPT 320 RC outpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WRIST ARTHORGRAM PX-320731150 CDM 73115 CPT 320 RC outpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HAND PX-320731200 CDM 73120 CPT 320 RC outpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC XR HAND, 3 VIEWS" PX-320731300 CDM 73130 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FINGER PX-320731400 CDM 73140 CPT 320 RC outpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HIP FOR PROGRESS, 1 VIEW" PX-320735010 CDM 73501 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC HIP FOR FX, 2 OR 3 VIEWS" PX-320735020 CDM 73502 CPT 320 RC outpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PELVIS/HIPS PX-320735230 CDM 73523 CPT 320 RC outpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR HIP ARTHROGRAM PX-320735250 CDM 73525 CPT 320 RC outpatient 1095 1073.1 All Payors / Plans All Payors / Plans 1095 other 1095 1095 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR FEMUR (1)VIEW PX-320735510 CDM 73551 CPT 320 RC outpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FEMUR PX-320735520 CDM 73552 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KNEE PX-320735600 CDM 73560 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KNEE COMPLETE PX-320735640 CDM 73564 CPT 320 RC outpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KNEES WEIGHT BEAR BOTH PX-320735650 CDM 73565 CPT 320 RC outpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARTHROGRAM KNEE PX-320735800 CDM 73580 CPT 320 RC outpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LEG PX-320735900 CDM 73590 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANKLE PX-320736000 CDM 73600 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC XR ANKLE, 3 VIEWS" PX-320736100 CDM 73610 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARTHROGRAM ANKLE PX-320736150 CDM 73615 CPT 320 RC outpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FOOT PX-320736200 CDM 73620 CPT 320 RC outpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR FOOT 3 VIEWS PX-320736300 CDM 73630 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEEL BRODENS VIEW 4 VIEWS PX-320736500 CDM 73650 CPT 320 RC outpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TOE PX-320736600 CDM 73660 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ABDOMEN SINGLE VIEW PX-320740000 CDM 74018 CPT 320 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ABDOMEN 2 VIEWS PX-320740200 CDM 74019 CPT 320 RC outpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACUTE ABD MULTIVIEWS W 1 VIEW CXR PX-320740220 CDM 74022 CPT 320 RC outpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CERVICAL ESOPHAGUS W SCOUT/DELAYED W CONTRAST PX-320742100 CDM 74210 CPT 320 RC outpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ESOPHAGUS SINGLE CONTRAST INC. SCOUT CHEST/DELAYED IMAGES PX-320742200 CDM 74220 CPT 320 RC outpatient 512 501.76 All Payors / Plans All Payors / Plans 512 other 512 512 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ESOPHAGUS DOUBLE CONTRAST PX-320742210 CDM 74221 CPT 320 RC outpatient 512 501.76 All Payors / Plans All Payors / Plans 512 other 512 512 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MODIFIED BARIUM SWALLOW W SCOUT/DELAYED IMAGES PX-320742300 CDM 74230 CPT 320 RC outpatient 796 780.08 All Payors / Plans All Payors / Plans 796 other 796 796 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GASTROGRAFIN GI W SCOUT W/WO DELAYED IMAGES PX-320742400 CDM 74240 CPT 320 RC outpatient 625 612.5 All Payors / Plans All Payors / Plans 625 other 625 625 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR SM BOWEL SITZMARKER PX-320742450 CDM 74248 CPT 320 RC outpatient 995 975.1 All Payors / Plans All Payors / Plans 995 other 995 995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UGI DOUBLE CONTRAST PX-320742460 CDM 74246 CPT 320 RC outpatient 739 724.22 All Payors / Plans All Payors / Plans 739 other 739 739 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UPPER GI SERIES PX-320742470 CDM 74246 CPT 320 RC outpatient 739 724.22 All Payors / Plans All Payors / Plans 739 other 739 739 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UGI/SMALL BOWEL PX-320742490 CDM 74248 CPT 320 RC outpatient 995 975.1 All Payors / Plans All Payors / Plans 995 other 995 995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SMALL BOWEL SERIES W SCOUT/SINGLE CONTRAST PX-320742500 CDM 74250 CPT 320 RC outpatient 625 612.5 All Payors / Plans All Payors / Plans 625 other 625 625 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR SM B SERIES VIA ENTEROCLYSIS TUBE PX-320742510 CDM 74251 CPT 320 RC outpatient 3070 3008.6 All Payors / Plans All Payors / Plans 3070 other 3070 3070 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BARIUM ENEMA SINGLE CONTRAST W SCOUT/DELAYED IMAGES PX-320742700 CDM 74270 CPT 320 RC outpatient 910 891.8 All Payors / Plans All Payors / Plans 910 other 910 910 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BARIUM ENEMA W/AIR DOUBELE CONTRAST W SCOUT/DELAYED IMAGES PX-320742800 CDM 74280 CPT 320 RC outpatient 1308 1281.84 All Payors / Plans All Payors / Plans 1308 other 1308 1308 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPER CHOLANGIOGRM PX-320743000 CDM 74300 CPT 320 RC outpatient 2190 2146.2 All Payors / Plans All Payors / Plans 2190 other 2190 2190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPER CHOLAGIOGRAM ADDITIONAL IMAGES PX-320743010 CDM 74301 CPT 320 RC outpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IV PYLEOGRAMS PX-320744000 CDM 74400 CPT 320 RC outpatient 3869 3791.62 All Payors / Plans All Payors / Plans 3869 other 3869 3869 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RETRO PYLEOGRAM PX-320744200 CDM 74420 CPT 320 RC outpatient 881 863.38 All Payors / Plans All Payors / Plans 881 other 881 881 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC UROGRAPHY ANTEGRADE, RAD SUP & INTERPRETATION" PX-320744250 CDM 74425 CPT 320 RC outpatient 2190 2146.2 All Payors / Plans All Payors / Plans 2190 other 2190 2190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CYSTOGRAM PX-320744300 CDM 74430 CPT 320 RC outpatient 3723 3648.54 All Payors / Plans All Payors / Plans 3723 other 3723 3723 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URETHROGRAM PX-320744550 CDM 74455 CPT 320 RC outpatient 1679 1645.42 All Payors / Plans All Payors / Plans 1679 other 1679 1679 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR HYSTEROSALPINGOGRAM PX-320747400 CDM 74740 CPT 320 RC outpatient 2409 2360.82 All Payors / Plans All Payors / Plans 2409 other 2409 2409 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SHUNT SERIES PX-320758090 CDM 75809 CPT 320 RC outpatient 292 286.16 All Payors / Plans All Payors / Plans 292 other 292 292 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VENOGRAM PX-320758200 CDM 75820 CPT 320 RC outpatient 365 357.7 All Payors / Plans All Payors / Plans 365 other 365 365 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUORO ONLY-UP TO 1 HR PX-320760000 CDM 76000 CPT 320 RC outpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FOREIGN BODY LOCALIZATION PX-320760100 CDM 76010 CPT 320 RC outpatient 142 139.16 All Payors / Plans All Payors / Plans 142 other 142 142 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SINUS TRACT INJECTION PX-320760800 CDM 76080 CPT 320 RC outpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR FLUO CONTRAST LARYNOGOGRAPHY PX-320764992 CDM 76499 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLURO GUIDE NEEDLE PLACEMENT PX-320770020 CDM 77002 CPT 320 RC outpatient 3504 3433.92 All Payors / Plans All Payors / Plans 3504 other 3504 3504 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FOOT ARTHROGRAM PX-320770021 CDM 77002 CPT 320 RC outpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TOE ARTHROGRAM PX-320770022 CDM 77002 CPT 320 RC outpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR EPIDUR DIAG/THER INJ ONLY PX-320770030 CDM 77003 CPT 320 RC outpatient 365 357.7 All Payors / Plans All Payors / Plans 365 other 365 365 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE AGE SURVEY PX-320770720 CDM 77072 CPT 320 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SCANOGRAM PX-320770730 CDM 77073 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LONG BONE SURVEY PX-320770740 CDM 77074 CPT 320 RC outpatient 341 334.18 All Payors / Plans All Payors / Plans 341 other 341 341 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC METASTATIC BONE SURVEY PX-320770750 CDM 77075 CPT 320 RC outpatient 341 334.18 All Payors / Plans All Payors / Plans 341 other 341 341 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE SURVEY COMPLETE PX-320770755 CDM 77075 CPT 320 RC outpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFANT OSSEOUS SURVEY PX-320770760 CDM 77076 CPT 320 RC outpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE SURVEY JOINT 2 OR MORE PX-320770770 CDM 77077 CPT 320 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CHEMO,SUBQ/INTRA NON HOR ANTI NEO" PX-331964010 CDM 96401 CPT 331 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMO SUBQ/INTRA HOR ANTI NEO PX-331964020 CDM 96402 CPT 331 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMO ADMIN IV PUSH-SINGL/INITIAL PX-331964090 CDM 96409 CPT 331 RC outpatient 330 323.4 All Payors / Plans All Payors / Plans 330 other 330 330 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMO ADMIN IV PUSH-EACH ADD DRUG PX-331964110 CDM 96411 CPT 331 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SIMULATION, SIMPLE" PX-333772800 CDM 77280 CPT 333 RC outpatient 915 896.7 All Payors / Plans All Payors / Plans 915 other 915 915 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SIMULATION SIMPLE INITIAL PX-333772801 CDM 77280 CPT 333 RC outpatient 915 896.7 All Payors / Plans All Payors / Plans 915 other 915 915 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SIMULATION, INTERMEDIATE" PX-333772850 CDM 77285 CPT 333 RC outpatient 1441 1412.18 All Payors / Plans All Payors / Plans 1441 other 1441 1441 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC SIMULATION, COMPLEX" PX-333772900 CDM 77290 CPT 333 RC outpatient 1663 1629.74 All Payors / Plans All Payors / Plans 1663 other 1663 1663 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RESPIRATORY MOTION MGMT PX-333772930 CDM 77293 CPT 333 RC outpatient 1400 1372 All Payors / Plans All Payors / Plans 1400 other 1400 1400 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC 3D TREATMENT PLANNING PX-333772950 CDM 77295 CPT 333 RC outpatient 1026 1005.48 All Payors / Plans All Payors / Plans 1026 other 1026 1026 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BASIC DOSIMETRY CALC PX-333773000 CDM 77300 CPT 333 RC outpatient 125 122.5 All Payors / Plans All Payors / Plans 125 other 125 125 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMRT PLAN PX-333773010 CDM 77301 CPT 333 RC outpatient 5891 5773.18 All Payors / Plans All Payors / Plans 5891 other 5891 5891 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPUTER ISODOSE-SIMPLE PX-333773060 CDM 77306 CPT 333 RC outpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPUTER ISODOSE-COMPLEX PX-333773070 CDM 77307 CPT 333 RC outpatient 513 502.74 All Payors / Plans All Payors / Plans 513 other 513 513 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRACHY THERAPY DOS-SIMPLE PX-333773160 CDM 77316 CPT 333 RC outpatient 444 435.12 All Payors / Plans All Payors / Plans 444 other 444 444 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRACHY THERAPY DOS-INT PX-333773170 CDM 77317 CPT 333 RC outpatient 568 556.64 All Payors / Plans All Payors / Plans 568 other 568 568 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRACHY THERAPY DOS-COMP PX-333773180 CDM 77318 CPT 333 RC outpatient 776 760.48 All Payors / Plans All Payors / Plans 776 other 776 776 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPECIAL BEAM PLAN PX-333773210 CDM 77321 CPT 333 RC outpatient 166 162.68 All Payors / Plans All Payors / Plans 166 other 166 166 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPECIAL DOSIMETRY/TLD/MDM PX-333773310 CDM 77331 CPT 333 RC outpatient 69 67.62 All Payors / Plans All Payors / Plans 69 other 69 69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TREATMENT DEVICES-SIMPLE PX-333773320 CDM 77332 CPT 333 RC outpatient 208 203.84 All Payors / Plans All Payors / Plans 208 other 208 208 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TREATMENT DEVICES-INTERM. PX-333773330 CDM 77333 CPT 333 RC outpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TREATMENT DEVICES-COMPLEX PX-333773340 CDM 77334 CPT 333 RC outpatient 347 340.06 All Payors / Plans All Payors / Plans 347 other 347 347 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PHYSICS, CONSULT., CONT." PX-333773360 CDM 77336 CPT 333 RC outpatient 291 285.18 All Payors / Plans All Payors / Plans 291 other 291 291 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DESIGN MLC DEVICE FOR IMRT PX-333773380 CDM 77338 CPT 333 RC outpatient 1095 1073.1 All Payors / Plans All Payors / Plans 1095 other 1095 1095 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PHYSICS CONSULTATION PX-333773700 CDM 77370 CPT 333 RC outpatient 444 435.12 All Payors / Plans All Payors / Plans 444 other 444 444 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TREATMENT DELIVERY SRS LINEAR PX-333773720 CDM 77372 CPT 333 RC outpatient 4116 4033.68 All Payors / Plans All Payors / Plans 4116 other 4116 4116 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SBRT TREATMENT DELIVERY PER FRAC PX-333773730 CDM 77373 CPT 333 RC outpatient 5225 5120.5 All Payors / Plans All Payors / Plans 5225 other 5225 5225 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMRT TREATMENTS SIMPLE PX-333773850 CDM 77385 CPT 333 RC outpatient 1552 1520.96 All Payors / Plans All Payors / Plans 1552 other 1552 1552 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IMRT TREATMENTS COMPLEX PX-333773860 CDM 77386 CPT 333 RC outpatient 1552 1520.96 All Payors / Plans All Payors / Plans 1552 other 1552 1552 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STEREOSCOPIC GUIDE VOL RAD THER PX-333773870 CDM 77387 CPT 333 RC outpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT SCAN FOR THERAPY GUIDE PX-333773871 CDM 77387 CPT 333 RC outpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRMT DELIVERY =>1 MEV, SIMPLE" PX-333774020 CDM 77402 CPT 333 RC outpatient 624 611.52 All Payors / Plans All Payors / Plans 624 other 624 624 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRMT DELIVERY =>1MEV INTERMEDIATE PX-333774070 CDM 77407 CPT 333 RC outpatient 998 978.04 All Payors / Plans All Payors / Plans 998 other 998 998 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRMT DELIVERY =>1MEV, COMPLEX" PX-333774120 CDM 77412 CPT 333 RC outpatient 1067 1045.66 All Payors / Plans All Payors / Plans 1067 other 1067 1067 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PORT FILMS PX-333774170 CDM 77417 CPT 333 RC outpatient 42 41.16 All Payors / Plans All Payors / Plans 42 other 42 42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPECIAL TREATMENT PROCEDURE PX-333774700 CDM 77470 CPT 333 RC outpatient 180 176.4 All Payors / Plans All Payors / Plans 180 other 180 180 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTERCAV. RADIOLEM. SIMPLE PX-333777610 CDM 77761 CPT 333 RC outpatient 735 720.3 All Payors / Plans All Payors / Plans 735 other 735 735 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTERCAV. RADIOLEM. INTER PX-333777620 CDM 77762 CPT 333 RC outpatient 845 828.1 All Payors / Plans All Payors / Plans 845 other 845 845 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTERCAV. RADIOLEM. COMPLEX PX-333777630 CDM 77763 CPT 333 RC outpatient 1095 1073.1 All Payors / Plans All Payors / Plans 1095 other 1095 1095 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HIGH DOSE RATE BRACHYTHERAPY 1CH PX-333777700 CDM 77770 CPT 333 RC outpatient 638 625.24 All Payors / Plans All Payors / Plans 638 other 638 638 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HIGH DOSE RATE BRACHYTHERAPY 2-12 PX-333777710 CDM 77771 CPT 333 RC outpatient 1247 1222.06 All Payors / Plans All Payors / Plans 1247 other 1247 1247 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HIGH DOSE RATE BRACHYTHERAPY >12 PX-333777720 CDM 77772 CPT 333 RC outpatient 2037 1996.26 All Payors / Plans All Payors / Plans 2037 other 2037 2037 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INTERSTITIAL, SIMPLE" PX-333777760 CDM 77776 CPT 333 RC outpatient 887 869.26 All Payors / Plans All Payors / Plans 887 other 887 887 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INTERSTITIAL, INTERMEDIATE" PX-333777770 CDM 77777 CPT 333 RC outpatient 748 733.04 All Payors / Plans All Payors / Plans 748 other 748 748 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC INTERSTITIAL, COMPLEX" PX-333777780 CDM 77778 CPT 333 RC outpatient 1109 1086.82 All Payors / Plans All Payors / Plans 1109 other 1109 1109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRACHY TREATMENT HANDLING-LOAD PX-333777900 CDM 77790 CPT 333 RC outpatient 166 162.68 All Payors / Plans All Payors / Plans 166 other 166 166 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMO ADMIN BY INFUSION 0-1 HR PX-335964130 CDM 96413 CPT 335 RC outpatient 594 582.12 All Payors / Plans All Payors / Plans 594 other 594 594 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMO ADMIN BY INFUS EA ADD 1HR PX-335964150 CDM 96415 CPT 335 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMO ADMIN BY INFUSE PROL W PUMP PX-335964160 CDM 96416 CPT 335 RC outpatient 594 582.12 All Payors / Plans All Payors / Plans 594 other 594 594 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMO ADMIN BY INFUSE EA ADDL SEQ PX-335964170 CDM 96417 CPT 335 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMOTX ADMN IA NFS >8 HR PRTBLE IMPLTBL PMP PX-335964250 CDM 96425 CPT 335 RC outpatient 594 582.12 All Payors / Plans All Payors / Plans 594 other 594 594 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC REFILLING & MAINTENANCE PORTABLE PUMP PX-335965210 CDM 96521 CPT 335 RC outpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC REFILL&MAINTENANCE PUMP DRUG DLVR SYSTEMIC PX-335965220 CDM 96522 CPT 335 RC outpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONCURRENT CHEMO INFUSION PX-335965490 CDM 96549 CPT 335 RC outpatient 33 32.34 All Payors / Plans All Payors / Plans 33 other 33 33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMO EXTEND IV INFUS W/PUMP PX-335G04980 CDM G0498 CPT 335 RC outpatient 594 582.12 All Payors / Plans All Payors / Plans 594 other 594 594 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROID UPTAKE SING/MUL QM PX-340780120 CDM 78012 CPT 340 RC outpatient 437 428.26 All Payors / Plans All Payors / Plans 437 other 437 437 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROID SCAN PX-340780130 CDM 78013 CPT 340 RC outpatient 1040 1019.2 All Payors / Plans All Payors / Plans 1040 other 1040 1040 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROID IMAG SING/MUL QM PX-340780140 CDM 78014 CPT 340 RC outpatient 1310 1283.8 All Payors / Plans All Payors / Plans 1310 other 1310 1310 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROID CA METS-WHOLE BODY PX-340780180 CDM 78018 CPT 340 RC outpatient 1643 1610.14 All Payors / Plans All Payors / Plans 1643 other 1643 1643 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARATHYROID PLANAR INC SUBTR PX-340780700 CDM 78070 CPT 340 RC outpatient 1581 1549.38 All Payors / Plans All Payors / Plans 1581 other 1581 1581 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARATHYROID SCAN W SPECT PX-340780710 CDM 78071 CPT 340 RC outpatient 1810 1773.8 All Payors / Plans All Payors / Plans 1810 other 1810 1810 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARATHYROID SCAN W SPECT & CT PX-340780720 CDM 78072 CPT 340 RC outpatient 2038 1997.24 All Payors / Plans All Payors / Plans 2038 other 2038 2038 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NM BONE MARROW IMAGING, WHOLE BODY" PX-340781040 CDM 78104 CPT 340 RC outpatient 1269 1243.62 All Payors / Plans All Payors / Plans 1269 other 1269 1269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LYMPHATICS AND LYMPH NODE IMAGING PX-340781950 CDM 78195 CPT 340 RC outpatient 1810 1773.8 All Payors / Plans All Payors / Plans 1810 other 1810 1810 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC LIVER IMAGING, STATIC ONLY" PX-340782010 CDM 78201 CPT 340 RC outpatient 1019 998.62 All Payors / Plans All Payors / Plans 1019 other 1019 1019 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LIVER IMAGE W VASCULAR FLOW PX-340782020 CDM 78202 CPT 340 RC outpatient 1082 1060.36 All Payors / Plans All Payors / Plans 1082 other 1082 1082 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM LIVER IMAGING SPECT PX-340782050 CDM 78803 CPT 340 RC outpatient 1768 1732.64 All Payors / Plans All Payors / Plans 1768 other 1768 1768 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LIVER IMAGING (SPECT) W VASC FLOW PX-340782060 CDM 78202 CPT 340 RC outpatient 1082 1060.36 All Payors / Plans All Payors / Plans 1082 other 1082 1082 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LIVER/SPLEEN STATIC ONLY PX-340782150 CDM 78215 CPT 340 RC outpatient 1040 1019.2 All Payors / Plans All Payors / Plans 1040 other 1040 1040 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEPABILRY SYS IMAG INC GALLBLADDER PX-340782260 CDM 78226 CPT 340 RC outpatient 1789 1753.22 All Payors / Plans All Payors / Plans 1789 other 1789 1789 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEPABILRY SYS IMAG W PHARMA PX-340782270 CDM 78227 CPT 340 RC outpatient 2454 2404.92 All Payors / Plans All Payors / Plans 2454 other 2454 2454 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM ESOPHAGEAL MOTILITY PX-340782580 CDM 78258 CPT 340 RC outpatient 1144 1121.12 All Payors / Plans All Payors / Plans 1144 other 1144 1144 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GASTROESOPHAGEAL REFLUX PX-340782620 CDM 78262 CPT 340 RC outpatient 1269 1243.62 All Payors / Plans All Payors / Plans 1269 other 1269 1269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM GI GASTRIC EMPTY IMAGE STUDY PX-340782640 CDM 78264 CPT 340 RC outpatient 1810 1773.8 All Payors / Plans All Payors / Plans 1810 other 1810 1810 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM GI GASTRIC W SM BOWEL TRANSIT PX-340782650 CDM 78265 CPT 340 RC outpatient 2122 2079.56 All Payors / Plans All Payors / Plans 2122 other 2122 2122 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NM GI GASTRIC SM BOWEL, COLON MULTI DAYS" PX-340782660 CDM 78266 CPT 340 RC outpatient 2558 2506.84 All Payors / Plans All Payors / Plans 2558 other 2558 2558 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACUTE GI BLOOD LOSS PX-340782780 CDM 78278 CPT 340 RC outpatient 1830 1793.4 All Payors / Plans All Payors / Plans 1830 other 1830 1830 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BOWEL SCAN-MECKELS PX-340782900 CDM 78290 CPT 340 RC outpatient 1810 1773.8 All Payors / Plans All Payors / Plans 1810 other 1810 1810 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERITONEAL VENOUS SHUNT PX-340782910 CDM 78291 CPT 340 RC outpatient 1290 1264.2 All Payors / Plans All Payors / Plans 1290 other 1290 1290 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC UNLIST GI PROC HEPAT/GI BLD LOSS PX-340782990 CDM 78299 CPT 340 RC outpatient 229 224.42 All Payors / Plans All Payors / Plans 229 other 229 229 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE SCAN-LIMITED PX-340783000 CDM 78300 CPT 341 RC outpatient 915 896.7 All Payors / Plans All Payors / Plans 915 other 915 915 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE SCAN-WHOLE BODY PX-340783060 CDM 78306 CPT 340 RC outpatient 1269 1243.62 All Payors / Plans All Payors / Plans 1269 other 1269 1269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC 3 PHASE BONE SCAN PX-340783150 CDM 78315 CPT 340 RC outpatient 1810 1773.8 All Payors / Plans All Payors / Plans 1810 other 1810 1810 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE SPECT PX-340783200 CDM 78803 CPT 340 RC outpatient 1768 1732.64 All Payors / Plans All Payors / Plans 1768 other 1768 1768 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYOCARDIAL PERF-SPECT/SINGLE PX-340784510 CDM 78451 CPT 341 RC outpatient 1664 1630.72 All Payors / Plans All Payors / Plans 1664 other 1664 1664 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYOCARDIAL PERF-SPECT/MULTI PX-340784520 CDM 78452 CPT 340 RC outpatient 2392 2344.16 All Payors / Plans All Payors / Plans 2392 other 2392 2392 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MUGA-SINGLE STUDY PX-340784720 CDM 78472 CPT 340 RC outpatient 1102 1079.96 All Payors / Plans All Payors / Plans 1102 other 1102 1102 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM PULM VENT IMAG AEROSOL-GAS PX-340785790 CDM 78579 CPT 340 RC outpatient 978 958.44 All Payors / Plans All Payors / Plans 978 other 978 978 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULM PERFUSION PARTICULATE PX-340785800 CDM 78580 CPT 340 RC outpatient 1227 1202.46 All Payors / Plans All Payors / Plans 1227 other 1227 1227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM PULMONARY VENT PERFUSION IMAG PX-340785820 CDM 78582 CPT 340 RC outpatient 1706 1671.88 All Payors / Plans All Payors / Plans 1706 other 1706 1706 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM PULMON PERFUSION QUAN DIFF PX-340785970 CDM 78597 CPT 340 RC outpatient 1019 998.62 All Payors / Plans All Payors / Plans 1019 other 1019 1019 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM PULMON PERFUSION VENT QUAN DIF PX-340785980 CDM 78598 CPT 340 RC outpatient 1602 1569.96 All Payors / Plans All Payors / Plans 1602 other 1602 1602 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRAIN SCAN <4 VIEWS W VASC FLOW PX-340786010 CDM 78601 CPT 340 RC outpatient 1144 1121.12 All Payors / Plans All Payors / Plans 1144 other 1144 1144 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRAIN SCAN W VASCULAR FLOW PX-340786060 CDM 78606 CPT 340 RC outpatient 1810 1773.8 All Payors / Plans All Payors / Plans 1810 other 1810 1810 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRAIN SPECT PX-340786070 CDM 78803 CPT 340 RC outpatient 1768 1732.64 All Payors / Plans All Payors / Plans 1768 other 1768 1768 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CEREBROSPINAL FLUID FLOW PX-340786300 CDM 78630 CPT 340 RC outpatient 1851 1813.98 All Payors / Plans All Payors / Plans 1851 other 1851 1851 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CNS SHUNT EVALUATION PX-340786450 CDM 78645 CPT 340 RC outpatient 1810 1773.8 All Payors / Plans All Payors / Plans 1810 other 1810 1810 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CSF LEAK PX-340786500 CDM 78650 CPT 340 RC outpatient 1830 1793.4 All Payors / Plans All Payors / Plans 1830 other 1830 1830 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KIDNEY IMAG STATIC ONLY PX-340787000 CDM 78700 CPT 340 RC outpatient 915 896.7 All Payors / Plans All Payors / Plans 915 other 915 915 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM KIDNEY STATIC SCAN W/VASC FLOW PX-340787010 CDM 78701 CPT 340 RC outpatient 1144 1121.12 All Payors / Plans All Payors / Plans 1144 other 1144 1144 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM KIDNEY SCAN-VAS FLOW/FUNCT W/O PX-340787070 CDM 78707 CPT 340 RC outpatient 1123 1100.54 All Payors / Plans All Payors / Plans 1123 other 1123 1123 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KIDNEY IMAG-VASC FLOW/FUN W 1PHAR PX-340787080 CDM 78708 CPT 340 RC outpatient 707 692.86 All Payors / Plans All Payors / Plans 707 other 707 707 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KIDNEY IMAG-VASC FLOW/FUNC W PHAR PX-340787090 CDM 78709 CPT 340 RC outpatient 1810 1773.8 All Payors / Plans All Payors / Plans 1810 other 1810 1810 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KIDNEY SCAN-SPECT PX-340787100 CDM 78803 CPT 340 RC outpatient 1768 1732.64 All Payors / Plans All Payors / Plans 1768 other 1768 1768 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC URETHRAL REFLUX STUDY PX-340787400 CDM 78740 CPT 340 RC outpatient 1165 1141.7 All Payors / Plans All Payors / Plans 1165 other 1165 1165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TESTICULAR IMAGIMG WITH FLOW PX-340787610 CDM 78761 CPT 340 RC outpatient 1082 1060.36 All Payors / Plans All Payors / Plans 1082 other 1082 1082 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TUMOR IMAGING SINGLE AREA/SINGLE DAY PX-340788000 CDM 78800 CPT 340 RC outpatient 957 937.86 All Payors / Plans All Payors / Plans 957 other 957 957 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TUMOR IMAGING 2 OR MORE AREAS 1 OR MORE DAYS/SINGLE AREA 2 OR MORE DAYS PX-340788010 CDM 78801 CPT 340 RC outpatient 1352 1324.96 All Payors / Plans All Payors / Plans 1352 other 1352 1352 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TUMOR IMAGING-WB SINGLE DAY PX-340788020 CDM 78802 CPT 340 RC outpatient 1706 1671.88 All Payors / Plans All Payors / Plans 1706 other 1706 1706 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TUMOR IMAGING-SPECT SINGLE AREA SINGLE DAY PX-340788030 CDM 78803 CPT 340 RC outpatient 1768 1732.64 All Payors / Plans All Payors / Plans 1768 other 1768 1768 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TUMOR LOCALIZATION-WB 2 OR > DAYS PX-340788040 CDM 78804 CPT 340 RC outpatient 3120 3057.6 All Payors / Plans All Payors / Plans 3120 other 3120 3120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFLAMMATION IMAGING-WB PX-340788060 CDM 78306 CPT 340 RC outpatient 1269 1243.62 All Payors / Plans All Payors / Plans 1269 other 1269 1269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFLAMMATION IMAGING-SPECT PX-340788070 CDM 78803 CPT 340 RC outpatient 1768 1732.64 All Payors / Plans All Payors / Plans 1768 other 1768 1768 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM TUMOR IMAGING-SPECT CT SINGLE AREA SINGLE DAY PX-340788300 CDM 78830 CPT 340 RC outpatient 2496 2446.08 All Payors / Plans All Payors / Plans 2496 other 2496 2496 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM TUMOR IMAGING-SPECT CT SINGLE AREA/2 DAYS OR 2 AREAS/1DAY PX-340788320 CDM 78832 CPT 340 RC outpatient 4888 4790.24 All Payors / Plans All Payors / Plans 4888 other 4888 4888 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM SPECT CT QUANTIFICATION MEASUREMENT PX-340788350 CDM 78835 CPT 340 RC outpatient 478 468.44 All Payors / Plans All Payors / Plans 478 other 478 478 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RADIOPHARMACEUTICAL THERAPY ORAL PX-340790050 CDM 79005 CPT 340 RC outpatient 291 285.18 All Payors / Plans All Payors / Plans 291 other 291 291 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RADIOPHARMACEUTICAL THERAPY IV PX-340791010 CDM 79101 CPT 340 RC outpatient 291 285.18 All Payors / Plans All Payors / Plans 291 other 291 291 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RADIOPHARM THER MONOCLONAL ANTIBO PX-340794030 CDM 79403 CPT 340 RC outpatient 478 468.44 All Payors / Plans All Payors / Plans 478 other 478 478 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC RADIOPHARMACEUTICAL THERAPY, BY INTRA-ARTICULAR ADMIN" PX-340794450 CDM 79445 CPT 340 RC outpatient 104 101.92 All Payors / Plans All Payors / Plans 104 other 104 104 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC 10MCI GALLIUM PX-343000001 CDM 343 RC outpatient 159.1 155.92 All Payors / Plans All Payors / Plans 159.1 other 159.1 159.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PYROPHOSPHATE PX-343000002 CDM A9538 CPT 343 RC outpatient 29.38 28.79 All Payors / Plans All Payors / Plans 29.38 other 29.38 29.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M DTPA KIT PX-343000003 CDM 343 RC outpatient 22.83 22.37 All Payors / Plans All Payors / Plans 22.83 other 22.83 22.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ULTRATAG KIT PX-343000004 CDM 343 RC outpatient 61.04 59.82 All Payors / Plans All Payors / Plans 61.04 other 61.04 61.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M DISIDA PX-343000005 CDM 343 RC outpatient 28.28 27.71 All Payors / Plans All Payors / Plans 28.28 other 28.28 28.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC F-18 FDG PX-343000006 CDM A9552 CPT 343 RC outpatient 250 245 All Payors / Plans All Payors / Plans 250 other 250 250 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M MAG111 PX-343000007 CDM 343 RC outpatient 132.95 130.29 All Payors / Plans All Payors / Plans 132.95 other 132.95 132.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC P32 PX-343000008 CDM 343 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC Z NM I-123 CAPSULE (200UCI) PX-343000009 CDM A9516 CPT 343 RC outpatient 46.01 45.09 All Payors / Plans All Payors / Plans 46.01 other 46.01 46.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ONCOSCINT PX-343000010 CDM 343 RC outpatient 1915.05 1876.75 All Payors / Plans All Payors / Plans 1915.05 other 1915.05 1915.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OCTREOSCAN PX-343000011 CDM A9572 CPT 343 RC outpatient 2006.47 1966.34 All Payors / Plans All Payors / Plans 2006.47 other 2006.47 2006.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC I131 MIBG PX-343000012 CDM 343 RC outpatient 1280.6 1254.99 All Payors / Plans All Payors / Plans 1280.6 other 1280.6 1280.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM KINEVAC PX-343000013 CDM 343 RC outpatient 88.65 86.88 All Payors / Plans All Payors / Plans 88.65 other 88.65 88.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM TC99M SESTAMIBI PX-343095000 CDM A9500 CPT 343 RC outpatient 75 73.5 All Payors / Plans All Payors / Plans 75 other 75 75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M MDP PX-343095030 CDM A9503 CPT 343 RC outpatient 10.93 10.71 All Payors / Plans All Payors / Plans 10.93 other 10.93 10.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM TL 201 PER MCI PX-343095050 CDM A9505 CPT 343 RC outpatient 15.45 15.14 All Payors / Plans All Payors / Plans 15.45 other 15.45 15.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC Z NM I123 CAP WB PER MCI PX-343095090 CDM A9509 CPT 343 RC outpatient 280.84 275.22 All Payors / Plans All Payors / Plans 280.84 other 280.84 280.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM TC99M TC04 PER MCI PX-343095120 CDM A9512 CPT 343 RC outpatient 11.83 11.59 All Payors / Plans All Payors / Plans 11.83 other 11.83 11.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC04 PX-343095121 CDM A9512 CPT 343 RC outpatient 23.66 23.19 All Payors / Plans All Payors / Plans 23.66 other 23.66 23.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM I131 RX CAP 1ST MCI PX-343095170 CDM A9517 CPT 343 RC outpatient 79.57 77.98 All Payors / Plans All Payors / Plans 79.57 other 79.57 79.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM I131 RX CAP EA ADD MCI PX-343095171 CDM A9517 CPT 343 RC outpatient 12.48 12.23 All Payors / Plans All Payors / Plans 12.48 other 12.48 12.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99 CERETEC PX-343095210 CDM A9521 CPT 343 RC outpatient 1152.01 1128.97 All Payors / Plans All Payors / Plans 1152.01 other 1152.01 1152.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM I131 DX CAP PER MCI PX-343095280 CDM A9528 CPT 343 RC outpatient 9.98 9.78 All Payors / Plans All Payors / Plans 9.98 other 9.98 9.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M MEMBROFENIN PX-343095370 CDM A9537 CPT 343 RC outpatient 79.57 77.98 All Payors / Plans All Payors / Plans 79.57 other 79.57 79.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M DTPA PX-343095390 CDM A9539 CPT 343 RC outpatient 17.81 17.45 All Payors / Plans All Payors / Plans 17.81 other 17.81 17.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M MAA PX-343095400 CDM A9540 CPT 343 RC outpatient 138.95 136.17 All Payors / Plans All Payors / Plans 138.95 other 138.95 138.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M SULFUR COLLOID PX-343095410 CDM A9541 CPT 343 RC outpatient 76.91 75.37 All Payors / Plans All Payors / Plans 76.91 other 76.91 76.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM SULFUR COLLOID TC99M FILTERED PX-343095411 CDM A9541 CPT 343 RC outpatient 571.68 560.25 All Payors / Plans All Payors / Plans 571.68 other 571.68 571.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM SULFUR COLLOID FILTERED 2 PX-343095412 CDM A9541 CPT 343 RC outpatient 285.84 280.12 All Payors / Plans All Payors / Plans 285.84 other 285.84 285.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM IN111 ZEVALIN DX PX-343095420 CDM A9542 CPT 343 RC outpatient 3500 3430 All Payors / Plans All Payors / Plans 3500 other 3500 3500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM Y90 ZEVALIN RX PX-343095430 CDM A9543 CPT 343 RC outpatient 35000 34300 All Payors / Plans All Payors / Plans 35000 other 35000 35000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM IN111 OXINE PER 0.5 MCI PX-343095470 CDM A9547 CPT 343 RC outpatient 1572.48 1541.03 All Payors / Plans All Payors / Plans 1572.48 other 1572.48 1572.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM IN111 DTPA PER 0.5 MCI PX-343095480 CDM A9548 CPT 343 RC outpatient 446.56 437.63 All Payors / Plans All Payors / Plans 446.56 other 446.56 446.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M DMSA PX-343095510 CDM A9551 CPT 343 RC outpatient 412.58 404.33 All Payors / Plans All Payors / Plans 412.58 other 412.58 412.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99 NEUROLITE PX-343095570 CDM A9557 CPT 343 RC outpatient 1380.63 1353.02 All Payors / Plans All Payors / Plans 1380.63 other 1380.63 1380.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XE133 10MCI PX-343095580 CDM A9558 CPT 343 RC outpatient 44.55 43.66 All Payors / Plans All Payors / Plans 44.55 other 44.55 44.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XE133 20MCI PX-343095581 CDM A9558 CPT 343 RC outpatient 64.54 63.25 All Payors / Plans All Payors / Plans 64.54 other 64.54 64.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC Z NM TC99M TAG RRC PER DOSE 30MCI PX-343095600 CDM A9560 CPT 343 RC outpatient 35.64 34.93 All Payors / Plans All Payors / Plans 35.64 other 35.64 35.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TC99M MAG3 PX-343095620 CDM A9562 CPT 343 RC outpatient 168.27 164.9 All Payors / Plans All Payors / Plans 168.27 other 168.27 168.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM P32 PHOSPHOCOL PER MCI PX-343095640 CDM A9564 CPT 343 RC outpatient 4969.1 4869.72 All Payors / Plans All Payors / Plans 4969.1 other 4969.1 4969.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM GA67 GALLIUM PER MCI PX-343095660 CDM A9556 CPT 343 RC outpatient 21.06 20.64 All Payors / Plans All Payors / Plans 21.06 other 21.06 21.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM TC99M DTPA AEROSOL PX-343095670 CDM A9567 CPT 343 RC outpatient 28.6 28.03 All Payors / Plans All Payors / Plans 28.6 other 28.6 28.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM TC99M LABELED WBC PER DOSE PX-343095690 CDM A9569 CPT 343 RC outpatient 1834.14 1797.46 All Payors / Plans All Payors / Plans 1834.14 other 1834.14 1834.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM INDIUM 111 WBC PX-343095700 CDM A9570 CPT 343 RC outpatient 2119.09 2076.71 All Payors / Plans All Payors / Plans 2119.09 other 2119.09 2119.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC I123 MIBG PX-343095820 CDM A9582 CPT 343 RC outpatient 2992.5 2932.65 All Payors / Plans All Payors / Plans 2992.5 other 2992.5 2992.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NM IODINE I-123 IOFLUPANE, DIAG, UP TO 5MCI" PX-343095840 CDM A9584 CPT 343 RC outpatient 1675 1641.5 All Payors / Plans All Payors / Plans 1675 other 1675 1675 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM SR89 METASTRON PER MCI PX-343096000 CDM A9600 CPT 343 RC outpatient 4969.1 4869.72 All Payors / Plans All Payors / Plans 4969.1 other 4969.1 4969.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM QUADRAMET SR153 PX-343096040 CDM A9604 CPT 343 RC outpatient 6441.37 6312.54 All Payors / Plans All Payors / Plans 6441.37 other 6441.37 6441.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM PROSTASCINT PX-343096420 CDM A4642 CPT 343 RC outpatient 2571.88 2520.44 All Payors / Plans All Payors / Plans 2571.88 other 2571.88 2571.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC NM YTTIRIUM-90, THERASPHERE GLASS MICROSPHERES, BRACHTHERAPY SOURCE" PX-344000001 CDM C2616 CPT 344 RC outpatient 16262 15936.76 All Payors / Plans All Payors / Plans 16262 other 16262 16262 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT HEAD W/O CONTRAST PX-351704500 CDM 70450 CPT 351 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-HEAD SCAN W CONTRAST PX-351704600 CDM 70460 CPT 351 RC outpatient 155 151.9 All Payors / Plans All Payors / Plans 155 other 155 155 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-HEAD SCAN W/WO CONTRAST PX-351704700 CDM 70470 CPT 351 RC outpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CT ORBIT, SELLA POST FOSSA W/O CONTRAST" PX-351704800 CDM 70480 CPT 351 RC outpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CT ORBIT, SELLA POST FOSSA W CONTRAST" PX-351704810 CDM 70481 CPT 351 RC outpatient 300 294 All Payors / Plans All Payors / Plans 300 other 300 300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CT ORBIT, SELLA POST FOSSA W W/O" PX-351704820 CDM 70482 CPT 351 RC outpatient 332 325.36 All Payors / Plans All Payors / Plans 332 other 332 332 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-MAXILLOFACIAL WO CONTRAST PX-351704860 CDM 70486 CPT 351 RC outpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-MAXILLOFACIAL W CONTRAST PX-351704870 CDM 70487 CPT 351 RC outpatient 161 157.78 All Payors / Plans All Payors / Plans 161 other 161 161 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-MAXILLOFACIAL W/WO CONTRAS PX-351704880 CDM 70488 CPT 351 RC outpatient 207 202.86 All Payors / Plans All Payors / Plans 207 other 207 207 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-NECK SCAN W/O CONTRAST PX-351704900 CDM 70490 CPT 351 RC outpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-NECK SCAN W CONTRAST PX-351704910 CDM 70491 CPT 351 RC outpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-NECK SCAN W/WO CONTRAST PX-351704920 CDM 70492 CPT 351 RC outpatient 300 294 All Payors / Plans All Payors / Plans 300 other 300 300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT LUNG CANCER SCREENING PX-352002970 CDM 71271 CPT 352 RC outpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT PERFUSION CEREBRAL W CONTRAST PX-352004200 CDM 0042T CPT 352 RC outpatient 373 365.54 All Payors / Plans All Payors / Plans 373 other 373 373 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CT GUIDE DRAIN CATH ABD WALL,NECK" PX-352100300 CDM 10030 CPT 352 RC outpatient 181 177.38 All Payors / Plans All Payors / Plans 181 other 181 181 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GU SOFT TIS LOC DEVICE 1ST LESION PX-352100350 CDM 10035 CPT 352 RC outpatient 181 177.38 All Payors / Plans All Payors / Plans 181 other 181 181 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GU SOFT TIS LOC DEVICE EA ADD LESION PX-352100360 CDM 10036 CPT 352 RC outpatient 104 101.92 All Payors / Plans All Payors / Plans 104 other 104 104 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUID RFREQ BONE TUMOR SFT TISS PX-352209820 CDM 20982 CPT 352 RC outpatient 207 202.86 All Payors / Plans All Payors / Plans 207 other 207 207 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUID CRYOBLATION BONE TUMOR PX-352209830 CDM 20983 CPT 352 RC outpatient 207 202.86 All Payors / Plans All Payors / Plans 207 other 207 207 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT LUNG NEEDLE BIOPSY PX-352324080 CDM 32408 CPT 361 RC outpatient 2190 2146.2 All Payors / Plans All Payors / Plans 2190 other 2190 2190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUID CRYOBLATION LIVER TUMOR PX-352473830 CDM 47383 CPT 352 RC outpatient 207 202.86 All Payors / Plans All Payors / Plans 207 other 207 207 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUIDE CATH DRAIN VISCERAL PX-352494050 CDM 49405 CPT 352 RC outpatient 181 177.38 All Payors / Plans All Payors / Plans 181 other 181 181 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUIDE CATH PERITON RETROPER PX-352494060 CDM 49406 CPT 352 RC outpatient 181 177.38 All Payors / Plans All Payors / Plans 181 other 181 181 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUIDE CTH PER RETROP TRANSRECT PX-352494070 CDM 49407 CPT 352 RC outpatient 181 177.38 All Payors / Plans All Payors / Plans 181 other 181 181 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT TMJ (ALSO FOR SELLA) PX-352704800 CDM 70480 CPT 352 RC outpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA HEAD PX-352704960 CDM 70496 CPT 352 RC outpatient 300 294 All Payors / Plans All Payors / Plans 300 other 300 300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA NECK PX-352704980 CDM 70498 CPT 352 RC outpatient 295 289.1 All Payors / Plans All Payors / Plans 295 other 295 295 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT THORAX W/O CONTRAST PX-352712500 CDM 71250 CPT 352 RC outpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-THORAX SCAN W CONTRAST PX-352712600 CDM 71260 CPT 352 RC outpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT THORAX W/CONTRAST CARDIAC PX-352712601 CDM 71260 CPT 352 RC outpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-THORAX W/WO CONTRAST PX-352712700 CDM 71270 CPT 352 RC outpatient 300 294 All Payors / Plans All Payors / Plans 300 other 300 300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA CHEST PX-352712750 CDM 71275 CPT 352 RC outpatient 306 299.88 All Payors / Plans All Payors / Plans 306 other 306 306 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-C SPINE W/O CONTRAST PX-352721250 CDM 72125 CPT 352 RC outpatient 192 188.16 All Payors / Plans All Payors / Plans 192 other 192 192 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-C SPINE W CONTRAST PX-352721260 CDM 72126 CPT 352 RC outpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-C SPINE W/WO CONTRAST PX-352721270 CDM 72127 CPT 352 RC outpatient 300 294 All Payors / Plans All Payors / Plans 300 other 300 300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-T SPINE W/O CONTRAST PX-352721280 CDM 72128 CPT 352 RC outpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-T SPINE W CONTRAST PX-352721290 CDM 72129 CPT 352 RC outpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-T SPINE W/WO CONTRAST PX-352721300 CDM 72130 CPT 352 RC outpatient 300 294 All Payors / Plans All Payors / Plans 300 other 300 300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-L SPINE W/O CONTRAST PX-352721310 CDM 72131 CPT 352 RC outpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-L SPINE W CONTRAST PX-352721320 CDM 72132 CPT 352 RC outpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-L SPINE W/WO CONTRAST PX-352721330 CDM 72133 CPT 352 RC outpatient 300 294 All Payors / Plans All Payors / Plans 300 other 300 300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA PELVIS PX-352721910 CDM 72191 CPT 352 RC outpatient 311 304.78 All Payors / Plans All Payors / Plans 311 other 311 311 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT PELVIS W/O CONTRAST PX-352721920 CDM 72192 CPT 352 RC outpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-PELVIS SCAN W CONTRAST PX-352721930 CDM 72193 CPT 352 RC outpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-PELVIS SCAN W/WO CONTRAST PX-352721940 CDM 72194 CPT 352 RC outpatient 290 284.2 All Payors / Plans All Payors / Plans 290 other 290 290 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT UPPER EXTREM WO CONTRAST PX-352732000 CDM 73200 CPT 352 RC outpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT UPPER EXTREM W CONTRAST PX-352732010 CDM 73201 CPT 352 RC outpatient 238 233.24 All Payors / Plans All Payors / Plans 238 other 238 238 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT UPPER EXTREM WWO CONTRAST PX-352732020 CDM 73202 CPT 350 RC outpatient 316 309.68 All Payors / Plans All Payors / Plans 316 other 316 316 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA UPPER EXTREMITY PX-352732060 CDM 73206 CPT 352 RC outpatient 347 340.06 All Payors / Plans All Payors / Plans 347 other 347 347 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT LOWER EXTREM WO CONTRAST PX-352737000 CDM 73700 CPT 352 RC outpatient 186 182.28 All Payors / Plans All Payors / Plans 186 other 186 186 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT LOWER EXTREM W CONTRAST PX-352737010 CDM 73701 CPT 352 RC outpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT LOWER EXTR WWO CONTRAST PX-352737020 CDM 73702 CPT 352 RC outpatient 311 304.78 All Payors / Plans All Payors / Plans 311 other 311 311 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA LOWER EXTREMITY PX-352737060 CDM 73706 CPT 352 RC outpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT ABDOMEN W/O CONTRAST PX-352741500 CDM 74150 CPT 352 RC outpatient 130 127.4 All Payors / Plans All Payors / Plans 130 other 130 130 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-ABDOMEN W CONTRAST PX-352741600 CDM 74160 CPT 352 RC outpatient 243 238.14 All Payors / Plans All Payors / Plans 243 other 243 243 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-ABDOMEN W/WO CONTRAST PX-352741700 CDM 74170 CPT 352 RC outpatient 280 274.4 All Payors / Plans All Payors / Plans 280 other 280 280 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA ABD/PEL W CONTRAST PX-352741740 CDM 74174 CPT 352 RC outpatient 404 395.92 All Payors / Plans All Payors / Plans 404 other 404 404 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA ABDOMEN PX-352741750 CDM 74175 CPT 352 RC outpatient 316 309.68 All Payors / Plans All Payors / Plans 316 other 316 316 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT ABD AND PELVIS W/O CONTRAST PX-352741760 CDM 74176 CPT 352 RC outpatient 166 162.68 All Payors / Plans All Payors / Plans 166 other 166 166 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT ABD AND PELVIS W CONTRAST PX-352741770 CDM 74177 CPT 352 RC outpatient 321 314.58 All Payors / Plans All Payors / Plans 321 other 321 321 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT ABD AND PELVIS 1+ SECTION/REG PX-352741780 CDM 74178 CPT 352 RC outpatient 368 360.64 All Payors / Plans All Payors / Plans 368 other 368 368 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T ABD/PELVIS UROGRAM W&W/O PX-352741781 CDM 74178 CPT 352 RC outpatient 368 360.64 All Payors / Plans All Payors / Plans 368 other 368 368 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT HEART WOUT CONTRST CORO CALC PX-352755710 CDM 75571 CPT 352 RC outpatient 104 101.92 All Payors / Plans All Payors / Plans 104 other 104 104 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA HEART W CONTRAST PX-352755720 CDM 75572 CPT 352 RC outpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT CTA HEARTCARD STRU MORPH CONGE PX-352755730 CDM 75573 CPT 352 RC outpatient 383 375.34 All Payors / Plans All Payors / Plans 383 other 383 383 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA HEART CARD W CONTRAST PX-352755740 CDM 75574 CPT 352 RC outpatient 440 431.2 All Payors / Plans All Payors / Plans 440 other 440 440 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CTA AORTA W RUNOFF W CONTRST POST PX-352756350 CDM 75635 CPT 350 RC outpatient 383 375.34 All Payors / Plans All Payors / Plans 383 other 383 383 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUIDED TUBE PLACEMENT PX-352759890 CDM 75989 CPT 352 RC outpatient 803 786.94 All Payors / Plans All Payors / Plans 803 other 803 803 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC C/T-3D/MULTIPLANAR RECONSTRUCTION PX-352763770 CDM 76377 CPT 352 RC outpatient 47 46.06 All Payors / Plans All Payors / Plans 47 other 47 47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUIDED NEEDLE BIOPSY PX-352770120 CDM 77012 CPT 352 RC outpatient 1241 1216.18 All Payors / Plans All Payors / Plans 1241 other 1241 1241 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT GUIDANCE TISSUE ABLATION PX-352770130 CDM 77013 CPT 352 RC outpatient 2482 2432.36 All Payors / Plans All Payors / Plans 2482 other 2482 2482 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT-THERAPY PLAN PX-352770140 CDM 77014 CPT 352 RC outpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CT BONE DENSITY AXIAL 1 OR > SITE PX-352770780 CDM 77078 CPT 352 RC outpatient 150 147 All Payors / Plans All Payors / Plans 150 other 150 150 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000000 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000001 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000002 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000003 CDM 360 RC outpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000004 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000005 CDM 360 RC outpatient 35 34.3 All Payors / Plans All Payors / Plans 35 other 35 35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000006 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000007 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000008 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000009 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000010 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000011 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000012 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000013 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000014 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000015 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000016 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000017 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000018 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPERATING ROOM (MINUTES) PX-360000019 CDM 360 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPECIAL PROCEDURES MINUTES PX-360000020 CDM 361 RC outpatient 73 71.54 All Payors / Plans All Payors / Plans 73 other 73 73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NM INJ RADIOACT TRAC SENT NODE PX-360387920 CDM 38792 CPT 360 RC outpatient 125 122.5 All Payors / Plans All Payors / Plans 125 other 125 125 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INSERTION DRUG DELIVERY IMPLANT PX-361119810 CDM 11981 CPT 361 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC REMOVE DRUG IMPLANT DEVICE PX-361119820 CDM 11982 CPT 361 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC REMOVE W REINSERTION DRUG IMPLANT PX-361119830 CDM 11983 CPT 361 RC outpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CRYOSURGERY SKIN LESIONS UP TO 14 PX-361171100 CDM 17110 CPT 360 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US PERCUT NDL CORE W IMAG 1ST LES PX-361190830 CDM 19083 CPT 361 RC outpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC INJECTION(S);SINGLE OR MULTIPLE TRIGGER POINTS, 1 OR 2 MUSCLES" PX-361205529 CDM 20552 CPT 361 RC outpatient 29 28.42 All Payors / Plans All Payors / Plans 29 other 29 29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC EXCISE BENIGN LESION TURN, ARM,LEGS .6-1.0 CM" PX-361206009 CDM 11401 CPT 361 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC EXCISE MALIG LESION TRUNK,ARMS,LEGS .6-1.0 CM" PX-361206059 CDM 11601 CPT 361 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC EXCISE MALIG LESION TRUNK,ARMS,LEGS 1.0-2.0 CM" PX-361206109 CDM 11602 CPT 361 RC outpatient 185 181.3 All Payors / Plans All Payors / Plans 185 other 185 185 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC INJECT, INTRALESIONAL UP TO & INCLUDE 7 LESIONS" PX-361206119 CDM 11900 CPT 361 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC ABDOMINAL PARACENTESIS, WITH IMAGE GUIDE" PX-361206129 CDM 49083 CPT 361 RC outpatient 385 377.3 All Payors / Plans All Payors / Plans 385 other 385 385 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC EXCISE BENIGN LESION TRUNK,ARMS,LEGS 1.1-2.0 CM" PX-361266709 CDM 11402 CPT 361 RC outpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC EXCISE BENIGN LESION FACE,EARS,EYELID,NOSE .5CM OR<" PX-361272669 CDM 11440 CPT 361 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC EXCISE BENIGN LESION SCALP,NECK,HANDS,FEET .6-1.0CM" PX-361278409 CDM 11421 CPT 361 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDOTRACHEAL INTUBATION OR ASSIST PX-361315000 CDM 31500 CPT 361 RC outpatient 356 348.88 All Payors / Plans All Payors / Plans 356 other 356 356 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC REMOVAL SKIN TAGS, ANY AREA, UP TO & INCLUDE 15" PX-361325569 CDM 11200 CPT 361 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC INJECTION(S) SINGLE TENDON SHEATH OR LIGAMENT PX-361437609 CDM 20550 CPT 361 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC ARTHROCENT, ASPIRAT &/OR INJECT, INTERM JOINT/BURSA" PX-361437629 CDM 20605 CPT 361 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC I&D ABSCESS, SIMPLE" PX-361490829 CDM 10060 CPT 361 RC outpatient 114 111.72 All Payors / Plans All Payors / Plans 114 other 114 114 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC ARTHROCENT,APSIRAT &/OR INJECT, MAJOR JOINT/BURSA" PX-361490839 CDM 20610 CPT 361 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR REP GASTRO JEJUNGO UNDER FLUO PX-361494400 CDM 49440 CPT 361 RC outpatient 256 250.88 All Payors / Plans All Payors / Plans 256 other 256 256 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC XR REP DUOD/JEJUNO TUBE W FLUORO PX-361494510 CDM 49451 CPT 361 RC outpatient 256 250.88 All Payors / Plans All Payors / Plans 256 other 256 256 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BLADDER INSTILLATION ANTICARCIN PX-361517200 CDM 51720 CPT 361 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN I&D VULVA OR PERINEAL ABSCESS PX-361564050 CDM 56405 CPT 361 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN I&D BARTHOLINS GLAND ABSCESS PX-361564200 CDM 56420 CPT 361 RC outpatient 29 28.42 All Payors / Plans All Payors / Plans 29 other 29 29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN DESTR VULVA LESION PX-361565010 CDM 56501 CPT 361 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC GYN DESTR VULVA LESION PX-361565019 CDM 56501 CPT 361 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN VULVAR BIOPSY PX-361566050 CDM 56605 CPT 361 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN COLPOSCOPY VULVA PX-361568200 CDM 56820 CPT 361 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN COLPOSCOPY VULVA W BIOPSY PX-361568210 CDM 56821 CPT 361 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN VAGINA BIOPSY PX-361571000 CDM 57100 CPT 361 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC FIT/INSERTION PESSARY, OTHER INTRAVAGINAL DEVICE" PX-361571609 CDM 57160 CPT 361 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN COLPOSCOPY VAGINA PX-361574200 CDM 57420 CPT 361 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC GYN COLPOSCOPY VAGINA PX-361574209 CDM 57420 CPT 361 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN COLPOSCOPY VAGINA W BIOPSY PX-361574210 CDM 57421 CPT 361 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN COLPOSCOPY CX/UPPER VAGINA PX-361574520 CDM 57452 CPT 361 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN COLPO W CERVICAL BIOPSY/ECC PX-361574540 CDM 57454 CPT 361 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC GYN COLPO W CERVICAL BIOPSY/ECC PX-361574549 CDM 57454 CPT 361 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN COLPOSCOPY W CERVICAL BIOPSY PX-361574550 CDM 57455 CPT 361 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN COLPOSCOPY W ECC PX-361574560 CDM 57456 CPT 361 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN BIOPSY OF CERVIX PX-361575000 CDM 57500 CPT 361 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN ENDOCERVICAL CURETTAGE PX-361575050 CDM 57505 CPT 361 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN ECC PX-361575051 CDM 57505 CPT 361 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC ENDOCERVICL CURRETAGE PX-361575052 CDM 57505 CPT 361 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN CAUTERIZATION CERVIX/CRYOCAUT PX-361575110 CDM 57511 CPT 361 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN ENDOMETRIAL BIOPSY PX-361581000 CDM 58100 CPT 361 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC GYN ENDOMETRIAL BIOPSY PX-361581009 CDM 58100 CPT 361 RC outpatient 128 125.44 All Payors / Plans All Payors / Plans 128 other 128 128 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN ENDOMETRIAL BIOPSY W COLP ADD PX-361581100 CDM 58110 CPT 361 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC GYN INSERTION IUD PX-361583009 CDM 58300 CPT 361 RC outpatient 157 153.86 All Payors / Plans All Payors / Plans 157 other 157 157 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GYN REMOVAL IUD PX-361583010 CDM 58301 CPT 361 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC GYN REMOVAL IUD PX-361583019 CDM 58301 CPT 361 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LUMBAR PUNCTURE PX-361622700 CDM 62328 CPT 361 RC outpatient 967 947.66 All Payors / Plans All Payors / Plans 967 other 967 967 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FACET INJECTION PX-361644120 CDM 64412 CPT 361 RC outpatient 370 362.6 All Payors / Plans All Payors / Plans 370 other 370 370 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CERUMEN REMOVAL PX-361692098 CDM 69209 CPT 361 RC outpatient 29 28.42 All Payors / Plans All Payors / Plans 29 other 29 29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC CERUMEN REMOVAL BILATERAL PX-361692099 CDM 69209 CPT 361 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPLICATION ON-BODY INJECTOR TIMED SUBCUTANEOUS INJ PX-361963770 CDM 96377 CPT 361 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANESTHESIOLOGY PX-370000000 CDM 370 RC outpatient 2.1 2.06 All Payors / Plans All Payors / Plans 2.1 other 2.1 2.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC PH, HLA MATCHED LEUKORED, EA UNIT" PX-381090520 CDM P9052 CPT 390 RC outpatient 1367 1339.66 All Payors / Plans All Payors / Plans 1367 other 1367 1367 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LEUKOPOOR RBC'S PX-390090160 CDM P9016 CPT 390 RC outpatient 239 234.22 All Payors / Plans All Payors / Plans 239 other 239 239 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RHOGAM (UF) PX-390903840 CDM 90384 CPT 390 RC outpatient 75 73.5 All Payors / Plans All Payors / Plans 75 other 75 75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PSOORALEN TREATED PLATELETS PX-390907300 CDM P9073 CPT 390 RC outpatient 703.7 689.63 All Payors / Plans All Payors / Plans 703.7 other 703.7 703.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLATELET PHERESIS LEUKOREDUCED IRRADIATED PX-390P90370 CDM P9037 CPT 390 RC outpatient 713.5 699.23 All Payors / Plans All Payors / Plans 713.5 other 713.5 713.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RBC LEUKOREDUCED IRRADIATED PX-390P90400 CDM P9040 CPT 390 RC outpatient 239 234.22 All Payors / Plans All Payors / Plans 239 other 239 239 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PLASMA PROCESSING FEE PX-391000000 CDM P9017 CPT 390 RC outpatient 56 54.88 All Payors / Plans All Payors / Plans 56 other 56 56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CRYOPRECIPITATE PROCESSING FEE PX-391000001 CDM P9012 CPT 390 RC outpatient 347 340.06 All Payors / Plans All Payors / Plans 347 other 347 347 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RED BLOOD CELL PROCESS FEE PX-391000002 CDM P9016 CPT 390 RC outpatient 228 223.44 All Payors / Plans All Payors / Plans 228 other 228 228 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRANSFUS,BLOOD/BLOOD COMP 0-90MIN" PX-391364300 CDM 36430 CPT 391 RC outpatient 363 355.74 All Payors / Plans All Payors / Plans 363 other 363 363 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRANSF,BLOOD/BLOOD COMP 91-150MIN" PX-391364301 CDM 36430 CPT 391 RC outpatient 528 517.44 All Payors / Plans All Payors / Plans 528 other 528 528 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRANSF,BLOOD/BLOOD COMP 151-210MI" PX-391364302 CDM 36430 CPT 391 RC outpatient 693 679.14 All Payors / Plans All Payors / Plans 693 other 693 693 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRANSF,BLOOD/BLOOD COMP 211-270MI" PX-391364303 CDM 36430 CPT 391 RC outpatient 858 840.84 All Payors / Plans All Payors / Plans 858 other 858 858 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRANSF,BLOOD/BLOOD COMP 271-330MI" PX-391364304 CDM 36430 CPT 391 RC outpatient 1023 1002.54 All Payors / Plans All Payors / Plans 1023 other 1023 1023 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRANSF,BLOOD/BLOOD COMP 331-390MI" PX-391364305 CDM 36430 CPT 391 RC outpatient 1188 1164.24 All Payors / Plans All Payors / Plans 1188 other 1188 1188 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRANSF,BLOOD/BLOOD COMP 391-450MI" PX-391364306 CDM 36430 CPT 391 RC outpatient 1353 1325.94 All Payors / Plans All Payors / Plans 1353 other 1353 1353 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRANSF,BLOOD/BLOOD COMP 451-510MI" PX-391364307 CDM 36430 CPT 391 RC outpatient 1518 1487.64 All Payors / Plans All Payors / Plans 1518 other 1518 1518 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RED BLOOD CELL PROCESS FEE(A) PX-391868900 CDM 86890 CPT 391 RC outpatient 149 146.02 All Payors / Plans All Payors / Plans 149 other 149 149 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PHERESIS (PLATELETS) PX-399090350 CDM P9035 CPT 390 RC outpatient 674 660.52 All Payors / Plans All Payors / Plans 674 other 674 674 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STEREOTACTIC BREAST BIOPSY PX-401190810 CDM 19081 CPT 401 RC outpatient 682 668.36 All Payors / Plans All Payors / Plans 682 other 682 682 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD US BREAST BIOPSY 1ST LESION PX-401190830 CDM 19083 CPT 402 RC outpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US BREAST NEEDLE BIOPSY EA ADD PX-401190840 CDM 19084 CPT 402 RC outpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD MAMMO LOCALIZATION EA ADDL PX-401192820 CDM 19282 CPT 401 RC outpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD US NEEDLE BREAST GUIDE 1ST PX-401192850 CDM 19285 CPT 402 RC outpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BREAST SURGICAL SPECIMEN (2) PX-401760980 CDM 76098 CPT 401 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD DUCTOGRAM RT PX-401770535 CDM 77053 CPT 401 RC outpatient 52 50.96 All Payors / Plans All Payors / Plans 52 other 52 52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD DUCTOGRAM LT PX-401770536 CDM 77053 CPT 401 RC outpatient 52 50.96 All Payors / Plans All Payors / Plans 52 other 52 52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD CAD MAMMOGRAM DIAG UNILATERAL PX-401770650 CDM 77065 CPT 401 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WIRE LOCAL LYMPH NODE ONLY PX-402100350 CDM 10035 CPT 402 RC outpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US NEEDLE LOC BREAST GUIDE ADD PX-402192860 CDM 19286 CPT 402 RC outpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US THORA PX-402325550 CDM 32555 CPT 361 RC outpatient 1168 1144.64 All Payors / Plans All Payors / Plans 1168 other 1168 1168 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUIDE RF ABLAT LIVER OPEN 1OR> PX-402473800 CDM 47380 CPT 402 RC outpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUIDE CRYO ABLAT LIVR OPN 1OR> PX-402473810 CDM 47381 CPT 402 RC outpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUIDE RF ABLAT LIVER PERC 1OR> PX-402473820 CDM 47382 CPT 402 RC outpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUIDE CRYO ABLAT LIVR PER 1OR> PX-402473830 CDM 47383 CPT 402 RC outpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUIDE ABD PARACENTESIS PX-402490830 CDM 49083 CPT 402 RC outpatient 1825 1788.5 All Payors / Plans All Payors / Plans 1825 other 1825 1825 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUID PLEURAL DRAIN TUBE PX-402494050 CDM 49405 CPT 402 RC outpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC US GUID PERIT,RETRO DRAIN TUBE" PX-402494060 CDM 49406 CPT 361 RC outpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUID CTH PER PERITON RETRO PX-402494070 CDM 49407 CPT 402 RC outpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CATH AND INTRO OF SALINE CONTRAST PX-402583400 CDM 58340 CPT 402 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NEONATE CRANIAL SONO PX-402765060 CDM 76506 CPT 402 RC outpatient 682 668.36 All Payors / Plans All Payors / Plans 682 other 682 682 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THYROID SONOGRAPHY PX-402765360 CDM 76536 CPT 402 RC outpatient 711 696.78 All Payors / Plans All Payors / Plans 711 other 711 711 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEST PX-402766040 CDM 76604 CPT 402 RC outpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US BREAST PX-402766410 CDM 76641 CPT 402 RC outpatient 569 557.62 All Payors / Plans All Payors / Plans 569 other 569 569 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD BREAST ULTRASOUND UNI RT PX-402766415 CDM 76641 CPT 402 RC outpatient 94 92.12 All Payors / Plans All Payors / Plans 94 other 94 94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD BREAST ULTRASOUND UNI LT PX-402766416 CDM 76641 CPT 402 RC outpatient 94 92.12 All Payors / Plans All Payors / Plans 94 other 94 94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD US BREAST UNI LIMITED FOCUS PX-402766420 CDM 76642 CPT 402 RC outpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD BREAST ULTRASOUND LIMITED RT PX-402766425 CDM 76642 CPT 402 RC outpatient 72 70.56 All Payors / Plans All Payors / Plans 72 other 72 72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD BREAST ULTRASOUND LIMITED LT PX-402766426 CDM 76642 CPT 402 RC outpatient 72 70.56 All Payors / Plans All Payors / Plans 72 other 72 72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ABDOMEN COMPLETE PX-402767000 CDM 76700 CPT 402 RC outpatient 654 640.92 All Payors / Plans All Payors / Plans 654 other 654 654 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ABDOMEN LIMITED B PX-402767050 CDM 76705 CPT 402 RC outpatient 512 501.76 All Payors / Plans All Payors / Plans 512 other 512 512 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RETROPERITONEAL COMPLETE PX-402767700 CDM 76770 CPT 402 RC outpatient 625 612.5 All Payors / Plans All Payors / Plans 625 other 625 625 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US RETROPERITONEAL LTD PX-402767750 CDM 76775 CPT 402 RC outpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SONOGRAM OF TRANSPLANT KIDNEY PX-402767760 CDM 76776 CPT 402 RC outpatient 967 947.66 All Payors / Plans All Payors / Plans 967 other 967 967 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPINAL CANAL PX-402768000 CDM 76800 CPT 402 RC outpatient 654 640.92 All Payors / Plans All Payors / Plans 654 other 654 654 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OB 1ST TRIMESTER PX-402768010 CDM 76801 CPT 402 RC outpatient 597 585.06 All Payors / Plans All Payors / Plans 597 other 597 597 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OB 2ND & 3RD TRIMESTER PX-402768050 CDM 76805 CPT 402 RC outpatient 739 724.22 All Payors / Plans All Payors / Plans 739 other 739 739 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PREGNANCY EXAM MULTIPLE GESTATION PX-402768100 CDM 76810 CPT 402 RC outpatient 341 334.18 All Payors / Plans All Payors / Plans 341 other 341 341 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OB COMPLETE DETAILED PX-402768110 CDM 76811 CPT 402 RC outpatient 682 668.36 All Payors / Plans All Payors / Plans 682 other 682 682 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US OB COMPLETE DETAILED EA ADDL GESTATION PX-402768120 CDM 76812 CPT 402 RC outpatient 910 891.8 All Payors / Plans All Payors / Plans 910 other 910 910 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US OB NUCHAL TRANSLUCENCY 1 GEST PX-402768130 CDM 76813 CPT 402 RC outpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US OB NUCHAL TRANSLUCENCY ADD GES PX-402768140 CDM 76814 CPT 402 RC outpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US OB LIMITED PX-402768150 CDM 76815 CPT 402 RC outpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC US, PREGNANT UTERUS, TRANSVAGINAL" PX-402768170 CDM 76817 CPT 402 RC outpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIOPHYS PROFILE W/ NON STRESS PX-402768190 CDM 76819 CPT 402 RC outpatient 398 390.04 All Payors / Plans All Payors / Plans 398 other 398 398 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DOPPLER FETAL UMBILICAL ARTERY PX-402768200 CDM 76820 CPT 402 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DOPPLER FETAL MIDDLE CEREBRAL ART PX-402768210 CDM 76821 CPT 402 RC outpatient 455 445.9 All Payors / Plans All Payors / Plans 455 other 455 455 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRANSVAGINAL SONOGRAM PX-402768300 CDM 76830 CPT 402 RC outpatient 711 696.78 All Payors / Plans All Payors / Plans 711 other 711 711 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HYSTEROSONOGRAPHY SALINE SOL PX-402768310 CDM 76831 CPT 402 RC outpatient 219 214.62 All Payors / Plans All Payors / Plans 219 other 219 219 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PELVIC SONOGRAM PX-402768560 CDM 76856 CPT 402 RC outpatient 597 585.06 All Payors / Plans All Payors / Plans 597 other 597 597 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SONO PELVIS LIMITED PX-402768570 CDM 76857 CPT 402 RC outpatient 199 195.02 All Payors / Plans All Payors / Plans 199 other 199 199 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SCROTUM SONOGRAM PX-402768700 CDM 76870 CPT 402 RC outpatient 284 278.32 All Payors / Plans All Payors / Plans 284 other 284 284 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXTREMITY PX-402768810 CDM 76881 CPT 402 RC outpatient 711 696.78 All Payors / Plans All Payors / Plans 711 other 711 711 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US AXILLARY PX-402768820 CDM 76882 CPT 402 RC outpatient 85 83.3 All Payors / Plans All Payors / Plans 85 other 85 85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US HIPS BILATERAL PX-402768850 CDM 76885 CPT 402 RC outpatient 881 863.38 All Payors / Plans All Payors / Plans 881 other 881 881 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUIDANCE TISSUE ABLATION PX-402769400 CDM 76940 CPT 402 RC outpatient 1095 1073.1 All Payors / Plans All Payors / Plans 1095 other 1095 1095 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ULTRASONIC NEEDLE GUIDE BIOPSY PX-402769420 CDM 76942 CPT 402 RC outpatient 1095 1073.1 All Payors / Plans All Payors / Plans 1095 other 1095 1095 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL PSA INJECTION U/S GUIDE PX-402769421 CDM 76942 CPT 402 RC outpatient 1095 1073.1 All Payors / Plans All Payors / Plans 1095 other 1095 1095 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMNINOCENTESIS PX-402769460 CDM 76946 CPT 402 RC outpatient 341 334.18 All Payors / Plans All Payors / Plans 341 other 341 341 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC US GUIDANCE,INTRAOPERATIVE" PX-402769980 CDM 76998 CPT 402 RC outpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY REHAB-OTHER PX-410002390 CDM G0239 CPT 410 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY REHAB-OTHER >36 PX-410020390 CDM G0239 CPT 410 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MANUAL VENTILATION PX-410147992 CDM 94799 CPT 410 RC outpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SUCTIONING PX-410317200 CDM 31720 CPT 410 RC outpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPR PX-410929500 CDM 92950 CPT 410 RC outpatient 320 313.6 All Payors / Plans All Payors / Plans 320 other 320 320 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MECH VENT ADULT PX-410940020 CDM 94002 CPT 410 RC outpatient 1000 980 All Payors / Plans All Payors / Plans 1000 other 1000 1000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VENTILATOR - 1ST DAY PX-410940021 CDM 94002 CPT 410 RC outpatient 960 940.8 All Payors / Plans All Payors / Plans 960 other 960 960 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MECH VENT NEONATE PX-410940022 CDM 94002 CPT 410 RC outpatient 1200 1176 All Payors / Plans All Payors / Plans 1200 other 1200 1200 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MECH VENT SUBSEQUENT ADULT PX-410940030 CDM 94003 CPT 410 RC outpatient 1000 980 All Payors / Plans All Payors / Plans 1000 other 1000 1000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VENTILATOR/SUBSEQUENT DAYS PX-410940031 CDM 94003 CPT 410 RC outpatient 840 823.2 All Payors / Plans All Payors / Plans 840 other 840 840 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MECH VENT SUBSEQUENT NEONATE PX-410940032 CDM 94003 CPT 410 RC outpatient 1200 1176 All Payors / Plans All Payors / Plans 1200 other 1200 1200 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MDI INITIAL PX-410946404 CDM 94640 CPT 410 RC outpatient 160 156.8 All Payors / Plans All Payors / Plans 160 other 160 160 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONT NEB W/BRONCHODILATOR FIRST HR PX-410946407 CDM 94644 CPT 410 RC outpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONT NEB W/BRONCHODILAT ADDL HR PX-410946408 CDM 94645 CPT 410 RC outpatient 112 109.76 All Payors / Plans All Payors / Plans 112 other 112 112 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HAND HELD NEBULIZER/IPPB/MDI-IP PX-410946409 CDM 94640 CPT 410 RC outpatient 1920 1881.6 All Payors / Plans All Payors / Plans 1920 other 1920 1920 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HAND HELD NEBULIZER/IBB/MDI-OP PX-410946410 CDM 94640 CPT 410 RC outpatient 160 156.8 All Payors / Plans All Payors / Plans 160 other 160 160 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPAP PX-410946600 CDM 94660 CPT 410 RC outpatient 480 470.4 All Payors / Plans All Payors / Plans 480 other 480 480 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIPAP/CPAP PX-410946601 CDM 94660 CPT 410 RC outpatient 469 459.62 All Payors / Plans All Payors / Plans 469 other 469 469 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPT&POSTUAL DRAIN INITIAL RX 2POS PX-410946670 CDM 94667 CPT 410 RC outpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPT&POSTUAL DRAIN INITIAL RX 4POS PX-410946671 CDM 94667 CPT 410 RC outpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACAPELLA INITIAL RX PX-410946672 CDM 94667 CPT 410 RC outpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INEXSUFFILATOR INITIAL RX PX-410946673 CDM 94667 CPT 410 RC outpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPT&POSTUAL DRAIN SUBSEQ RX 2 POS PX-410946680 CDM 94668 CPT 410 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPT&POSTUAL DRAIN SUBSEQ RX 4 POS PX-410946681 CDM 94668 CPT 410 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ACAPELLA SUB RX PX-410946682 CDM 94668 CPT 410 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INEXSUFFILATOR SUB RX PX-410946683 CDM 94668 CPT 410 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULSE OXIMETRY CONTINUOUS PX-410947620 CDM 94762 CPT 410 RC outpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMPREHENSIVE PATIENT ASSESSMENTS PX-410947991 CDM 94799 CPT 410 RC outpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDOTRACHEAL TUBE CARE NON VENTED PX-410947992 CDM 94799 CPT 410 RC outpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRACHEOSTOMY TUBE CARE PX-410947993 CDM 94799 CPT 410 RC outpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPONTANEOUS MECHANICS NON VENTED PX-410947994 CDM 94799 CPT 410 RC outpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONTINOUS AEROSOL RX INITIAL DAY PX-410947995 CDM 94799 CPT 410 RC outpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONTINOUS AEROSOL RX SUBSEQ DAY PX-410947996 CDM 94799 CPT 410 RC outpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OXYGEN THERAPY INITIAL DAY PX-410947997 CDM 94799 CPT 410 RC outpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OXYGEN THERAPY SUBSEQ DAY PX-410947998 CDM 94799 CPT 410 RC outpatient 80 78.4 All Payors / Plans All Payors / Plans 80 other 80 80 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HBO2 TX - 16-46 MIN PX-413991830 CDM G0277 CPT 413 RC outpatient 391 383.18 All Payors / Plans All Payors / Plans 391 other 391 391 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HBO PER 30 MINS PX-413991831 CDM 99183 CPT 413 RC outpatient 782 766.36 All Payors / Plans All Payors / Plans 782 other 782 782 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HBO2 TX - 78-108 MIN PX-413991832 CDM G0277 CPT 413 RC outpatient 1173 1149.54 All Payors / Plans All Payors / Plans 1173 other 1173 1173 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HBO2 TX - 109-139 MIN PX-413991833 CDM G0277 CPT 413 RC outpatient 1564 1532.72 All Payors / Plans All Payors / Plans 1564 other 1564 1564 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG ARM SPLINT 23-37 PX-420291050 CDM 29105 CPT 420 RC outpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG ARM SPLINT 38-52 PX-420291051 CDM 29105 CPT 420 RC outpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG ARM SPLINT 53-67 PX-420291052 CDM 29105 CPT 420 RC outpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG ARM SPLINT 68-82 PX-420291053 CDM 29105 CPT 420 RC outpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG ARM SPLINT 8-22 PX-420291054 CDM 29105 CPT 420 RC outpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM STATIC 8-22 PX-420291250 CDM 29125 CPT 420 RC outpatient 316 309.68 All Payors / Plans All Payors / Plans 316 other 316 316 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM STATIC 23-37 PX-420291251 CDM 29125 CPT 420 RC outpatient 316 309.68 All Payors / Plans All Payors / Plans 316 other 316 316 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM STATIC 38-52 PX-420291252 CDM 29125 CPT 420 RC outpatient 316 309.68 All Payors / Plans All Payors / Plans 316 other 316 316 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM STATIC 53-67 PX-420291253 CDM 29125 CPT 420 RC outpatient 316 309.68 All Payors / Plans All Payors / Plans 316 other 316 316 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM STATIC 68-82 PX-420291254 CDM 29125 CPT 420 RC outpatient 316 309.68 All Payors / Plans All Payors / Plans 316 other 316 316 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM SPLINT DYNAM 8-22 PX-420291260 CDM 29126 CPT 420 RC outpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM DYNAMIC 23-37 PX-420291261 CDM 29126 CPT 420 RC outpatient 406 397.88 All Payors / Plans All Payors / Plans 406 other 406 406 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM DYNAMIC 38-52 PX-420291262 CDM 29126 CPT 420 RC outpatient 608 595.84 All Payors / Plans All Payors / Plans 608 other 608 608 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM DYNAMIC 53-67 PX-420291263 CDM 29126 CPT 420 RC outpatient 811 794.78 All Payors / Plans All Payors / Plans 811 other 811 811 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT ARM DYNAMIC 68-82 PX-420291264 CDM 29126 CPT 420 RC outpatient 1014 993.72 All Payors / Plans All Payors / Plans 1014 other 1014 1014 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT STATIC 8-22 PX-420291301 CDM 29130 CPT 420 RC outpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT STATIC 23-37 PX-420291302 CDM 29130 CPT 420 RC outpatient 270 264.6 All Payors / Plans All Payors / Plans 270 other 270 270 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT STATIC 38-52 PX-420291303 CDM 29130 CPT 420 RC outpatient 406 397.88 All Payors / Plans All Payors / Plans 406 other 406 406 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT STATIC 53-67 PX-420291304 CDM 29130 CPT 420 RC outpatient 541 530.18 All Payors / Plans All Payors / Plans 541 other 541 541 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT STATIC 68-82 PX-420291305 CDM 29130 CPT 420 RC outpatient 676 662.48 All Payors / Plans All Payors / Plans 676 other 676 676 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FING SPLINT DYN 8-22 PX-420291310 CDM 29131 CPT 420 RC outpatient 169 165.62 All Payors / Plans All Payors / Plans 169 other 169 169 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT DYNAMIC 23-37 PX-420291311 CDM 29131 CPT 420 RC outpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT DYNAMIC 38-52 PX-420291312 CDM 29131 CPT 420 RC outpatient 507 496.86 All Payors / Plans All Payors / Plans 507 other 507 507 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT DYNAMIC 53-67 PX-420291313 CDM 29131 CPT 420 RC outpatient 676 662.48 All Payors / Plans All Payors / Plans 676 other 676 676 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL FINGER SPLINT DYNAMIC 68-82 PX-420291314 CDM 29131 CPT 420 RC outpatient 845 828.1 All Payors / Plans All Payors / Plans 845 other 845 845 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG LEG SPLINT 8-22 PX-420295050 CDM 29505 CPT 420 RC outpatient 429 420.42 All Payors / Plans All Payors / Plans 429 other 429 429 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG LEG SPLINT 23-37 PX-420295051 CDM 29505 CPT 420 RC outpatient 429 420.42 All Payors / Plans All Payors / Plans 429 other 429 429 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG LEG SPLINT 38-52 PX-420295052 CDM 29505 CPT 420 RC outpatient 429 420.42 All Payors / Plans All Payors / Plans 429 other 429 429 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG LEG SPLINT 53-67 PX-420295053 CDM 29505 CPT 420 RC outpatient 429 420.42 All Payors / Plans All Payors / Plans 429 other 429 429 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL LONG LEG SPLINT 68-82 PX-420295054 CDM 29505 CPT 420 RC outpatient 429 420.42 All Payors / Plans All Payors / Plans 429 other 429 429 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT LEG SPLINT 8-22 PX-420295150 CDM 29515 CPT 420 RC outpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT LEG SPLINT 23-37 PX-420295151 CDM 29515 CPT 420 RC outpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT LEG SPLINT 38-52 PX-420295152 CDM 29515 CPT 420 RC outpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT LEG SPLINT 53-67 PX-420295153 CDM 29515 CPT 420 RC outpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPL SHORT LEG SPLINT 68-82 PX-420295154 CDM 29515 CPT 420 RC outpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STRAPPING UNA BOOT 8-22 PX-420295800 CDM 29580 CPT 420 RC outpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STRAPPING UNA BOOT 23-37 PX-420295801 CDM 29580 CPT 420 RC outpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STRAPPING UNNA BOOT 38-52 PX-420295802 CDM 29580 CPT 420 RC outpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STRAPPING UNA BOOT 53-67 PX-420295803 CDM 29580 CPT 420 RC outpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STRAPPING UNA BOOT 68-82 PX-420295804 CDM 29580 CPT 420 RC outpatient 293 287.14 All Payors / Plans All Payors / Plans 293 other 293 293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM L LEG/FT 8-22 PX-420295810 CDM 29581 CPT 420 RC outpatient 474 464.52 All Payors / Plans All Payors / Plans 474 other 474 474 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COMP L LEG/FT23-37 PX-420295811 CDM 29581 CPT 420 RC outpatient 474 464.52 All Payors / Plans All Payors / Plans 474 other 474 474 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COMP L LEG/FT38-52 PX-420295812 CDM 29581 CPT 420 RC outpatient 474 464.52 All Payors / Plans All Payors / Plans 474 other 474 474 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COMP L FEG/FT53-67 PX-420295813 CDM 29581 CPT 420 RC outpatient 474 464.52 All Payors / Plans All Payors / Plans 474 other 474 474 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COMP L LEG/FT 68-82 PX-420295814 CDM 29581 CPT 420 RC outpatient 474 464.52 All Payors / Plans All Payors / Plans 474 other 474 474 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APPL MLT-LAY COMP THIG/LEG8-22 PX-420295820 CDM 29582 CPT 420 RC outpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COMP THI/LEG 23-37 PX-420295821 CDM 29583 CPT 420 RC outpatient 406 397.88 All Payors / Plans All Payors / Plans 406 other 406 406 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COMP THI/LEG 38-52 PX-420295822 CDM 29584 CPT 420 RC outpatient 608 595.84 All Payors / Plans All Payors / Plans 608 other 608 608 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COMP THI/LEG 53-67 PX-420295823 CDM 29585 CPT 420 RC outpatient 811 794.78 All Payors / Plans All Payors / Plans 811 other 811 811 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COMP THI/LEG 68-73 PX-420295824 CDM 29586 CPT 420 RC outpatient 1014 993.72 All Payors / Plans All Payors / Plans 1014 other 1014 1014 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UPARM/FO8-22 PX-420295830 CDM 29583 CPT 420 RC outpatient 169 165.62 All Payors / Plans All Payors / Plans 169 other 169 169 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FO23-37 PX-420295831 CDM 29583 CPT 420 RC outpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FO38-52 PX-420295832 CDM 29583 CPT 420 RC outpatient 507 496.86 All Payors / Plans All Payors / Plans 507 other 507 507 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FO53-67 PX-420295833 CDM 29583 CPT 420 RC outpatient 676 662.48 All Payors / Plans All Payors / Plans 676 other 676 676 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FO68-73 PX-420295834 CDM 29583 CPT 420 RC outpatient 845 828.1 All Payors / Plans All Payors / Plans 845 other 845 845 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FI8-22 PX-420295840 CDM 29584 CPT 420 RC outpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FI23-37 PX-420295841 CDM 29584 CPT 420 RC outpatient 406 397.88 All Payors / Plans All Payors / Plans 406 other 406 406 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FI38-52 PX-420295842 CDM 29584 CPT 420 RC outpatient 608 595.84 All Payors / Plans All Payors / Plans 608 other 608 608 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FI53-67 PX-420295843 CDM 29584 CPT 420 RC outpatient 811 794.78 All Payors / Plans All Payors / Plans 811 other 811 811 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT APP MLT-LAY COM UP ARM/FI 68-82 PX-420295844 CDM 29584 CPT 420 RC outpatient 1014 993.72 All Payors / Plans All Payors / Plans 1014 other 1014 1014 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIOFEEDBACK TRAINING 8-22 MIN PX-420909111 CDM 90911 CPT 420 RC outpatient 118 115.64 All Payors / Plans All Payors / Plans 118 other 118 118 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIOFEEDBACK TRAINING 23-37 MIN PX-420909112 CDM 90911 CPT 420 RC outpatient 237 232.26 All Payors / Plans All Payors / Plans 237 other 237 237 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIOFEEDBACK TRAINING 38-52 MIN PX-420909113 CDM 90911 CPT 420 RC outpatient 355 347.9 All Payors / Plans All Payors / Plans 355 other 355 355 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIOFEEDBACK TRAINING 53-67 MIN PX-420909114 CDM 90911 CPT 420 RC outpatient 473 463.54 All Payors / Plans All Payors / Plans 473 other 473 473 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BIOFEEDBACK TRAINING 68-82 MIN PX-420909115 CDM 90911 CPT 420 RC outpatient 592 580.16 All Payors / Plans All Payors / Plans 592 other 592 592 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CANALITH REPOSITIONING PROC PX-420959920 CDM 95992 CPT 420 RC outpatient 113 110.74 All Payors / Plans All Payors / Plans 113 other 113 113 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT DEVEL SCREEN W INTER RPT 8-22 PX-420961100 CDM 96114 CPT 420 RC outpatient 152 148.96 All Payors / Plans All Payors / Plans 152 other 152 152 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RE EVALUATION 8-22 MIN PX-420970020 CDM 97164 CPT 420 RC outpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RE EVALUATION 23-37 MIN PX-420970021 CDM 97164 CPT 420 RC outpatient 271 265.58 All Payors / Plans All Payors / Plans 271 other 271 271 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RE EVALUATION 38-52 MIN PX-420970022 CDM 97164 CPT 420 RC outpatient 406 397.88 All Payors / Plans All Payors / Plans 406 other 406 406 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RE EVALUATION 53-67 MIN PX-420970023 CDM 97164 CPT 420 RC outpatient 541 530.18 All Payors / Plans All Payors / Plans 541 other 541 541 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT MECHANICAL TRACT 8-22 PX-420970120 CDM 97012 CPT 420 RC outpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRACTION (MECHANICAL) PX-420970121 CDM 97012 CPT 420 RC outpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT MECHANICAL TRACT 38-52 PX-420970122 CDM 97012 CPT 420 RC outpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT MECHANCIAL TRACT 53-67 PX-420970123 CDM 97012 CPT 420 RC outpatient 270 264.6 All Payors / Plans All Payors / Plans 270 other 270 270 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT MECHANICAL TRACT 68-82 PX-420970124 CDM 97012 CPT 420 RC outpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ELECTRICAL STIMULATN UNATT NON WOUND PX-420970141 CDM 97014 CPT 420 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXTREM PUMP 8-22 MIN PX-420970160 CDM 97016 CPT 420 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXTREM PUMP 23-37 PX-420970161 CDM 97016 CPT 420 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXTREM PUMP 38-52 PX-420970162 CDM 97016 CPT 420 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXTREM PUMP 53-67 PX-420970163 CDM 97016 CPT 420 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXTREM PUMP 68-82 MIN PX-420970164 CDM 97016 CPT 420 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARAFFIN BATH 8-22 MIN PX-420970180 CDM 97018 CPT 420 RC outpatient 34 33.32 All Payors / Plans All Payors / Plans 34 other 34 34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARAFFIN BATH 23-37 MIN PX-420970181 CDM 97018 CPT 420 RC outpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARAFFIN BATH 38-52 MIN PX-420970182 CDM 97018 CPT 420 RC outpatient 101 98.98 All Payors / Plans All Payors / Plans 101 other 101 101 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARAFFIN BATH 53-67 MIN PX-420970183 CDM 97018 CPT 420 RC outpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARAFFIN BATH 68-82 PX-420970184 CDM 97018 CPT 420 RC outpatient 169 165.62 All Payors / Plans All Payors / Plans 169 other 169 169 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT E-STIM NOT WC MANUAL 8-22 PX-420970320 CDM 97032 CPT 420 RC outpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IONTOPHORESIS ONE OR MORE AREA 15 PX-420970330 CDM 97033 CPT 420 RC outpatient 85 83.3 All Payors / Plans All Payors / Plans 85 other 85 85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ULTRASOUND PX-420970350 CDM 97035 CPT 420 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUIDOTHERAPY 8-22 MIN PX-420970390 CDM 97039 CPT 420 RC outpatient 34 33.32 All Payors / Plans All Payors / Plans 34 other 34 34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUIDOTHERAPY 23-37 PX-420970391 CDM 97039 CPT 420 RC outpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUIDOTHERAPY 38-52 PX-420970392 CDM 97039 CPT 420 RC outpatient 101 98.98 All Payors / Plans All Payors / Plans 101 other 101 101 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FLUIDOTHERAPY 53-67 MIN PX-420970393 CDM 97039 CPT 420 RC outpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THERAPEUTIC EXERCISES TH PX-420971100 CDM 97110 CPT 420 RC outpatient 90 88.2 All Payors / Plans All Payors / Plans 90 other 90 90 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NEUROMUSCULAR REEDUCATION PX-420971120 CDM 97112 CPT 420 RC outpatient 113 110.74 All Payors / Plans All Payors / Plans 113 other 113 113 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMBULATION TRAIN PX-420971160 CDM 97116 CPT 420 RC outpatient 90 88.2 All Payors / Plans All Payors / Plans 90 other 90 90 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MASSAGE 15 MIN PX-420971240 CDM 97124 CPT 420 RC outpatient 113 110.74 All Payors / Plans All Payors / Plans 113 other 113 113 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MANUAL THERAPY PX-420971400 CDM 97140 CPT 420 RC outpatient 90 88.2 All Payors / Plans All Payors / Plans 90 other 90 90 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT GROUP THERAPY 8-22 MIN 2 PTS PX-420971500 CDM 97150 CPT 420 RC outpatient 101 98.98 All Payors / Plans All Payors / Plans 101 other 101 101 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THERAPEUTIC EX. GROUP PX-420971501 CDM 97150 CPT 420 RC outpatient 101 98.98 All Payors / Plans All Payors / Plans 101 other 101 101 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT GROUP THERAPY 38-52 MIN 2 PTS PX-420971502 CDM 97150 CPT 420 RC outpatient 101 98.98 All Payors / Plans All Payors / Plans 101 other 101 101 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT GROUP THERAPY 8-22 MIN 3 PTS PX-420971503 CDM 97150 CPT 420 RC outpatient 152 148.96 All Payors / Plans All Payors / Plans 152 other 152 152 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT GROUP THERAPY 23-37 MIN 3 PTS PX-420971504 CDM 97150 CPT 420 RC outpatient 152 148.96 All Payors / Plans All Payors / Plans 152 other 152 152 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT GROUP THERAPY 38-52 MIN 3 PTS PX-420971505 CDM 97150 CPT 420 RC outpatient 152 148.96 All Payors / Plans All Payors / Plans 152 other 152 152 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT GROUP THERAPY 8-22 MIN 4 PTS PX-420971506 CDM 97150 CPT 420 RC outpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT GROUP THERAPY 23-37 MIN 4 PTS PX-420971507 CDM 97150 CPT 420 RC outpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT GROUP THERAPY 38-52 MIN 4 PTS PX-420971508 CDM 97150 CPT 420 RC outpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION LOW COMPLEXITY 8-22 MIN PX-420971610 CDM 97161 CPT 420 RC outpatient 180 176.4 All Payors / Plans All Payors / Plans 180 other 180 180 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION LOW COMPLEXITY 23-37 MIN PX-420971611 CDM 97161 CPT 420 RC outpatient 361 353.78 All Payors / Plans All Payors / Plans 361 other 361 361 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION LOW COMPLEXITY 38-52 MIN PX-420971612 CDM 97161 CPT 420 RC outpatient 541 530.18 All Payors / Plans All Payors / Plans 541 other 541 541 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION LOW COMPLEXITY 53-67 MIN PX-420971613 CDM 97161 CPT 420 RC outpatient 722 707.56 All Payors / Plans All Payors / Plans 722 other 722 722 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION LOW COMPLEXITY 68-82 MIN PX-420971614 CDM 97161 CPT 420 RC outpatient 902 883.96 All Payors / Plans All Payors / Plans 902 other 902 902 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION MOD COMPLEXITY 8-22 MIN PX-420971620 CDM 97162 CPT 420 RC outpatient 180 176.4 All Payors / Plans All Payors / Plans 180 other 180 180 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION MOD COMPLEXITY 23-37MIN PX-420971621 CDM 97162 CPT 420 RC outpatient 361 353.78 All Payors / Plans All Payors / Plans 361 other 361 361 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION MOD COMPLEXITY 38-52 MIN PX-420971622 CDM 97162 CPT 420 RC outpatient 541 530.18 All Payors / Plans All Payors / Plans 541 other 541 541 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION MOD COMPLEXITY 53-67 MIN PX-420971623 CDM 97162 CPT 420 RC outpatient 722 707.56 All Payors / Plans All Payors / Plans 722 other 722 722 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION MOD COMPLEXITY 68-82 MIN PX-420971624 CDM 97162 CPT 420 RC outpatient 902 883.96 All Payors / Plans All Payors / Plans 902 other 902 902 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION HIGH COMPLEXITY 8-22 MIN PX-420971630 CDM 97163 CPT 420 RC outpatient 180 176.4 All Payors / Plans All Payors / Plans 180 other 180 180 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION HIGH COMPLEXITY 23-37 MIN PX-420971631 CDM 97163 CPT 420 RC outpatient 361 353.78 All Payors / Plans All Payors / Plans 361 other 361 361 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION HIGH COMPLEXITY 38-52 MIN PX-420971632 CDM 97163 CPT 420 RC outpatient 541 530.18 All Payors / Plans All Payors / Plans 541 other 541 541 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION HIGH COMPLEXITY 53-67 MIN PX-420971633 CDM 97163 CPT 420 RC outpatient 722 707.56 All Payors / Plans All Payors / Plans 722 other 722 722 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EVALUATION HIGH COMPLEXITY 68-82 MIN PX-420971634 CDM 97163 CPT 420 RC outpatient 902 883.96 All Payors / Plans All Payors / Plans 902 other 902 902 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FUNCTIONAL ACTIVITY TH PX-420975300 CDM 97530 CPT 420 RC outpatient 158 154.84 All Payors / Plans All Payors / Plans 158 other 158 158 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT TRMT/SENSORIMO IND 15 MIN PX-420975330 CDM 97533 CPT 420 RC outpatient 85 83.3 All Payors / Plans All Payors / Plans 85 other 85 85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT SELF CARE/HOME MGMT 15 MIN PX-420975350 CDM 97535 CPT 420 RC outpatient 101 98.98 All Payors / Plans All Payors / Plans 101 other 101 101 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COMM/WORK REINTEGRATION 15 MIN PX-420975370 CDM 97537 CPT 420 RC outpatient 85 83.3 All Payors / Plans All Payors / Plans 85 other 85 85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WHEELCHARI MGMT/PROPOLUSION 15MIN PX-420975420 CDM 97542 CPT 420 RC outpatient 113 110.74 All Payors / Plans All Payors / Plans 113 other 113 113 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT WC SELECT DEBRIDE <=20 CM PX-420975970 CDM 97597 CPT 420 RC outpatient 496 486.08 All Payors / Plans All Payors / Plans 496 other 496 496 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PT WC SELECT DEBRIDE >20 CM PX-420975980 CDM 97598 CPT 420 RC outpatient 180 176.4 All Payors / Plans All Payors / Plans 180 other 180 180 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NON-SELECT DEBRIDEMENT/WOUND CARE PX-420976020 CDM 97602 CPT 420 RC outpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FABRICATION/ORTHOTIC PX-420977600 CDM 97760 CPT 420 RC outpatient 203 198.94 All Payors / Plans All Payors / Plans 203 other 203 203 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROSTHETIC TRAIN UP/LOW 15MIN PX-420977610 CDM 97761 CPT 420 RC outpatient 158 154.84 All Payors / Plans All Payors / Plans 158 other 158 158 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHECKOUT ORTHO/PROTH EST PT 15 MI PX-420977620 CDM 97763 CPT 420 RC outpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 38-52 2 PTS PX-430171500 CDM 97150 CPT 430 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 38-52 3 PTS PX-430171501 CDM 97150 CPT 430 RC outpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 38-52 4 PTS PX-430171502 CDM 97150 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 53-67 2 PTS PX-430171503 CDM 97150 CPT 430 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 53-67 3 PTS PX-430171504 CDM 97150 CPT 430 RC outpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 53-67 4 PTS PX-430171505 CDM 97150 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT SENSORIMO 15 MIN 2 PTS PX-430171506 CDM 97150 CPT 430 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/SENSORIMO 15 MIN 3 PTS PX-430171507 CDM 97150 CPT 430 RC outpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/SENSORIMO 15 MIN 4 PTS PX-430171508 CDM 97150 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT COGNITIVE SKILLS 15 MIN 2 PTS PX-430171509 CDM 97150 CPT 430 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT COGNITIVE SKILL 15 MIN 3 PTS PX-430171510 CDM 97150 CPT 430 RC outpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT COGNITIVE SKILLS 15 MIN 4 PTS PX-430171511 CDM 97150 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT ASSIST/ADAPT EQUIP 8-22 2 PTS PX-430171512 CDM 97150 CPT 430 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AS/AD EQUIP GRP 8-22 MIN 3 PTS PX-430171513 CDM 97150 CPT 430 RC outpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT ASSIST/ADAPT EQUIP 8-22 4 PTS PX-430171514 CDM 97150 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 8-22 MIN 2 PTS PX-430171515 CDM 97150 CPT 430 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 8-22 3 PTS PX-430171516 CDM 97150 CPT 430 RC outpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 8-22 MIN 4 PTS PX-430171517 CDM 97150 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 23-37 MIN 2 PTS PX-430171518 CDM 97150 CPT 430 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 23-37 3 PTS PX-430171519 CDM 97150 CPT 430 RC outpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 23-37 MIN 4 PTS PX-430171520 CDM 97150 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 38-52 MIN 2 PTS PX-430171521 CDM 97150 CPT 430 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 38-52 MIN 3 PTS PX-430171522 CDM 97150 CPT 430 RC outpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 38-52 MIN 4 PTS PX-430171523 CDM 97150 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 53-67 MIN 2 PTS PX-430171524 CDM 97150 CPT 430 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 53-67 MIN 3 PTS PX-430171525 CDM 97150 CPT 430 RC outpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/PREVENT 53-67 MIN 4 PTS PX-430171526 CDM 97150 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG ARM SPLNT SHLDR-HAND 8-22 PX-430291050 CDM 29105 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG ARM SPLNT SHLDR-HAND 23-37 PX-430291051 CDM 29105 CPT 430 RC outpatient 218 213.64 All Payors / Plans All Payors / Plans 218 other 218 218 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG ARM SPLNT SHLDR-HAND 38-52 PX-430291052 CDM 29105 CPT 430 RC outpatient 327 320.46 All Payors / Plans All Payors / Plans 327 other 327 327 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG ARM SPLNT SHLDR-HAND 53-67 PX-430291053 CDM 29105 CPT 430 RC outpatient 436 427.28 All Payors / Plans All Payors / Plans 436 other 436 436 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG ARM SPLNT SHLDR-HAND 68-82 PX-430291054 CDM 29105 CPT 430 RC outpatient 545 534.1 All Payors / Plans All Payors / Plans 545 other 545 545 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL STATIC 8-22 PX-430291250 CDM 29125 CPT 430 RC outpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL STATIC 23-37 PX-430291251 CDM 29125 CPT 430 RC outpatient 182 178.36 All Payors / Plans All Payors / Plans 182 other 182 182 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL STATIC 38-52 PX-430291252 CDM 29125 CPT 430 RC outpatient 273 267.54 All Payors / Plans All Payors / Plans 273 other 273 273 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT SHORT ARM SPL STATIC 53-67 PX-430291253 CDM 29125 CPT 430 RC outpatient 364 356.72 All Payors / Plans All Payors / Plans 364 other 364 364 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL STATIC 68-82 PX-430291254 CDM 29125 CPT 430 RC outpatient 455 445.9 All Payors / Plans All Payors / Plans 455 other 455 455 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL DYNAMIC 8-22 PX-430291260 CDM 29126 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL DYNAMIC 23-37 PX-430291261 CDM 29126 CPT 430 RC outpatient 218 213.64 All Payors / Plans All Payors / Plans 218 other 218 218 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL DYNAMIC 38-52 PX-430291262 CDM 29126 CPT 430 RC outpatient 327 320.46 All Payors / Plans All Payors / Plans 327 other 327 327 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL DYNAMIC 53-67 PX-430291263 CDM 29126 CPT 430 RC outpatient 436 427.28 All Payors / Plans All Payors / Plans 436 other 436 436 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHORT ARM SPL DYNAMIC 68-82 PX-430291264 CDM 29126 CPT 430 RC outpatient 545 534.1 All Payors / Plans All Payors / Plans 545 other 545 545 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT STATIC 8-22 PX-430291300 CDM 29130 CPT 430 RC outpatient 73 71.54 All Payors / Plans All Payors / Plans 73 other 73 73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT STATIC 23-37 PX-430291301 CDM 29130 CPT 430 RC outpatient 145 142.1 All Payors / Plans All Payors / Plans 145 other 145 145 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT STATIC 38-52 PX-430291302 CDM 29130 CPT 430 RC outpatient 218 213.64 All Payors / Plans All Payors / Plans 218 other 218 218 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT STATIC 53-67 PX-430291303 CDM 29130 CPT 430 RC outpatient 291 285.18 All Payors / Plans All Payors / Plans 291 other 291 291 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT FINGER SPLINT STATIC 68-82 PX-430291304 CDM 29130 CPT 430 RC outpatient 364 356.72 All Payors / Plans All Payors / Plans 364 other 364 364 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT DYNAMIC 8-22 PX-430291310 CDM 29131 CPT 430 RC outpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT DYNAMIC 23-37 PX-430291311 CDM 29131 CPT 430 RC outpatient 182 178.36 All Payors / Plans All Payors / Plans 182 other 182 182 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT DYNAMIC 38-52 PX-430291312 CDM 29131 CPT 430 RC outpatient 273 267.54 All Payors / Plans All Payors / Plans 273 other 273 273 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT DYNAMIC 53-67 PX-430291313 CDM 29131 CPT 430 RC outpatient 364 356.72 All Payors / Plans All Payors / Plans 364 other 364 364 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP FINGER SPLINT DYNAMIC 68-82 PX-430291314 CDM 29131 CPT 430 RC outpatient 455 445.9 All Payors / Plans All Payors / Plans 455 other 455 455 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG LEG SPL THI-ANK/TOES 8-22 PX-430295050 CDM 29505 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG LEG SPL THI-ANK/TOES 23-37 PX-430295051 CDM 29505 CPT 430 RC outpatient 218 213.64 All Payors / Plans All Payors / Plans 218 other 218 218 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG LEG SPL THI-ANK/TOES 38-52 PX-430295052 CDM 29505 CPT 430 RC outpatient 327 320.46 All Payors / Plans All Payors / Plans 327 other 327 327 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG LEG SPL THI-ANK/TOES 53-67 PX-430295053 CDM 29505 CPT 430 RC outpatient 436 427.28 All Payors / Plans All Payors / Plans 436 other 436 436 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT LNG LEG SPL THI-ANK/TOES 68-82 PX-430295054 CDM 29505 CPT 430 RC outpatient 545 534.1 All Payors / Plans All Payors / Plans 545 other 545 545 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHRT LEG SPL CALF-FOOT 8-22 PX-430295150 CDM 29515 CPT 430 RC outpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHRT LEG SPL CALF-FOOT23-37 PX-430295151 CDM 29515 CPT 430 RC outpatient 182 178.36 All Payors / Plans All Payors / Plans 182 other 182 182 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHRT LEG SPL CALF-FOOT38-52 PX-430295152 CDM 29515 CPT 430 RC outpatient 273 267.54 All Payors / Plans All Payors / Plans 273 other 273 273 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHRT LEG SP CALF-FOOT 68-82 PX-430295153 CDM 29515 CPT 430 RC outpatient 455 445.9 All Payors / Plans All Payors / Plans 455 other 455 455 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT STRAPPING UNNA BOOT 8-22 PX-430295800 CDM 29580 CPT 430 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT STRAPPING UNNA BOOT 23-37 PX-430295801 CDM 29580 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT STRAPPING UNNA BOOT 38-52 PX-430295802 CDM 29580 CPT 430 RC outpatient 164 160.72 All Payors / Plans All Payors / Plans 164 other 164 164 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT STRAPPING UNNA BOOT 53-67 PX-430295803 CDM 29580 CPT 430 RC outpatient 218 213.64 All Payors / Plans All Payors / Plans 218 other 218 218 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT STRAPPING UNNA BOOT 68-82 PX-430295804 CDM 29580 CPT 430 RC outpatient 273 267.54 All Payors / Plans All Payors / Plans 273 other 273 273 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP L LEG/FT 8-22 PX-430295810 CDM 29581 CPT 430 RC outpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP L LEG/FT 23-37 PX-430295811 CDM 29581 CPT 430 RC outpatient 182 178.36 All Payors / Plans All Payors / Plans 182 other 182 182 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP L LEG/FT 38-52 PX-430295812 CDM 29581 CPT 430 RC outpatient 273 267.54 All Payors / Plans All Payors / Plans 273 other 273 273 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP L LEG/FT 53-67 PX-430295813 CDM 29581 CPT 430 RC outpatient 364 356.72 All Payors / Plans All Payors / Plans 364 other 364 364 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L L LEG/FT 68-82 PX-430295814 CDM 29581 CPT 430 RC outpatient 455 445.9 All Payors / Plans All Payors / Plans 455 other 455 455 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP MLT-LAY COMP THI/LEG 8-22 PX-430295820 CDM 29582 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP MLT-LAY COMP THI/LEG 23-37 PX-430295821 CDM 29582 CPT 430 RC outpatient 218 213.64 All Payors / Plans All Payors / Plans 218 other 218 218 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP MLT-LAY COMP THI/LEG 38-52 PX-430295822 CDM 29582 CPT 430 RC outpatient 327 320.46 All Payors / Plans All Payors / Plans 327 other 327 327 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP MLT-LAY COMP THI/LEG 53-67 PX-430295823 CDM 29582 CPT 430 RC outpatient 436 427.28 All Payors / Plans All Payors / Plans 436 other 436 436 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP MLT-LAY COMP THI/LEG68-73 PX-430295824 CDM 29582 CPT 430 RC outpatient 545 534.1 All Payors / Plans All Payors / Plans 545 other 545 545 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FOR 8-22 PX-430295830 CDM 29583 CPT 430 RC outpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FOR 23-37 PX-430295831 CDM 29583 CPT 430 RC outpatient 182 178.36 All Payors / Plans All Payors / Plans 182 other 182 182 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FOR 38-52 PX-430295832 CDM 29583 CPT 430 RC outpatient 273 267.54 All Payors / Plans All Payors / Plans 273 other 273 273 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FOR 53-67 PX-430295833 CDM 29583 CPT 430 RC outpatient 364 356.72 All Payors / Plans All Payors / Plans 364 other 364 364 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FOR 68-73 PX-430295834 CDM 29583 CPT 430 RC outpatient 455 445.9 All Payors / Plans All Payors / Plans 455 other 455 455 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FING 8-22 PX-430295840 CDM 29584 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP APP M/L COMP UP ARM/FING 23-37 PX-430295841 CDM 29584 CPT 430 RC outpatient 218 213.64 All Payors / Plans All Payors / Plans 218 other 218 218 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FING 38-52 PX-430295842 CDM 29584 CPT 430 RC outpatient 327 320.46 All Payors / Plans All Payors / Plans 327 other 327 327 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FING 53-67 PX-430295843 CDM 29584 CPT 430 RC outpatient 436 427.28 All Payors / Plans All Payors / Plans 436 other 436 436 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT APP M/L COMP UP ARM/FING 68-82 PX-430295844 CDM 29584 CPT 430 RC outpatient 545 534.1 All Payors / Plans All Payors / Plans 545 other 545 545 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DEVEL SCREEN W INTER RPT 8-22 PX-430961100 CDM 96110 CPT 430 RC outpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DEVEL SCREEN W INTER RPT 23-37 PX-430961102 CDM 96110 CPT 430 RC outpatient 164 160.72 All Payors / Plans All Payors / Plans 164 other 164 164 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DEVEL SCREEN W INTER RPT 38-52 PX-430961103 CDM 96110 CPT 430 RC outpatient 245 240.1 All Payors / Plans All Payors / Plans 245 other 245 245 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DEVEL SCREEN W INTER RPT 53-67 PX-430961104 CDM 96110 CPT 430 RC outpatient 327 320.46 All Payors / Plans All Payors / Plans 327 other 327 327 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DEVEL SCREEN W INTER RPT 68-82 PX-430961105 CDM 96110 CPT 430 RC outpatient 409 400.82 All Payors / Plans All Payors / Plans 409 other 409 409 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DEVEL TEST EXT W/INT RPT 15MIN PX-430961106 CDM 96110 CPT 430 RC outpatient 436 427.28 All Payors / Plans All Payors / Plans 436 other 436 436 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT STANDARD COGNIT TEST 31MINOR> PX-430961250 CDM 96125 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT REASSESSMENT INDIVIDUAL 8-22 PX-430970040 CDM 97168 CPT 430 RC outpatient 72 70.56 All Payors / Plans All Payors / Plans 72 other 72 72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT REASSESSMENT INDIVIDUAL 23-37 PX-430970041 CDM 97168 CPT 430 RC outpatient 144 141.12 All Payors / Plans All Payors / Plans 144 other 144 144 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT REASSESSMENT INDIVIDUAL 38-52 PX-430970042 CDM 97168 CPT 430 RC outpatient 215 210.7 All Payors / Plans All Payors / Plans 215 other 215 215 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT REASSESSMENT INDIVIDUAL 53-67 PX-430970043 CDM 97168 CPT 430 RC outpatient 287 281.26 All Payors / Plans All Payors / Plans 287 other 287 287 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT MECHANICAL TRACT 8-22 PX-430970120 CDM 97012 CPT 430 RC outpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT MECHANICAL TRACT 23-37 PX-430970121 CDM 97012 CPT 430 RC outpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT MECHANICAL TRACT 38-52 PX-430970122 CDM 97012 CPT 430 RC outpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT MECHANICAL TRACT 53-67 PX-430970123 CDM 97012 CPT 430 RC outpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PARAFFIN BATH 8-22 PX-430970180 CDM 97018 CPT 430 RC outpatient 18 17.64 All Payors / Plans All Payors / Plans 18 other 18 18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARAFFIN BATH PX-430970181 CDM 97018 CPT 430 RC outpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PARAFFIN BATH 38-52 PX-430970182 CDM 97018 CPT 430 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PARAFFIN BATH 53-67 PX-430970183 CDM 97018 CPT 430 RC outpatient 73 71.54 All Payors / Plans All Payors / Plans 73 other 73 73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PARAFFIN BATH 68-82 PX-430970184 CDM 97018 CPT 430 RC outpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT ELEC STIMUL MANUAL 15 MIN PX-430970320 CDM 97032 CPT 430 RC outpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT IONTOPHORESIS 15 MIN PX-430970330 CDM 97033 CPT 430 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT CONTRAST BATH 15 MIN PX-430970340 CDM 97034 CPT 430 RC outpatient 27 26.46 All Payors / Plans All Payors / Plans 27 other 27 27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT ULTRASOUND 15 MIN PX-430970350 CDM 97035 CPT 430 RC outpatient 27 26.46 All Payors / Plans All Payors / Plans 27 other 27 27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT FLUIDTHERAPY 8-22 PX-430970390 CDM 97039 CPT 430 RC outpatient 18 17.64 All Payors / Plans All Payors / Plans 18 other 18 18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT FLUIDTHERAPY 23-37 PX-430970391 CDM 97039 CPT 430 RC outpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT THERAPEUTIC EXERCISE 15 MIN TH PX-430971100 CDM 97110 CPT 430 RC outpatient 48 47.04 All Payors / Plans All Payors / Plans 48 other 48 48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT NEUROMUSCULAR REED 15 MIN PX-430971120 CDM 97112 CPT 430 RC outpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT MASSAGE 15 MIN PX-430971240 CDM 97124 CPT 430 RC outpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT COGNITIVE SLILLS IND EA ADD'L 15 MIN PX-430971301 CDM 97130 CPT 430 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT MANUAL THERAPY 15 MIN PX-430971400 CDM 97140 CPT 430 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DAILY LIVING SKILLS 15 MIN 2PT PX-430971500 CDM 97150 CPT 430 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC THERAPEUTIC EX. GROUP PX-430971501 CDM 97150 CPT 430 RC outpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DAILY LIVING SKILLS 15MIN 4PTS PX-430971502 CDM 97150 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 8-22 2 PTS PX-430971503 CDM 97150 CPT 430 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 8-22 3 PTS PX-430971504 CDM 97150 CPT 430 RC outpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 8-22 4 PTS PX-430971505 CDM 97150 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 23-37 2 PTS PX-430971506 CDM 97150 CPT 430 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 23-37 3 PTS PX-430971507 CDM 97150 CPT 430 RC outpatient 82 80.36 All Payors / Plans All Payors / Plans 82 other 82 82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS 23-47 4 PTS PX-430971508 CDM 97150 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION LOW COMPLEXITY 8-22 PX-430971650 CDM 97165 CPT 430 RC outpatient 96 94.08 All Payors / Plans All Payors / Plans 96 other 96 96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION LOW COMPLEXITY 23-37 PX-430971651 CDM 97165 CPT 430 RC outpatient 191 187.18 All Payors / Plans All Payors / Plans 191 other 191 191 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION LOW COMPLEXITY 38-52 PX-430971652 CDM 97165 CPT 430 RC outpatient 287 281.26 All Payors / Plans All Payors / Plans 287 other 287 287 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION LOW COMPLEXITY 53-67 PX-430971653 CDM 97165 CPT 430 RC outpatient 383 375.34 All Payors / Plans All Payors / Plans 383 other 383 383 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION MOD COMPLEXITY 8-22 PX-430971660 CDM 97166 CPT 430 RC outpatient 96 94.08 All Payors / Plans All Payors / Plans 96 other 96 96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION MOD COMPLEXITY 23-37 PX-430971661 CDM 97166 CPT 430 RC outpatient 191 187.18 All Payors / Plans All Payors / Plans 191 other 191 191 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION MOD COMPLEXITY 38-52 PX-430971662 CDM 97166 CPT 430 RC outpatient 287 281.26 All Payors / Plans All Payors / Plans 287 other 287 287 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION MOD COMPLEXITY 53-67 PX-430971663 CDM 97166 CPT 430 RC outpatient 383 375.34 All Payors / Plans All Payors / Plans 383 other 383 383 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION HIGH COMPLEXITY 8-22 PX-430971670 CDM 97167 CPT 430 RC outpatient 96 94.08 All Payors / Plans All Payors / Plans 96 other 96 96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION HIGH COMPLEXITY 23-37 PX-430971671 CDM 97167 CPT 430 RC outpatient 191 187.18 All Payors / Plans All Payors / Plans 191 other 191 191 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION HIGH COMPLEXITY 38-52 PX-430971672 CDM 97167 CPT 430 RC outpatient 287 281.26 All Payors / Plans All Payors / Plans 287 other 287 287 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT EVALUATION HIGH COMPLEXITY 53-67 PX-430971673 CDM 97167 CPT 430 RC outpatient 383 375.34 All Payors / Plans All Payors / Plans 383 other 383 383 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT FUNCTIONAL ACTIVITY 15 MIN TH PX-430975300 CDM 97530 CPT 430 RC outpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS IND 8-22 PX-430975320 CDM 97127 CPT 430 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS IND 23-37 PX-430975321 CDM 97127 CPT 430 RC outpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS IND 38-52 PX-430975322 CDM 97127 CPT 430 RC outpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PSY/SOCIAL SKILLS IND 53-67 PX-430975323 CDM 97127 CPT 430 RC outpatient 182 178.36 All Payors / Plans All Payors / Plans 182 other 182 182 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT COGNITIVIE SKILLS IND INITIAL 15 MIN PX-430975324 CDM 97129 CPT 430 RC outpatient 48 47.04 All Payors / Plans All Payors / Plans 48 other 48 48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT TRMT/SENSORIMO IND 15 MIN PX-430975330 CDM 97533 CPT 430 RC outpatient 167 163.66 All Payors / Plans All Payors / Plans 167 other 167 167 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT COMM/WORK REINTEGRATION 15 MIN PX-430975371 CDM 97537 CPT 430 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT WHEELCHAIR MGMT/PROP 15 MIN PX-430975420 CDM 97542 CPT 430 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT WC SELECT DEBRIDE <= 20 CM PX-430975970 CDM 97597 CPT 430 RC outpatient 109 106.82 All Payors / Plans All Payors / Plans 109 other 109 109 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT WC SELECT DEBRIDE > 20 CM PX-430975980 CDM 97598 CPT 430 RC outpatient 218 213.64 All Payors / Plans All Payors / Plans 218 other 218 218 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT ORTHOTIC MGMT 15 MIN PX-430977600 CDM 97760 CPT 430 RC outpatient 55 53.9 All Payors / Plans All Payors / Plans 55 other 55 55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT PROSTHETIC TRAIN UP/LOW EXT 15 PX-430977610 CDM 97761 CPT 430 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT RECHECK PROST/ORTH 15 MIN PX-430977620 CDM 97763 CPT 430 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT DAILY LIVING SKILLS 15 MIN PX-430985350 CDM 97535 CPT 430 RC outpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST BASIC TREATMENT/8-22 MIN IND PX-440925070 CDM 92507 CPT 440 RC outpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST BASIC TREATMENT/23-37 MIN IND PX-440925071 CDM 92507 CPT 440 RC outpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST BASIC TREATMENT/38-52 MIN IND PX-440925072 CDM 92507 CPT 440 RC outpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST BASIC TREATMENT/53-67 MIN IND PX-440925073 CDM 92507 CPT 440 RC outpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST SP THERAPY GRP OF 2-4 8-22 MIN PX-440925080 CDM 92508 CPT 440 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST SP THERAPY GROUP OF 2-4 23-37 PX-440925081 CDM 92508 CPT 440 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST SP THERAPY GROUP OF 2-4 38-52 PX-440925082 CDM 92508 CPT 440 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST SP THERAPY GROUP OF 2-4 53-67 PX-440925083 CDM 92508 CPT 440 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST SP GROUP 5 OR MORE 8-22 PX-440925084 CDM 92508 CPT 440 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST SP GROUP 5 OR MORE 23-37 PX-440925085 CDM 92508 CPT 440 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST SP GROUP 5 OR MORE 38-52 MIN PX-440925086 CDM 92508 CPT 440 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST SP GROUP 5 OR MORE 53-68 MIN PX-440925087 CDM 92508 CPT 440 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL SOUND/LANG COMPRE 8-22 PX-440925230 CDM 92523 CPT 444 RC outpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL SOUND/LANG COMPRE 23-37 PX-440925231 CDM 92523 CPT 440 RC outpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL SOUND/LANG COMPRE 38-52 PX-440925232 CDM 92523 CPT 440 RC outpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL SOUND/LANG COMPRE 53-67 PX-440925233 CDM 92523 CPT 440 RC outpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL SOUND/LANG COMPRE 68-82 PX-440925234 CDM 92523 CPT 440 RC outpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL SOUND/LANG COMPRE 83-97 PX-440925235 CDM 92523 CPT 440 RC outpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL SOUND/LANG COMPRE 98-112 PX-440925236 CDM 92523 CPT 440 RC outpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL SOUND/LANG COMPRE 113-127 PX-440925237 CDM 92523 CPT 440 RC outpatient 313 306.74 All Payors / Plans All Payors / Plans 313 other 313 313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL BEHAV QUAL VOICE 8-22 PX-440925240 CDM 92524 CPT 440 RC outpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL BEHAV QUAL VOICE 23-37 PX-440925241 CDM 92524 CPT 440 RC outpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL BEHAV QUAL VOICE 38-52 PX-440925242 CDM 92524 CPT 440 RC outpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL BEHAV QUAL VOICE 53-67 PX-440925243 CDM 92524 CPT 440 RC outpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL BEHAV QUAL VOICE 68-82 PX-440925244 CDM 92524 CPT 440 RC outpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL BEHAV QUAL VOICE 83-97 PX-440925245 CDM 92524 CPT 440 RC outpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL BEHAV QUAL VOICE 98-112 PX-440925246 CDM 92524 CPT 440 RC outpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL BEHAV QUAL VOICE 113-127 PX-440925247 CDM 92524 CPT 440 RC outpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT SWALLOW/ORAL FEED 8-22MN PX-440925260 CDM 92526 CPT 440 RC outpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT SWALLOW/ORAL FEED/23-37 PX-440925261 CDM 92526 CPT 440 RC outpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT SWALLOW/ORAL FEED/38-52 PX-440925262 CDM 92526 CPT 440 RC outpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT SWALLOW/ORAL FEED/53-67 PX-440925263 CDM 92526 CPT 440 RC outpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL USE/FIT VOICE PROST 8-22 PX-440925970 CDM 92597 CPT 440 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL USE/FIT VOICE PROST 23-37 PX-440925971 CDM 92597 CPT 440 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL USE/FIT VOICE PROS 38-52 PX-440925972 CDM 92597 CPT 440 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL USE/FIT VOICE PROS 53-67 PX-440925973 CDM 92597 CPT 440 RC outpatient 86 84.28 All Payors / Plans All Payors / Plans 86 other 86 86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL NONSP AUG/ALT DEV 8-22 PX-440926050 CDM 92605 CPT 440 RC outpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL NON SP AUG/ALT DEV 23-37 PX-440926051 CDM 92605 CPT 440 RC outpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL NON SP AUG/ALT DEV 38-52 PX-440926052 CDM 92605 CPT 440 RC outpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL NON SP AUG/ALT DEV 53-67 PX-440926053 CDM 92605 CPT 440 RC outpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT PROGRM NON SP DEV 8-22 PX-440926060 CDM 92606 CPT 440 RC outpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT/PROG NON SP DEV 23-37 PX-440926061 CDM 92606 CPT 440 RC outpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT/PROG NON SP DEVICE 38-52 PX-440926062 CDM 92606 CPT 440 RC outpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT/PROG NON SP DEVICE 53-67 PX-440926063 CDM 92606 CPT 440 RC outpatient 97 95.06 All Payors / Plans All Payors / Plans 97 other 97 97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EV SP GEN AUG/ALT DEVICE 1 HR PX-440926070 CDM 92607 CPT 440 RC outpatient 194 190.12 All Payors / Plans All Payors / Plans 194 other 194 194 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EV SP GEN AUG/ALT DEVICE 30MIN PX-440926080 CDM 92608 CPT 440 RC outpatient 76 74.48 All Payors / Plans All Payors / Plans 76 other 76 76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT/PROG SP GEN DEVICE 8-22 PX-440926090 CDM 92609 CPT 440 RC outpatient 162 158.76 All Payors / Plans All Payors / Plans 162 other 162 162 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT/PROG SP GEN DEVICE 23-37 PX-440926091 CDM 92609 CPT 440 RC outpatient 162 158.76 All Payors / Plans All Payors / Plans 162 other 162 162 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT/PROG SP GEN DEVICE 38-52 PX-440926092 CDM 92609 CPT 440 RC outpatient 162 158.76 All Payors / Plans All Payors / Plans 162 other 162 162 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TREAT/PROG SP GEN DEVICE 53-67 PX-440926093 CDM 92609 CPT 440 RC outpatient 162 158.76 All Payors / Plans All Payors / Plans 162 other 162 162 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL ORAL/PHARYN SWALLOW 8-22 PX-440926100 CDM 92610 CPT 440 RC outpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL ORAL/PHARYN SWALLOW 23-37 PX-440926101 CDM 92610 CPT 440 RC outpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL ORAL/PHARYN SWALLOW 38-52 PX-440926102 CDM 92610 CPT 440 RC outpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL ORAL/PHARYN SWALLOW 53-67 PX-440926103 CDM 92610 CPT 440 RC outpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL ORAL/PHARYN SWALLOW 68-82 PX-440926104 CDM 92610 CPT 440 RC outpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL ORAL/PHARYN/SWALLOW 83-97 PX-440926105 CDM 92610 CPT 440 RC outpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL ORAL/PHARYN/SWALLOW98-112 PX-440926106 CDM 92610 CPT 440 RC outpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST EVAL ORAL/PHARYN/SWALL 113-127 PX-440926107 CDM 92610 CPT 440 RC outpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST MOTION FLUORO EVAL SWALLOW8-22 PX-440926110 CDM 92611 CPT 440 RC outpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST MOTION FLUORO EVAL SWALL 23-37 PX-440926111 CDM 92611 CPT 440 RC outpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST MOTION FLUORO EVAL SWALL 38-52 PX-440926112 CDM 92611 CPT 440 RC outpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST MOTION FLUORO EVAL SWALL 53-67 PX-440926113 CDM 92611 CPT 440 RC outpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST MOTION FLUORO SWAL 68-82 PX-440926114 CDM 92611 CPT 440 RC outpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST MOTION FLUORO EVAL SWAL 83-97 PX-440926115 CDM 92611 CPT 440 RC outpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST MOTION FLUORO EVAL SWAL 98-112 PX-440926116 CDM 92611 CPT 440 RC outpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST MOTION FLUORO EVAL SWAL113-127 PX-440926117 CDM 92611 CPT 440 RC outpatient 248 243.04 All Payors / Plans All Payors / Plans 248 other 248 248 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ST FLEXIBLE FIBEROPTIC ENDOSC EVAL SWALLOW 8-22 PX-440926120 CDM 92612 CPT 440 RC outpatient 496 486.08 All Payors / Plans All Payors / Plans 496 other 496 496 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ST FLEXIBLE FIBEROPTIC ENDOSC EVAL SWALLOW 23-37 PX-440926121 CDM 92612 CPT 440 RC outpatient 496 486.08 All Payors / Plans All Payors / Plans 496 other 496 496 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ST FLEXIBLE FIBEROPTIC ENDOSC EVAL SWALLOW 38-52 PX-440926122 CDM 92612 CPT 440 RC outpatient 496 486.08 All Payors / Plans All Payors / Plans 496 other 496 496 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ST FLEXIBLE FIBEROPTIC ENDOSC EVAL SWALLOW 53-67 PX-440926123 CDM 92612 CPT 440 RC outpatient 496 486.08 All Payors / Plans All Payors / Plans 496 other 496 496 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST ASSESS APHASIA W/RPT PER HR PX-440961050 CDM 96105 CPT 440 RC outpatient 119 116.62 All Payors / Plans All Payors / Plans 119 other 119 119 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST DEVELOPMNTL TEST/LMTD 8-22 PX-440961100 CDM 96110 CPT 440 RC outpatient 32 31.36 All Payors / Plans All Payors / Plans 32 other 32 32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST DEVELOPMNTL TEST/LMTD 23-37 PX-440961101 CDM 96110 CPT 440 RC outpatient 32 31.36 All Payors / Plans All Payors / Plans 32 other 32 32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST DEVELOPMNTL TEST/LMTD 38-52 PX-440961102 CDM 96110 CPT 440 RC outpatient 32 31.36 All Payors / Plans All Payors / Plans 32 other 32 32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST DEVELOPMNTL TEST/LMTD 53-67 PX-440961103 CDM 96110 CPT 440 RC outpatient 32 31.36 All Payors / Plans All Payors / Plans 32 other 32 32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST STANDARD COGNITIVE PERFORMANCE TESTING PX-440961250 CDM 96125 CPT 440 RC outpatient 140 137.2 All Payors / Plans All Payors / Plans 140 other 140 140 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST ORAL MOTOR EXERC 15 MIN TPR PX-440971100 CDM 97110 CPT 440 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST THER EXNEUROMUSC/ 15 MIN PX-440971120 CDM 97112 CPT 440 RC outpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST DEVELOP COGNITIVE SKILLS EA ADD'L 15 MIN PX-440971301 CDM 97130 CPT 440 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST DEVELOP COGNITIVE SKILLS INITIAL 15 MN PX-440975320 CDM 97129 CPT 440 RC outpatient 43 42.14 All Payors / Plans All Payors / Plans 43 other 43 43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TRMT/SENSORIMO IND 15 MIN PX-440975330 CDM 97533 CPT 440 RC outpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ST TEP CHECKOUT EST PT 15 MIN PX-440977620 CDM 97763 CPT 440 RC outpatient 119 116.62 All Payors / Plans All Payors / Plans 119 other 119 119 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ER-BRIEF VISIT PX-451992810 CDM 99281 CPT 451 RC outpatient 110 107.8 All Payors / Plans All Payors / Plans 110 other 110 110 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ER-SCREENING PX-451992811 CDM 99281 CPT 451 RC outpatient 110 107.8 All Payors / Plans All Payors / Plans 110 other 110 110 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ER-EXTENDED CARE PX-452000000 CDM 452 RC outpatient 110 107.8 All Payors / Plans All Payors / Plans 110 other 110 110 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ER-INTERMEDIATE VISIT PX-452992820 CDM 99282 CPT 452 RC outpatient 110 107.8 All Payors / Plans All Payors / Plans 110 other 110 110 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ER-EXTENDED VISIT PX-452992830 CDM 99283 CPT 452 RC outpatient 220 215.6 All Payors / Plans All Payors / Plans 220 other 220 220 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ER-INTENSIVE VISIT PX-452992840 CDM 99284 CPT 452 RC outpatient 440 431.2 All Payors / Plans All Payors / Plans 440 other 440 440 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ER-COMPREHENSIVE VISIT PX-452992850 CDM 99285 CPT 452 RC outpatient 770 754.6 All Payors / Plans All Payors / Plans 770 other 770 770 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RT CAPILLARY ABG DRAW PX-460364160 CDM 36416 CPT 460 RC outpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RT BLOOD GAS PUNCTURE PX-460366000 CDM 36600 CPT 460 RC outpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PF ARTERIAL GASES PX-460366001 CDM 36600 CPT 460 RC outpatient 138 135.24 All Payors / Plans All Payors / Plans 138 other 138 138 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ARTERIAL LINE SET UP PX-460366200 CDM 36620 CPT 460 RC outpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SCREENING SPIROMETRY PX-460940101 CDM 94010 CPT 460 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INCENTIVE SPIROMETRY INITIAL PX-460940102 CDM 94010 CPT 460 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INCENTIVE SPIROMETRY SUBSEQUENT PX-460940103 CDM 94010 CPT 460 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SCREENING SPIRO. C BD PX-460940600 CDM 94060 CPT 460 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRONCHIAL CHALLENGE PX-460940700 CDM 94070 CPT 460 RC outpatient 775 759.5 All Payors / Plans All Payors / Plans 775 other 775 775 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VITAL CAPACITY PX-460941500 CDM 94150 CPT 460 RC outpatient 72 70.56 All Payors / Plans All Payors / Plans 72 other 72 72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MAXIMUM VOLUME VENT PX-460942000 CDM 94200 CPT 460 RC outpatient 111 108.78 All Payors / Plans All Payors / Plans 111 other 111 111 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEASUREMENT OF CO LEVEL PX-460942500 CDM 94250 CPT 460 RC outpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WALK TEST PX-460946202 CDM 94618 CPT 460 RC outpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY STRESS TESTING PX-460946204 CDM 94618 CPT 460 RC outpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CPAP SET-UP AND MANAGEMENT PX-460946600 CDM 94660 CPT 460 RC outpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEMONSTRATION OF NEBULAZATION PX-460946640 CDM 94664 CPT 460 RC outpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIFFUSION/VOLUME PX-460947290 CDM 94729 CPT 460 RC outpatient 185 181.3 All Payors / Plans All Payors / Plans 185 other 185 185 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEMBRANE DIFFUSION CAPACITY PX-460947291 CDM 94729 CPT 460 RC outpatient 185 181.3 All Payors / Plans All Payors / Plans 185 other 185 185 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PF PULSE OX PX-460947600 CDM 94760 CPT 460 RC outpatient 74 72.52 All Payors / Plans All Payors / Plans 74 other 74 74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULSE OXIMETRY PX-460947601 CDM 94760 CPT 460 RC outpatient 32 31.36 All Payors / Plans All Payors / Plans 32 other 32 32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PF PULSE OX PX-460947602 CDM 94760 CPT 460 RC outpatient 74 72.52 All Payors / Plans All Payors / Plans 74 other 74 74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MULTIPLE DETERIMATION PULSE OX/EXERC PX-460947611 CDM 94761 CPT 460 RC outpatient 240 235.2 All Payors / Plans All Payors / Plans 240 other 240 240 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULSE OXIMETRY MULTIPLE READINGS PX-460947612 CDM 94761 CPT 460 RC outpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERICARDIALCENTESIS W/ECHO PX-480769300 CDM 76930 CPT 480 RC outpatient 1460 1430.8 All Payors / Plans All Payors / Plans 1460 other 1460 1460 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EK CARDIOVERSION PX-480929600 CDM 92960 CPT 480 RC outpatient 202 197.96 All Payors / Plans All Payors / Plans 202 other 202 202 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONGENITAL ECHO (2D)/M PX-480933030 CDM 93303 CPT 480 RC outpatient 202 197.96 All Payors / Plans All Payors / Plans 202 other 202 202 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CONGENITAL ECHO 2D LTD F/U PX-480933040 CDM 93304 CPT 480 RC outpatient 90 88.2 All Payors / Plans All Payors / Plans 90 other 90 90 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EC ECHO 2D-M DOPPLER/COLOR PX-480933060 CDM 93306 CPT 480 RC outpatient 269 263.62 All Payors / Plans All Payors / Plans 269 other 269 269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ECHOCARDIOGRAM (2D)/M PX-480933070 CDM 93307 CPT 480 RC outpatient 202 197.96 All Payors / Plans All Payors / Plans 202 other 202 202 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ECHO 2D LIMITED/FOLLOW-UP PX-480933080 CDM 93308 CPT 480 RC outpatient 90 88.2 All Payors / Plans All Payors / Plans 90 other 90 90 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARDIAC DOPPLER PX-480933200 CDM 93320 CPT 480 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARDIAC DOPPLER FOLLOW-UP PX-480933210 CDM 93321 CPT 480 RC outpatient 36 35.28 All Payors / Plans All Payors / Plans 36 other 36 36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DOPPLER COLOR FLOW PX-480933250 CDM 93325 CPT 480 RC outpatient 22 21.56 All Payors / Plans All Payors / Plans 22 other 22 22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MYOCARD STRAIN IMG SPECKLE TRCK ASSMT PX-480933560 CDM 93356 CPT 480 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EK TILT TABLE 45 MIN OR LESS PX-480936600 CDM 93660 CPT 480 RC outpatient 269 263.62 All Payors / Plans All Payors / Plans 269 other 269 269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EK TILT TABLE >45 MIN PX-480936601 CDM 93660 CPT 480 RC outpatient 404 395.92 All Payors / Plans All Payors / Plans 404 other 404 404 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARDIAC CATH LAB SUPPLIES PX-481000000 CDM 481 RC outpatient 532.56 521.91 All Payors / Plans All Payors / Plans 532.56 other 532.56 532.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CL CARDIAC CATH MINUTES PX-481000020 CDM 481 RC outpatient 73 71.54 All Payors / Plans All Payors / Plans 73 other 73 73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EP EP MINUTES PX-481000030 CDM 481 RC outpatient 73 71.54 All Payors / Plans All Payors / Plans 73 other 73 73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXER TOLERANCE TEST PX-482930170 CDM 93017 CPT 482 RC outpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARDIOVASCULAR STRESS TEST PX-482930171 CDM 93017 CPT 482 RC outpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXER TOLERANCE TEST PX-482930172 CDM 93017 CPT 482 RC outpatient 135 132.3 All Payors / Plans All Payors / Plans 135 other 135 135 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TRANSESOPHAGEAL ECHO PX-483933120 CDM 93312 CPT 483 RC outpatient 269 263.62 All Payors / Plans All Payors / Plans 269 other 269 269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STRESS/PHARMACOLOGICAL ECHO PX-483933500 CDM 93350 CPT 483 RC outpatient 269 263.62 All Payors / Plans All Payors / Plans 269 other 269 269 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC DIAB SELF MGMT, IND 30 MIN" PX-510001089 CDM G0108 CPT 942 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC DIAB SELF MGMT, GROUP 30 MIN" PX-510001099 CDM G0109 CPT 942 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTERDISCIPLINARY VISIT PX-510001750 CDM G0175 CPT 510 RC outpatient 362 354.76 All Payors / Plans All Payors / Plans 362 other 362 362 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC MED NUT THER IND 2ND REG EA 15 MIN PX-510002709 CDM G0270 CPT 942 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC MED NUTRU THER GROUP 30 MIN PX-510002719 CDM G0271 CPT 942 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC FIRST ANNUAL WELLNESS VISIT MEDICARE 0-10 MIN PX-510004385 CDM G0438 CPT 510 RC outpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC FIRST ANNUAL WELLNESS VISIT MEDICARE 11-25 MIN PX-510004386 CDM G0438 CPT 510 RC outpatient 121 118.58 All Payors / Plans All Payors / Plans 121 other 121 121 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC FIRST ANNUAL WELLNESS VISIT MEDICARE 26-45 MIN PX-510004387 CDM G0438 CPT 510 RC outpatient 211 206.78 All Payors / Plans All Payors / Plans 211 other 211 211 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC FIRST ANNUAL WELLNESS VISIT MEDICARE 46-90 MIN PX-510004388 CDM G0438 CPT 510 RC outpatient 453 443.94 All Payors / Plans All Payors / Plans 453 other 453 453 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC FIRST ANNUAL WELLNESS VISIT MEDICARE 90 MIN OR GREATER PX-510004389 CDM G0438 CPT 510 RC outpatient 543 532.14 All Payors / Plans All Payors / Plans 543 other 543 543 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SUBSEQUENT ANNUAL WELLNESS VISIT MEDICARE 0-10 MIN PX-510004395 CDM G0439 CPT 510 RC outpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SUBSEQUENT ANNUAL WELLNESS VISIT MEDICARE 11-25 MIN PX-510004396 CDM G0439 CPT 510 RC outpatient 121 118.58 All Payors / Plans All Payors / Plans 121 other 121 121 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SUBSEQUENT ANNUAL WELLNESS VISIT MEDICARE 26-45 MIN PX-510004397 CDM G0439 CPT 510 RC outpatient 211 206.78 All Payors / Plans All Payors / Plans 211 other 211 211 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SUBSEQUENT WELLNESS VISIT MEDICARE 46-90 MIN PX-510004398 CDM G0439 CPT 510 RC outpatient 453 443.94 All Payors / Plans All Payors / Plans 453 other 453 453 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SUBSEQUENT ANNUAL WELLNESS VISIT MEDICARE 90 MIN OR GREATER PX-510004399 CDM G0439 CPT 510 RC outpatient 543 532.14 All Payors / Plans All Payors / Plans 543 other 543 543 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC EXCHANGE TRANSFUSION, BLOOD" PX-510364550 CDM 36455 CPT 510 RC outpatient 693 679.14 All Payors / Plans All Payors / Plans 693 other 693 693 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APHERESIS WHITE BLOOD CELLS PX-510365110 CDM 36511 CPT 510 RC outpatient 1650 1617 All Payors / Plans All Payors / Plans 1650 other 1650 1650 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APHERESIS RED BLOOD CELLS PX-510365120 CDM 36512 CPT 510 RC outpatient 1650 1617 All Payors / Plans All Payors / Plans 1650 other 1650 1650 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APHERESIS PLATELETS PX-510365130 CDM 36513 CPT 510 RC outpatient 1650 1617 All Payors / Plans All Payors / Plans 1650 other 1650 1650 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APHERESIS PLASMA PHERESIS PX-510365140 CDM 36514 CPT 510 RC outpatient 1650 1617 All Payors / Plans All Payors / Plans 1650 other 1650 1650 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COLL OF BLOOD VENOUS ACCESS DEV PX-510365910 CDM 36591 CPT 510 RC outpatient 264 258.72 All Payors / Plans All Payors / Plans 264 other 264 264 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DECLOT THROMBO AGENT DEV/CATHETER PX-510365930 CDM 36593 CPT 510 RC outpatient 330 323.4 All Payors / Plans All Payors / Plans 330 other 330 330 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC IMMUNIZATION EA ADD PX-510904729 CDM 90472 CPT 510 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC IMMUN ORAL OR INTRANASAL PX-510904739 CDM 90473 CPT 510 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC IMMUN ORAL EA ADDL PX-510904749 CDM 90474 CPT 510 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INJECTION - SUB Q OR IM PX-510963720 CDM 96372 CPT 510 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC INJECTION PX-510963729 CDM 96372 CPT 260 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC IV PUSH PX-510963749 CDM 96374 CPT 260 RC outpatient 330 323.4 All Payors / Plans All Payors / Plans 330 other 330 330 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC MED NUTR THER IND INITIAL PX-510978029 CDM 97802 CPT 942 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC MED NUT THER, IND RE ASSES" PX-510978039 CDM 97803 CPT 942 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MC MED NUT THER, GROUP RE" PX-510978049 CDM 97804 CPT 942 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TELEPHONE MEDICAL DISCUSSION 5-10 MINUTES PX-510989660 CDM 98966 CPT 510 RC outpatient 30 29.4 All Payors / Plans All Payors / Plans 30 other 30 30 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TELEPHONE MEDICAL DISCUSSION 11-20 MINUTES PX-510989670 CDM 98967 CPT 510 RC outpatient 30 29.4 All Payors / Plans All Payors / Plans 30 other 30 30 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TELEPHONE MEDICAL DISCUSSION 21-30 MINUTES PX-510989680 CDM 98968 CPT 510 RC outpatient 60 58.8 All Payors / Plans All Payors / Plans 60 other 60 60 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC OP VISIT, NEW 0-10 MIN" PX-510992010 CDM 99202 CPT 510 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC DOT PHYSICAL NEW PX-510992017 CDM 99202 CPT 510 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SPORTS/SCHOOL PHYSICAL NEW PX-510992018 CDM 99202 CPT 510 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PRE EMPLOYMENT PHYSICAL NEW PX-510992019 CDM 99202 CPT 510 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT NEW 11-25 MIN PX-510992020 CDM 99202 CPT 510 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT NEW 26-45 MIN PX-510992030 CDM 99203 CPT 510 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT NEW 46-90 MIN PX-510992040 CDM 99204 CPT 510 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT NEW 90 MIN OR > PX-510992050 CDM 99205 CPT 510 RC outpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT EST 0-10 MIN PX-510992110 CDM 99211 CPT 510 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC DOT PHYSICAL ESTABLISHED PX-510992117 CDM 99211 CPT 510 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC DOT SPORTS/SCHOOL PHYSICAL ESTABLISHED PX-510992118 CDM 99211 CPT 510 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PRE EMPLOYMENT PHYSICAL ESTABLISHED PX-510992119 CDM 99211 CPT 510 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT EST 11-25 MIN PX-510992120 CDM 99212 CPT 510 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT EST 26-45 MIN PX-510992130 CDM 99213 CPT 510 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT EST 46-90 MIN PX-510992140 CDM 99214 CPT 510 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OP VISIT EST 90 MIN OR > PX-510992150 CDM 99215 CPT 510 RC outpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PROLONGED FIRST HOUR PX-510993549 CDM 99354 CPT 510 RC outpatient 151 147.98 All Payors / Plans All Payors / Plans 151 other 151 151 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PROLONGED EA ADDITIONAL 30 MIN PX-510993559 CDM 99355 CPT 510 RC outpatient 91 89.18 All Payors / Plans All Payors / Plans 91 other 91 91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTIVE VISIT 12-17 0-10 MIN PX-510993845 CDM 99384 CPT 510 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 12-17 11-25 MIN PX-510993846 CDM 99384 CPT 510 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 12-17 26-45 MIN PX-510993847 CDM 99384 CPT 510 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 12-17 46-90 MIN PX-510993848 CDM 99384 CPT 510 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 12-17 90 MIN OR GREATER PX-510993849 CDM 99384 CPT 510 RC outpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTIVE VISIT 18-39 0-10 MIN PX-510993855 CDM 99385 CPT 510 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 18-39 11-25 MIN PX-510993856 CDM 99385 CPT 510 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 18-39 26-45 MIN PX-510993857 CDM 99385 CPT 510 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 18-39 46-90 MIN PX-510993858 CDM 99385 CPT 510 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 18-39 90 MIN OR GREATER PX-510993859 CDM 99385 CPT 510 RC outpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTIVE VISIT 40-64 0-10 MIN PX-510993865 CDM 99386 CPT 510 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 40-64 11-25 MIN PX-510993866 CDM 99386 CPT 510 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 40-64 26-45 MIN PX-510993867 CDM 99386 CPT 510 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 40-64 46-90 MIN PX-510993868 CDM 99386 CPT 510 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT 40-64 90 MIN OR GREATER PX-510993869 CDM 99386 CPT 510 RC outpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTIVE VISIT AGE 65+ 0-10 MIN PX-510993875 CDM 99387 CPT 510 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT AGE 65+ 11-25 MIN PX-510993876 CDM 99387 CPT 510 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT AGE 65+ 26-45 MIN PX-510993877 CDM 99387 CPT 510 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT AGE 65+ 46-90 MIN PX-510993878 CDM 99387 CPT 510 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC NEW PREVENTATIVE VISIT AGE 65+ 90 MIN OR GREATER PX-510993879 CDM 99387 CPT 510 RC outpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTIVE VISIT 12-17 0-10 MIN PX-510993945 CDM 99394 CPT 510 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 12-17 11-25 MIN PX-510993946 CDM 99394 CPT 510 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 12-17 26-45 MIN PX-510993947 CDM 99394 CPT 510 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 12-17 46-90 MIN PX-510993948 CDM 99394 CPT 510 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 12-17 90 MIN OR GREATER PX-510993949 CDM 99394 CPT 510 RC outpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTIVE VISIT 18-39 0-10 MIN PX-510993955 CDM 99395 CPT 510 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 18-39 11-25 MIN PX-510993956 CDM 99395 CPT 510 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 18-39 26-45 MIN PX-510993957 CDM 99395 CPT 510 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 18-39 46-90 MIN PX-510993958 CDM 99395 CPT 510 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 18-39 90 MIN OR GREATER PX-510993959 CDM 99395 CPT 510 RC outpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTIVE VISIT 40-64 0-10 MIN PX-510993965 CDM 99396 CPT 510 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 40-64 11-25 MIN PX-510993966 CDM 99396 CPT 510 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 40-64 26-45 MIN PX-510993967 CDM 99396 CPT 510 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 40-64 46-90 MIN PX-510993968 CDM 99396 CPT 510 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT 40-64 90 MIN OR GREATER PX-510993969 CDM 99396 CPT 510 RC outpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTIVE VISIT AGE 65+ 0-10 MIN PX-510993975 CDM 99397 CPT 510 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT AGE 65+ 11-25 MIN PX-510993976 CDM 99397 CPT 510 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT AGE 65+ 26-45 MIN PX-510993977 CDM 99397 CPT 510 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT AGE 65+ 46-90 MIN PX-510993978 CDM 99397 CPT 510 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC EST PREVENTATIVE VISIT AGE 65+ 90 MIN OR GREATER PX-510993979 CDM 99397 CPT 510 RC outpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OT AP SHRT LEG SP CALF-FOOT 53-67 PX-530295150 CDM 29515 CPT 530 RC outpatient 364 356.72 All Payors / Plans All Payors / Plans 364 other 364 364 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD MRI BREAST BIOPSY PX-610190850 CDM 19085 CPT 610 RC outpatient 190 186.2 All Payors / Plans All Payors / Plans 190 other 190 190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD MRI BREAST BIOPSY EA ADDL PX-610190860 CDM 19086 CPT 610 RC outpatient 190 186.2 All Payors / Plans All Payors / Plans 190 other 190 190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-TMJ PX-610703360 CDM 70336 CPT 610 RC outpatient 888 870.24 All Payors / Plans All Payors / Plans 888 other 888 888 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-TMJ W CONTRAST PX-610703361 CDM 70336 CPT 610 RC outpatient 888 870.24 All Payors / Plans All Payors / Plans 888 other 888 888 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-TMJ W/WO CONTRAST PX-610703362 CDM 70336 CPT 610 RC outpatient 888 870.24 All Payors / Plans All Payors / Plans 888 other 888 888 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MRI ORBIT, FACE, OR NECK W/O" PX-610705400 CDM 70540 CPT 610 RC outpatient 837 820.26 All Payors / Plans All Payors / Plans 837 other 837 837 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MRI ORBIT, FACE, OR NECK W" PX-610705420 CDM 70542 CPT 610 RC outpatient 913 894.74 All Payors / Plans All Payors / Plans 913 other 913 913 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC MRI ORBIT, FACE, OR NECK W WO" PX-610705430 CDM 70543 CPT 610 RC outpatient 1103 1080.94 All Payors / Plans All Payors / Plans 1103 other 1103 1103 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-CHEST PX-610715500 CDM 71550 CPT 610 RC outpatient 1217 1192.66 All Payors / Plans All Payors / Plans 1217 other 1217 1217 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-CHEST W CONTRAST PX-610715510 CDM 71551 CPT 610 RC outpatient 1331 1304.38 All Payors / Plans All Payors / Plans 1331 other 1331 1331 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-CHEST W/WO CONTRAST PX-610715520 CDM 71552 CPT 610 RC outpatient 1661 1627.78 All Payors / Plans All Payors / Plans 1661 other 1661 1661 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-PELVIS PX-610721950 CDM 72195 CPT 610 RC outpatient 1078 1056.44 All Payors / Plans All Payors / Plans 1078 other 1078 1078 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-PELVIS W CONTRAST PX-610721960 CDM 72196 CPT 610 RC outpatient 1154 1130.92 All Payors / Plans All Payors / Plans 1154 other 1154 1154 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-PELVIS W/WO CONTRAST PX-610721970 CDM 72197 CPT 610 RC outpatient 1395 1367.1 All Payors / Plans All Payors / Plans 1395 other 1395 1395 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI UPPER EXTREM WO CONTRAST PX-610732180 CDM 73218 CPT 610 RC outpatient 1065 1043.7 All Payors / Plans All Payors / Plans 1065 other 1065 1065 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI UPPER EXTREM W CONTRAST PX-610732190 CDM 73219 CPT 610 RC outpatient 1141 1118.18 All Payors / Plans All Payors / Plans 1141 other 1141 1141 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI UPPER EXTREM W WO CONTRAST PX-610732200 CDM 73220 CPT 610 RC outpatient 1395 1367.1 All Payors / Plans All Payors / Plans 1395 other 1395 1395 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI UPPER EXTREM JOINT WO CONT PX-610732210 CDM 73221 CPT 610 RC outpatient 596 584.08 All Payors / Plans All Payors / Plans 596 other 596 596 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI UPPER EXTREM JOINT W CONT PX-610732220 CDM 73222 CPT 610 RC outpatient 1052 1030.96 All Payors / Plans All Payors / Plans 1052 other 1052 1052 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI UPPER EXTREM JOINT WWO CONT PX-610732230 CDM 73223 CPT 610 RC outpatient 1293 1267.14 All Payors / Plans All Payors / Plans 1293 other 1293 1293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI LOWER EXTREM JOINT WWO CONT PX-610732730 CDM 73723 CPT 610 RC outpatient 1293 1267.14 All Payors / Plans All Payors / Plans 1293 other 1293 1293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI LOWER EXTREM WO CONTRAST PX-610737180 CDM 73718 CPT 610 RC outpatient 1052 1030.96 All Payors / Plans All Payors / Plans 1052 other 1052 1052 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI LOWER EXTREM W CONTRAST PX-610737190 CDM 73719 CPT 610 RC outpatient 1154 1130.92 All Payors / Plans All Payors / Plans 1154 other 1154 1154 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI LOWER EXTREM WWO CONTRAST PX-610737200 CDM 73720 CPT 610 RC outpatient 1407 1378.86 All Payors / Plans All Payors / Plans 1407 other 1407 1407 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI LOWER EXTREM JOINT WO CONT PX-610737210 CDM 73721 CPT 610 RC outpatient 596 584.08 All Payors / Plans All Payors / Plans 596 other 596 596 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI LOWER EXTREM JOINT W CONT PX-610737220 CDM 73722 CPT 610 RC outpatient 1065 1043.7 All Payors / Plans All Payors / Plans 1065 other 1065 1065 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI LOWER EXTREM JOINT WWO CONT PX-610737230 CDM 73723 CPT 610 RC outpatient 1293 1267.14 All Payors / Plans All Payors / Plans 1293 other 1293 1293 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI ABDOMEN WO CONTRAST PX-610741810 CDM 74181 CPT 610 RC outpatient 926 907.48 All Payors / Plans All Payors / Plans 926 other 926 926 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI ABDOMEN W CONTRAST PX-610741820 CDM 74182 CPT 610 RC outpatient 1306 1279.88 All Payors / Plans All Payors / Plans 1306 other 1306 1306 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI ABDOMEN W WO CONTRAST PX-610741830 CDM 74183 CPT 610 RC outpatient 1407 1378.86 All Payors / Plans All Payors / Plans 1407 other 1407 1407 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI FETAL FIRST GESTATION PX-610747120 CDM 74712 CPT 610 RC outpatient 1179 1155.42 All Payors / Plans All Payors / Plans 1179 other 1179 1179 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI FETAL EACH ADD GESTATION PX-610747130 CDM 74713 CPT 610 RC outpatient 495 485.1 All Payors / Plans All Payors / Plans 495 other 495 495 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-CARDIAC MORPHOLOGY W/O CONT PX-610755570 CDM 75557 CPT 610 RC outpatient 723 708.54 All Payors / Plans All Payors / Plans 723 other 723 723 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI CARDIAC W STRESS IMAGING PX-610755590 CDM 75559 CPT 610 RC outpatient 1052 1030.96 All Payors / Plans All Payors / Plans 1052 other 1052 1052 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-CARDIAC MORPHOLOGY W CONTRAST PX-610755610 CDM 75561 CPT 610 RC outpatient 1052 1030.96 All Payors / Plans All Payors / Plans 1052 other 1052 1052 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI CARD W&WO STRESS IMAG PX-610755630 CDM 75563 CPT 610 RC outpatient 1281 1255.38 All Payors / Plans All Payors / Plans 1281 other 1281 1281 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI CARD W FLOW VEL STRESS IMG PX-610755650 CDM 75565 CPT 610 RC outpatient 152 148.96 All Payors / Plans All Payors / Plans 152 other 152 152 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-GUIDANCE TISSUE ABLATION PX-610770220 CDM 77022 CPT 610 RC outpatient 190 186.2 All Payors / Plans All Payors / Plans 190 other 190 190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD MRI BREAST UNILATERAL W/WO CONTRAST PX-610770480 CDM 77048 CPT 610 RC outpatient 1636 1603.28 All Payors / Plans All Payors / Plans 1636 other 1636 1636 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD MRI BREAST BILATERAL W/WO CONTRAST PX-610770490 CDM 77049 CPT 610 RC outpatient 1623 1590.54 All Payors / Plans All Payors / Plans 1623 other 1623 1623 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD MRI BREAST UNILATERAL NO CONTRAST PX-610770580 CDM 77046 CPT 610 RC outpatient 1636 1603.28 All Payors / Plans All Payors / Plans 1636 other 1636 1636 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BD MRI BREAST BILATERAL NO CONTRAST PX-610770590 CDM 77047 CPT 610 RC outpatient 1623 1590.54 All Payors / Plans All Payors / Plans 1623 other 1623 1623 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI BRAIN WO CONTRAST PX-611705510 CDM 70551 CPT 611 RC outpatient 558 546.84 All Payors / Plans All Payors / Plans 558 other 558 558 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MRI BRAIN W CONTRAST PX-611705520 CDM 70552 CPT 611 RC outpatient 824 807.52 All Payors / Plans All Payors / Plans 824 other 824 824 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI SPECTROSCOPY PX-611763900 CDM 76390 CPT 611 RC outpatient 1344 1317.12 All Payors / Plans All Payors / Plans 1344 other 1344 1344 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-C-SPINE PX-612721410 CDM 72141 CPT 612 RC outpatient 533 522.34 All Payors / Plans All Payors / Plans 533 other 533 533 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-C SPINE W CONTRAST PX-612721420 CDM 72142 CPT 612 RC outpatient 837 820.26 All Payors / Plans All Payors / Plans 837 other 837 837 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-T-SPINE PX-612721460 CDM 72146 CPT 612 RC outpatient 533 522.34 All Payors / Plans All Payors / Plans 533 other 533 533 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-T-SPINE W CONTRAST PX-612721470 CDM 72147 CPT 612 RC outpatient 837 820.26 All Payors / Plans All Payors / Plans 837 other 837 837 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-L-SPINE PX-612721480 CDM 72148 CPT 612 RC outpatient 533 522.34 All Payors / Plans All Payors / Plans 533 other 533 533 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-L-SPINE W CONTRAST PX-612721490 CDM 72149 CPT 612 RC outpatient 837 820.26 All Payors / Plans All Payors / Plans 837 other 837 837 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-C SPINE W/WO CONTRAST PX-612721560 CDM 72156 CPT 612 RC outpatient 938 919.24 All Payors / Plans All Payors / Plans 938 other 938 938 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-T SPINE W/WO CONTRAST PX-612721570 CDM 72157 CPT 612 RC outpatient 951 931.98 All Payors / Plans All Payors / Plans 951 other 951 951 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRI-L-SPINE W/WO CONTRAST PX-612721580 CDM 72158 CPT 612 RC outpatient 938 919.24 All Payors / Plans All Payors / Plans 938 other 938 938 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRA HEAD WO CONTRAST PX-615705440 CDM 70544 CPT 615 RC outpatient 1179 1155.42 All Payors / Plans All Payors / Plans 1179 other 1179 1179 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRA-NECK PX-615705470 CDM 70547 CPT 615 RC outpatient 1192 1168.16 All Payors / Plans All Payors / Plans 1192 other 1192 1192 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRA LOWER EXTREMITY PX-616737250 CDM 73725 CPT 616 RC outpatient 1103 1080.94 All Payors / Plans All Payors / Plans 1103 other 1103 1103 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRA-CHEST PX-618715550 CDM 71555 CPT 618 RC outpatient 1103 1080.94 All Payors / Plans All Payors / Plans 1103 other 1103 1103 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRA-PELVIS PX-618721980 CDM 72198 CPT 618 RC outpatient 1116 1093.68 All Payors / Plans All Payors / Plans 1116 other 1116 1116 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRA UPPER EXTREMITY PX-618732250 CDM 73225 CPT 618 RC outpatient 1154 1130.92 All Payors / Plans All Payors / Plans 1154 other 1154 1154 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MRA ABDOMEN W WO CONTRAST PX-618741850 CDM 74185 CPT 618 RC outpatient 1116 1093.68 All Payors / Plans All Payors / Plans 1116 other 1116 1116 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PRE-OP/POST-OP CARE PX-710000000 CDM 710 RC outpatient 1190 1166.2 All Payors / Plans All Payors / Plans 1190 other 1190 1190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INDUCTION PX-720000007 CDM 720 RC outpatient 556 544.88 All Payors / Plans All Payors / Plans 556 other 556 556 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NON-STRESS TEST PX-720000008 CDM 720 RC outpatient 695 681.1 All Payors / Plans All Payors / Plans 695 other 695 695 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC STRESS TEST PX-720000009 CDM 720 RC outpatient 695 681.1 All Payors / Plans All Payors / Plans 695 other 695 695 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMNIOCENTESIS PX-720000010 CDM 720 RC outpatient 417 408.66 All Payors / Plans All Payors / Plans 417 other 417 417 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ULTRASOUND PX-720000011 CDM 720 RC outpatient 417 408.66 All Payors / Plans All Payors / Plans 417 other 417 417 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXT. NEONATE ROTATION PX-720000012 CDM 720 RC outpatient 1390 1362.2 All Payors / Plans All Payors / Plans 1390 other 1390 1390 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DELIVERY OUTSIDE HOSPITAL PX-720000020 CDM 720 RC outpatient 1668 1634.64 All Payors / Plans All Payors / Plans 1668 other 1668 1668 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OUTPATIENT MATERNAL OBSERVATION PX-720000021 CDM 720 RC outpatient 139 136.22 All Payors / Plans All Payors / Plans 139 other 139 139 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NEONATAL CARE PX-720000022 CDM 720 RC outpatient 556 544.88 All Payors / Plans All Payors / Plans 556 other 556 556 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FETAL DEMISE 2ND OR 3RD TRIMESTER PX-720000023 CDM 720 RC outpatient 4170 4086.6 All Payors / Plans All Payors / Plans 4170 other 4170 4170 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FETAL DEMISE 2ND/3RD TRIM W/EPID PX-720000024 CDM 720 RC outpatient 5004 4903.92 All Payors / Plans All Payors / Plans 5004 other 5004 5004 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AMNIOINFUSION PX-720000025 CDM 720 RC outpatient 834 817.32 All Payors / Plans All Payors / Plans 834 other 834 834 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INTRAUTERIN PRES CATH MONIT(IUPC) PX-720000026 CDM 720 RC outpatient 278 272.44 All Payors / Plans All Payors / Plans 278 other 278 278 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MULTIPLE BIRTH QUADS PX-720000027 CDM 720 RC outpatient 1668 1634.64 All Payors / Plans All Payors / Plans 1668 other 1668 1668 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ASSESSMENT/TRIAGE SERVICE PX-720000028 CDM 720 RC outpatient 139 136.22 All Payors / Plans All Payors / Plans 139 other 139 139 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CIRCUMCISION PX-720000029 CDM 723 RC outpatient 417 408.66 All Payors / Plans All Payors / Plans 417 other 417 417 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OUTPATIENT MATERNAL INTENSIVE CARE PX-720000030 CDM 720 RC outpatient 278 272.44 All Payors / Plans All Payors / Plans 278 other 278 278 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ELECTROCARDIOGRAM PX-730930050 CDM 93005 CPT 730 RC outpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EKG (UNREG RATE) PX-730930051 CDM 93005 CPT 730 RC outpatient 15.25 14.95 All Payors / Plans All Payors / Plans 15.25 other 15.25 15.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ML EKG (UNREG RATE) PX-730930052 CDM 93005 CPT 730 RC outpatient 15.25 14.95 All Payors / Plans All Payors / Plans 15.25 other 15.25 15.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC ELECTROCARDIOGRAM PX-730930059 CDM 93005 CPT 730 RC outpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC RHYTHM STRIP PX-730930410 CDM 93041 CPT 730 RC outpatient 22 21.56 All Payors / Plans All Payors / Plans 22 other 22 22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXT ECG CONNECTION >48HR UP TO 7 DAYS PX-730932410 CDM 93242 CPT 731 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXT ECG CONNECTION >7 UP TO 15 DAYS PX-730932450 CDM 93246 CPT 731 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARDIAC EVENT RECORDER HOOK-UP PX-730932700 CDM 93270 CPT 730 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HOLTER MONITOR HOOK-UP PX-731932250 CDM 93225 CPT 731 RC outpatient 45 44.1 All Payors / Plans All Payors / Plans 45 other 45 45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HOLTER 24 HOUR PX-731932260 CDM 93226 CPT 731 RC outpatient 225 220.5 All Payors / Plans All Payors / Plans 225 other 225 225 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HOLTER 48 HOUR PX-731932261 CDM 93226 CPT 731 RC outpatient 449 440.02 All Payors / Plans All Payors / Plans 449 other 449 449 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ABORTED HOLTER CHARGE PX-731932262 CDM 93226 CPT 731 RC outpatient 67 65.66 All Payors / Plans All Payors / Plans 67 other 67 67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POLYSOM AGE <6 W/PARAM 4OR> PX-740957820 CDM 95782 CPT 740 RC outpatient 4387 4299.26 All Payors / Plans All Payors / Plans 4387 other 4387 4387 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SLEEP STUDY UNATTENDED WATCH PAT PX-740958000 CDM 95800 CPT 740 RC outpatient 629 616.42 All Payors / Plans All Payors / Plans 629 other 629 629 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MULT SLEEP LATENCY TEST PX-740958050 CDM 95805 CPT 740 RC outpatient 1800 1764 All Payors / Plans All Payors / Plans 1800 other 1800 1800 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POLYSOM AGE 6>W/PARAM 4 OR> PX-740958100 CDM 95810 CPT 740 RC outpatient 2447 2398.06 All Payors / Plans All Payors / Plans 2447 other 2447 2447 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POLYSOM AGE 6> SPLIT/CPAP PX-740958110 CDM 95811 CPT 740 RC outpatient 2587 2535.26 All Payors / Plans All Payors / Plans 2587 other 2587 2587 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EEG PX-740958190 CDM 95819 CPT 740 RC outpatient 1765 1729.7 All Payors / Plans All Payors / Plans 1765 other 1765 1765 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VISUAL EVOKED RESPONSE PX-740958191 CDM 95819 CPT 740 RC outpatient 1765 1729.7 All Payors / Plans All Payors / Plans 1765 other 1765 1765 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDOSCOPY(MINUTES) PX-750000001 CDM 750 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ESOPHAGEAL MANOMETRY PX-750910100 CDM 91010 CPT 750 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROLONGED ACID REFLUX TEST PX-750910340 CDM 91034 CPT 750 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BRAVO STUDY-ELECTRODE PH PX-750910350 CDM 91035 CPT 750 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SMALL BOWEL GI CAPUSULE ENDO PX-750911100 CDM 91110 CPT 750 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AGILE TEST CAPSULE ENDO PX-750912990 CDM 91299 CPT 750 RC outpatient 41 40.18 All Payors / Plans All Payors / Plans 41 other 41 41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC I&D ABSCESS-SINGLE PX-761100600 CDM 10060 CPT 761 RC outpatient 328 321.44 All Payors / Plans All Payors / Plans 328 other 328 328 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC I&D ABSCESS-MULTIPLE PX-761100610 CDM 10061 CPT 761 RC outpatient 641 628.18 All Payors / Plans All Payors / Plans 641 other 641 641 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC I&D HEMATOMA, SEROMA" PX-761101400 CDM 10140 CPT 761 RC outpatient 542 531.16 All Payors / Plans All Payors / Plans 542 other 542 542 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PUNCTURE ASPIRATION OF ABSCESS PX-761101600 CDM 10160 CPT 761 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC I&D POST-OP WOUND PX-761101800 CDM 10180 CPT 761 RC outpatient 328 321.44 All Payors / Plans All Payors / Plans 328 other 328 328 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE SUB Q PX-761110420 CDM 11042 CPT 761 RC outpatient 470 460.6 All Payors / Plans All Payors / Plans 470 other 470 470 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE SUB Q W/MOD PX-761110421 CDM 11042 CPT 761 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE MUSCLE PX-761110430 CDM 11043 CPT 761 RC outpatient 499 489.02 All Payors / Plans All Payors / Plans 499 other 499 499 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE MUSCLE W/MOD PX-761110431 CDM 11043 CPT 761 RC outpatient 314 307.72 All Payors / Plans All Payors / Plans 314 other 314 314 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE BONE PX-761110440 CDM 11044 CPT 761 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE SUB Q EA ADD 20 SQ CM PX-761110450 CDM 11045 CPT 761 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE MUSCLE EACH ADD. 20SQ PX-761110460 CDM 11046 CPT 761 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE BONE EA ADD 20 SQ CM PX-761110470 CDM 11047 CPT 761 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARING BENIGN LESION - ONE PX-761110550 CDM 11055 CPT 761 RC outpatient 328 321.44 All Payors / Plans All Payors / Plans 328 other 328 328 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARING BENIGN LESION - 2-4 PX-761110560 CDM 11056 CPT 761 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PARING BENIGN LESION >4 PX-761110570 CDM 11057 CPT 761 RC outpatient 570 558.6 All Payors / Plans All Payors / Plans 570 other 570 570 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TANGENTIAL BIOPSY OF SKIN PX-761111020 CDM 11102 CPT 761 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TANGENTIAL BIOPSY OF SKIN EACH ADD'L PX-761111030 CDM 11103 CPT 761 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PUNCH BIOPSY OF SKIN PX-761111040 CDM 11104 CPT 761 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PUNCH BIOPSY OF SKIN EACH ADD'L PX-761111050 CDM 11105 CPT 761 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INSICIONAL BIOSPY OF SKIN PX-761111060 CDM 11106 CPT 761 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INSICIONAL BIOSPY OF SKIN EACH ADD'L PX-761111070 CDM 11107 CPT 761 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXCISIONAL BIOPSY MALIGNANT LESION .5CM OR LESS PX-761116000 CDM 11600 CPT 761 RC outpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXCISIONAL BIOPSY MALIGNANT LESION .6-1.0 CM PX-761116010 CDM 11601 CPT 761 RC outpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXCISIONAL BIOPSY MALIGNANT LESION 1.1-2.0 CM PX-761116020 CDM 11602 CPT 761 RC outpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TRIM NONDYSTROPHIC NAILS, ANY NO." PX-761117190 CDM 11719 CPT 761 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE NAIL 1-5 PX-761117200 CDM 11720 CPT 761 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE NAIL >5 PX-761117210 CDM 11721 CPT 761 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC AVULSION OF NAIL PLATE SINGLE PX-761117300 CDM 11730 CPT 761 RC outpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC AVULSION OF NAIL PLATE, EA ADDL" PX-761117320 CDM 11732 CPT 761 RC outpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EXCISION NAIL PARTIAL OR COMPLETE PX-761117500 CDM 11750 CPT 761 RC outpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC CLOSURE SURGICAL WOUND, EXTESIVE/COMPLICATED" PX-761131600 CDM 13160 CPT 761 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC ADJ TISS XFER HEAD,FAC, HAND <10 SQCM" PX-761140400 CDM 14040 CPT 761 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GFT SKIN SUB T/A/L >100CM 1ST 25 PX-761152710 CDM 15271 CPT 761 RC outpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GFT SKIN SUB T/A/L <100CM ADD 25 PX-761152720 CDM 15272 CPT 761 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GFT SKIN SUB T/A/L >100CM 1ST 100 PX-761152730 CDM 15273 CPT 761 RC outpatient 713 698.74 All Payors / Plans All Payors / Plans 713 other 713 713 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GFT SKIN SUB T/A/L >100CM EA ADDL PX-761152740 CDM 15274 CPT 761 RC outpatient 356 348.88 All Payors / Plans All Payors / Plans 356 other 356 356 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GFT SKIN SUB F/S/E <100CM 1ST 25 PX-761152750 CDM 15275 CPT 761 RC outpatient 285 279.3 All Payors / Plans All Payors / Plans 285 other 285 285 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GFT SKIN SUB F/S <100CM EA ADD 25 PX-761152760 CDM 15276 CPT 761 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GFT SKIN SUB F/S/E >100CM 1ST 100 PX-761152770 CDM 15277 CPT 761 RC outpatient 713 698.74 All Payors / Plans All Payors / Plans 713 other 713 713 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GFT SKIN SUB F/S>100CM EA ADD 100 PX-761152780 CDM 15278 CPT 761 RC outpatient 356 348.88 All Payors / Plans All Payors / Plans 356 other 356 356 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESS/DEBRIDE PART THICK BURN <5% PX-761160200 CDM 16020 CPT 761 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESS/DEBRIDE PART THICK BURN 5-10% PX-761160250 CDM 16025 CPT 761 RC outpatient 157 153.86 All Payors / Plans All Payors / Plans 157 other 157 157 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DRESS/DEBRIDE PART THICK BURN >10% PX-761160300 CDM 16030 CPT 761 RC outpatient 299 293.02 All Payors / Plans All Payors / Plans 299 other 299 299 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CHEMICAL CAUTERIZATION PX-761172500 CDM 17250 CPT 761 RC outpatient 328 321.44 All Payors / Plans All Payors / Plans 328 other 328 328 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BONE BIOSPY-SUPERFICIAL RIBS, ILIUM, STERNUM,SPINOUS" PX-761202400 CDM 20240 CPT 761 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC BONE BIOPSY-DEEP BONE HUMERUS,ISCHIUM,FEMUR" PX-761202450 CDM 20245 CPT 761 RC outpatient 171 167.58 All Payors / Plans All Payors / Plans 171 other 171 171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INCISION SUBCUT TOE TENDON PX-761280100 CDM 28010 CPT 761 RC outpatient 71 69.58 All Payors / Plans All Payors / Plans 71 other 71 71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TENOTOMY,OPEN,FLEXOR,FOOT SNG/MUL" PX-761282300 CDM 28230 CPT 761 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC TENOTOMY, TOE SINGLE TENDON" PX-761282320 CDM 28232 CPT 761 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC AMPUTATION TOE, I-P JT" PX-761288250 CDM 28825 CPT 761 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPLY TL CONTACT LEG CAST PX-761294450 CDM 29445 CPT 761 RC outpatient 741 726.18 All Payors / Plans All Payors / Plans 741 other 741 741 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPLY UNNA BOOT PX-761295800 CDM 29580 CPT 761 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPLY UNNA BOOT BILATERAL PX-761295805 CDM 29580 CPT 761 RC outpatient 641 628.18 All Payors / Plans All Payors / Plans 641 other 641 641 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPLY PROFORE PX-761295810 CDM 29581 CPT 761 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APPLY PROFORE BILATERAL PX-761295811 CDM 29581 CPT 761 RC outpatient 641 628.18 All Payors / Plans All Payors / Plans 641 other 641 641 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BONE MARROW/ASPIRATION PX-761382210 CDM 38221 CPT 761 RC outpatient 214 209.72 All Payors / Plans All Payors / Plans 214 other 214 214 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE OPEN PX-761975970 CDM 97597 CPT 761 RC outpatient 428 419.44 All Payors / Plans All Payors / Plans 428 other 428 428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE OPEN WOUND W/MOD PX-761975971 CDM 97597 CPT 761 RC outpatient 185 181.3 All Payors / Plans All Payors / Plans 185 other 185 185 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DEBRIDE OPEN EACH ADD. 20SQ PX-761975980 CDM 97598 CPT 761 RC outpatient 143 140.14 All Payors / Plans All Payors / Plans 143 other 143 143 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WC NEGATIVE PRESSURE <=50 CM PX-761976052 CDM 97605 CPT 761 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC NEG PRESSURE WOUND TREATMENT >50CM PX-761976062 CDM 97606 CPT 761 RC outpatient 684 670.32 All Payors / Plans All Payors / Plans 684 other 684 684 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC WC TOTAL WOUND SURFACE <=50CM PX-761976070 CDM 97607 CPT 761 RC outpatient 342 335.16 All Payors / Plans All Payors / Plans 342 other 342 342 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TOTAL WOUND SURFACE >50CM PX-761976080 CDM 97608 CPT 761 RC outpatient 684 670.32 All Payors / Plans All Payors / Plans 684 other 684 684 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OBSERVATION CARVE OUT PX-762003780 CDM G0378 CPT 762 RC outpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OBSERVATION SERVICE PX-762003781 CDM G0378 CPT 762 RC outpatient 68 66.64 All Payors / Plans All Payors / Plans 68 other 68 68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INFLUENZA ADMINISTRATION PX-771000080 CDM G0008 CPT 771 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PNEUMOCOCCAL ADMINISTRATION PX-771000090 CDM G0009 CPT 771 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HEP B ADMINISTRATION PX-771000100 CDM G0010 CPT 771 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PNEUMO VACCINE ADMIN PX-771904717 CDM 90471 CPT 771 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC IMMUNIZATION PX-771904718 CDM 90471 CPT 771 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC FLU VACCINE ADMIN PX-771904719 CDM 90471 CPT 771 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INJ TIXAGEVIMAB/CILAGAVIMAB PX-771M02200 CDM M0220 CPT 771 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LITHOTRIPSY PX-790505900 CDM 50590 CPT 790 RC outpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH MED ASSIST IND TX PER 15 MIN PX-900000049 CDM H0004 CPT 900 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH IOP PER 15 MIN PX-900000159 CDM H0015 CPT 906 RC outpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PSYCHIATRIC DIAGNOSTIC EVALUATION PX-900907910 CDM 90791 CPT 900 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH PSYCH ASSESSMENT PX-900907919 CDM 90791 CPT 900 RC outpatient 396 388.08 All Payors / Plans All Payors / Plans 396 other 396 396 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC PSYCHIATRIC EVAL W/MED SERVICES PX-900907929 CDM 90792 CPT 900 RC outpatient 495 485.1 All Payors / Plans All Payors / Plans 495 other 495 495 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH THERAPY 30 MIN IND PX-900908329 CDM 90832 CPT 914 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH THERAPY 45 MIN IND PX-900908349 CDM 90834 CPT 914 RC outpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH THERAPY 60 MIN IND PX-900908379 CDM 90837 CPT 914 RC outpatient 297 291.06 All Payors / Plans All Payors / Plans 297 other 297 297 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH PSYCHOTHERAPY CRISIS 60 MIN PX-900908399 CDM 90839 CPT 914 RC outpatient 297 291.06 All Payors / Plans All Payors / Plans 297 other 297 297 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH PSYCHOTHERAPY CRISIS ADD 30 MIN PX-900908409 CDM 90840 CPT 914 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GROUP PSYCHOTHERAPY PX-912004100 CDM G0410 CPT 912 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PSYCHOTHERAPY 30 MINUTES PX-912908320 CDM 90832 CPT 912 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PSYCHOTHERAPY 45 MINUTES PX-912908340 CDM 90834 CPT 912 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC FAMILY PSYCHOTHERAPY PX-912908470 CDM 90847 CPT 912 RC outpatient 100 98 All Payors / Plans All Payors / Plans 100 other 100 100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GROUP PSYCHOTHERAPY ENTIRE DAY PX-912908530 CDM 90853 CPT 912 RC outpatient 672 658.56 All Payors / Plans All Payors / Plans 672 other 672 672 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GROUP PSYCHOTHERAPY HALF DAY PX-912908531 CDM 90853 CPT 912 RC outpatient 336 329.28 All Payors / Plans All Payors / Plans 336 other 336 336 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH GROUP THERAPY PX-915908539 CDM 90853 CPT 915 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH FAMILY PSYCHOTHERAPY W/O PATIENT PX-916908469 CDM 90846 CPT 916 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH FAMILY PSYCHOTHERAPY W/ PATIENT PX-916908479 CDM 90847 CPT 916 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC BH MULTIPLE FAMILY GROUP THERAPY PX-916908499 CDM 90849 CPT 916 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SLEEP STUDY UNATTENDED PX-920958061 CDM 95806 CPT 920 RC outpatient 524 513.52 All Payors / Plans All Payors / Plans 524 other 524 524 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL VEIN MAPPING PX-921003650 CDM 93985 CPT 921 RC outpatient 540 529.2 All Payors / Plans All Payors / Plans 540 other 540 540 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL AAA SCREEN INITIAL PX-921003890 CDM 76706 CPT 402 RC outpatient 540 529.2 All Payors / Plans All Payors / Plans 540 other 540 540 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL CAROTID DUPLEX BILATERAL PX-921938800 CDM 93880 CPT 921 RC outpatient 1308 1281.84 All Payors / Plans All Payors / Plans 1308 other 1308 1308 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL CAROTID DUPLEX UNILATERAL PX-921938820 CDM 93882 CPT 921 RC outpatient 824 807.52 All Payors / Plans All Payors / Plans 824 other 824 824 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VL TRANSCRANIAL DOPPLER, COMPLETE" PX-921938860 CDM 93886 CPT 921 RC outpatient 1848 1811.04 All Payors / Plans All Payors / Plans 1848 other 1848 1848 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VL TRANSCRANIAL DOPPLER, LIMITED" PX-921938880 CDM 93888 CPT 921 RC outpatient 995 975.1 All Payors / Plans All Payors / Plans 995 other 995 995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL QUANTIT CAROTID INTIMA BILAT PX-921938950 CDM 93895 CPT 921 RC outpatient 824 807.52 All Payors / Plans All Payors / Plans 824 other 824 824 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL SINGLE LEVEL BILATERAL PX-921939220 CDM 93922 CPT 921 RC outpatient 597 585.06 All Payors / Plans All Payors / Plans 597 other 597 597 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ANKLE BRACHIAL INDEX VASCULAR CENTER PX-921939221 CDM 93922 CPT 921 RC outpatient 57 55.86 All Payors / Plans All Payors / Plans 57 other 57 57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL MULTIPLE LEVEL BILATERAL PX-921939230 CDM 93923 CPT 921 RC outpatient 910 891.8 All Payors / Plans All Payors / Plans 910 other 910 910 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ATERIAL DOPPLER-LOWER-VASCULAR LAB PX-921939231 CDM 93923 CPT 921 RC outpatient 341 334.18 All Payors / Plans All Payors / Plans 341 other 341 341 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX LEA BILATERAL PX-921939250 CDM 93925 CPT 921 RC outpatient 1763 1727.74 All Payors / Plans All Payors / Plans 1763 other 1763 1763 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX LEA UNILATERAL PX-921939260 CDM 93926 CPT 921 RC outpatient 1023 1002.54 All Payors / Plans All Payors / Plans 1023 other 1023 1023 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX UEA BILATERAL PX-921939300 CDM 93930 CPT 921 RC outpatient 1336 1309.28 All Payors / Plans All Payors / Plans 1336 other 1336 1336 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX UEA UNILATERAL PX-921939310 CDM 93931 CPT 921 RC outpatient 824 807.52 All Payors / Plans All Payors / Plans 824 other 824 824 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL VENOUS DOPPLER PX-921939650 CDM 93965 CPT 921 RC outpatient 525.25 514.75 All Payors / Plans All Payors / Plans 525.25 other 525.25 525.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX VENOUS MAP BILAT PX-921939700 CDM 93970 CPT 921 RC outpatient 1308 1281.84 All Payors / Plans All Payors / Plans 1308 other 1308 1308 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX VENOUS MAP UNILAT PX-921939710 CDM 93971 CPT 921 RC outpatient 796 780.08 All Payors / Plans All Payors / Plans 796 other 796 796 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL RENAL ARTERY DUPLEX COMPLETE PX-921939750 CDM 93975 CPT 921 RC outpatient 1791 1755.18 All Payors / Plans All Payors / Plans 1791 other 1791 1791 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL RENAL ARTERY DUPLEX LIMITED PX-921939760 CDM 93976 CPT 921 RC outpatient 995 975.1 All Payors / Plans All Payors / Plans 995 other 995 995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL AORTIC DUPLEX SCAN COMPLETE PX-921939780 CDM 93978 CPT 921 RC outpatient 1222 1197.56 All Payors / Plans All Payors / Plans 1222 other 1222 1222 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL AORTIC DUPLEX SCAN LIMITED PX-921939790 CDM 93979 CPT 921 RC outpatient 768 752.64 All Payors / Plans All Payors / Plans 768 other 768 768 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX HD ART/VEN PENILE COMPLETE PX-921939800 CDM 93980 CPT 921 RC outpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX HD ART/VEN PENILE LTD PX-921939810 CDM 93981 CPT 921 RC outpatient 426 417.48 All Payors / Plans All Payors / Plans 426 other 426 426 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HC VL DUPLEX ART/VEN PRE-OP VESSEL MAPPING, UNILATERAL" PX-921939860 CDM 93986 CPT 921 RC outpatient 256 250.88 All Payors / Plans All Payors / Plans 256 other 256 256 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VL DUPLEX HD ART AV GRAFT PX-921939900 CDM 93990 CPT 921 RC outpatient 1080 1058.4 All Payors / Plans All Payors / Plans 1080 other 1080 1080 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC BODY PLETHYSMOGRAPHY PX-921947260 CDM 94726 CPT 921 RC outpatient 175 171.5 All Payors / Plans All Payors / Plans 175 other 175 175 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG ANAL OR URETHRAL SPHINCTER PX-922517850 CDM 51785 CPT 922 RC outpatient 350 343 All Payors / Plans All Payors / Plans 350 other 350 350 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG CRANIAL NERVES UNI PX-922958670 CDM 95867 CPT 922 RC outpatient 262 256.76 All Payors / Plans All Payors / Plans 262 other 262 262 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG LMT LIMBS/AXIAL MUSCLES PX-922958700 CDM 95870 CPT 922 RC outpatient 350 343 All Payors / Plans All Payors / Plans 350 other 350 350 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG EA EXTREM 4 OR LESS MUSCLES PX-922958850 CDM 95885 CPT 922 RC outpatient 192 188.16 All Payors / Plans All Payors / Plans 192 other 192 192 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG EA EXTREM 5 OR MORE MUSCLES PX-922958860 CDM 95886 CPT 922 RC outpatient 227 222.46 All Payors / Plans All Payors / Plans 227 other 227 227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG NON EXTREMITY PX-922958870 CDM 95887 CPT 922 RC outpatient 210 205.8 All Payors / Plans All Payors / Plans 210 other 210 210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG NERVE CONDUCTINO 1-2 STUDIES PX-922959070 CDM 95907 CPT 922 RC outpatient 210 205.8 All Payors / Plans All Payors / Plans 210 other 210 210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG NERVE CONDUCTION 3-4 STUDIES PX-922959080 CDM 95908 CPT 922 RC outpatient 280 274.4 All Payors / Plans All Payors / Plans 280 other 280 280 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG NERVE CONDUCTION 5-6 STUDIES PX-922959090 CDM 95909 CPT 922 RC outpatient 332 325.36 All Payors / Plans All Payors / Plans 332 other 332 332 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG NERVE CONDUCTION 7-8 STUDIES PX-922959100 CDM 95910 CPT 922 RC outpatient 437 428.26 All Payors / Plans All Payors / Plans 437 other 437 437 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG NERVE CONDUCTION 9-10 STUDIES PX-922959110 CDM 95911 CPT 922 RC outpatient 489 479.22 All Payors / Plans All Payors / Plans 489 other 489 489 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG NERVE CONDUCTION 11-12 STUDY PX-922959120 CDM 95912 CPT 922 RC outpatient 489 479.22 All Payors / Plans All Payors / Plans 489 other 489 489 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC EMG NERVE CONDUCT 13OR MORE STUDY PX-922959130 CDM 95913 CPT 922 RC outpatient 542 531.16 All Payors / Plans All Payors / Plans 542 other 542 542 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INHALATION BRONCHIAL CHALLENGE PX-924950700 CDM 95070 CPT 924 RC outpatient 277 271.46 All Payors / Plans All Payors / Plans 277 other 277 277 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PHLEBOTOMY-THERAPEUTIC PX-940991591 CDM 99195 CPT 940 RC outpatient 94.5 92.61 All Payors / Plans All Payors / Plans 94.5 other 94.5 94.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PHLEBOTOMY (PHLE) PX-940991950 CDM 99195 CPT 940 RC outpatient 94.5 92.61 All Payors / Plans All Payors / Plans 94.5 other 94.5 94.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIABETES OP SELF MGMT INDIV. PX-942001080 CDM G0108 CPT 942 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC D IABETES OP SELF MGMT GROUP PX-942001090 CDM G0109 CPT 942 RC outpatient 65 63.7 All Payors / Plans All Payors / Plans 65 other 65 65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MNT CHG BENE COND IN 15 MIN EA PX-942002700 CDM G0270 CPT 942 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MNT CHG BENE COND GRP 30 MIN PX-942002710 CDM G0271 CPT 942 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLUCOSE MONITOR CONTINOUS PT EQUIP PX-942952490 CDM 95249 CPT 942 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC GLUCOSE MONITOR CONTINUOUS PX-942952500 CDM 95250 CPT 942 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MNT INITIAL ASSESS IND 15 MIN PX-942978020 CDM 97802 CPT 942 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MNT INTERV & REASS IND 15 MIN PX-942978030 CDM 97803 CPT 942 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MNT INIT/FOLLOWUP GROUP 30MIN PX-942978040 CDM 97804 CPT 942 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIABETES OP SELF MGMT IND. RN PX-942990780 CDM 98960 CPT 942 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIABETES OP SELF MGMT GROUP 2-4 PX-942990781 CDM 98961 CPT 942 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIABETES OP SELF MGMT GROUP 5-8 PX-942990782 CDM 98962 CPT 942 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SMOKING CESSATION-INTERMEDIATE PX-942994060 CDM 99406 CPT 942 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SMOKING CESSATION 3-10 MIN PX-942994069 CDM 99406 CPT 942 RC outpatient 66 64.68 All Payors / Plans All Payors / Plans 66 other 66 66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SMOKING CESSATION - INTENSIVE PX-942994070 CDM 99407 CPT 942 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MC SMOKING CESSATION > 10 MIN PX-942994079 CDM 99407 CPT 942 RC outpatient 99 97.02 All Payors / Plans All Payors / Plans 99 other 99 99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERIPHERAL ARTERIAL DISEASE REHAB PX-943936680 CDM 93668 CPT 943 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERIPHERAL ARTERIAL DISEASE REHAB >36 PX-943936681 CDM 93668 CPT 943 RC outpatient 132 129.36 All Payors / Plans All Payors / Plans 132 other 132 132 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARDIAC REHAB THERAPY >36 PX-943937980 CDM 93798 CPT 943 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARDIAC REHAB THERAPY PX-943937981 CDM 93798 CPT 943 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INITIAL ASSESSMENT - C REHAB PX-943937982 CDM 93798 CPT 943 RC outpatient 165 161.7 All Payors / Plans All Payors / Plans 165 other 165 165 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY REHAB-COPD PX-948004240 CDM G0424 CPT 948 RC outpatient 151 147.98 All Payors / Plans All Payors / Plans 151 other 151 151 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY REHAB-COPD >36 PX-948042400 CDM G0424 CPT 948 RC outpatient 151 147.98 All Payors / Plans All Payors / Plans 151 other 151 151 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY REHAB W/O CONTINUOUS OXIMETRY MONITOR PX-948946250 CDM 94625 CPT 948 RC outpatient 495 485.1 All Payors / Plans All Payors / Plans 495 other 495 495 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY REHAB W/O CONTINUOUS OXIMETRY MONITOR>36 PX-948946251 CDM 94625 CPT 948 RC outpatient 495 485.1 All Payors / Plans All Payors / Plans 495 other 495 495 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY REHAB W/ CONTINUOUS OXIMETRY MONITOR PX-948946260 CDM 94626 CPT 948 RC outpatient 528 517.44 All Payors / Plans All Payors / Plans 528 other 528 528 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PULMONARY REHAB W/ CONTINUOUS OXIMETRY MONITOR>36 PX-948946261 CDM 94626 CPT 948 RC outpatient 528 517.44 All Payors / Plans All Payors / Plans 528 other 528 528 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INITIAL HOSPITAL CARE/DAY PX-988992211 CDM 99221 CPT 988 RC outpatient 165.44 162.13 All Payors / Plans All Payors / Plans 165.44 other 165.44 165.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INITIAL HOSPITAL CARE/DAY 50 MINUTES 99222 PX-988992221 CDM 99222 CPT 988 RC outpatient 261.1 255.88 All Payors / Plans All Payors / Plans 261.1 other 261.1 261.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INITIAL HOSPITAL CARE/DAY 70 MINUTES 99223 PX-988992231 CDM 99223 CPT 988 RC outpatient 346 339.08 All Payors / Plans All Payors / Plans 346 other 346 346 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MRI BRAIN W WO CONTRAST PX-IMG271B CDM 70553 CPT 611 RC outpatient 938 919.24 All Payors / Plans All Payors / Plans 938 other 938 938 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC US GUIDE SCLEROTHERAPY PX-IMG9700 CDM 49185 CPT 402 RC outpatient 371.75 364.32 All Payors / Plans All Payors / Plans 371.75 other 371.75 371.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRRT DIALYSATE 4/3 ERX-250000000 CDM 250 RC 0000-0000-09 NDC 5000 ML inpatient 102.19 100.15 All Payors / Plans All Payors / Plans 102.19 other 102.19 102.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE-PRILOCAINE 2.5-2.5 % CREAM 30 G TUBE ERX-250000000 CDM 250 RC 0990-7990-09 NDC 30 GR inpatient 64.98 63.68 All Payors / Plans All Payors / Plans 64.98 other 64.98 64.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE-PRILOCAINE 2.5-2.5 % CREAM 5 G TUBE ERX-250000000 CDM 250 RC 54643-5649-1 NDC 5 GR inpatient 30.93 30.31 All Payors / Plans All Payors / Plans 30.93 other 30.93 30.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCHLOROSENE RECON SOLN ERX-250000000 CDM 250 RC 0338-1138-03 NDC 2 GR inpatient 30.56 29.95 All Payors / Plans All Payors / Plans 30.56 other 30.56 30.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZINC OXIDE-CORN STARCH 15-81 % POWDER 142 G BOTTLE ERX-250000000 CDM 250 RC 0338-0180-01 NDC 142 GR inpatient 16.12 15.8 All Payors / Plans All Payors / Plans 16.12 other 16.12 16.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADULT 2-IN-1 TPN INFUSION ERX-250000000 CDM 250 RC 51754-4250-1 NDC 321.4 ML inpatient 288 282.24 All Payors / Plans All Payors / Plans 288 other 288 288 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ADULT MULTIVITAMIN 3,300 UNIT- 150 MCG/10 ML SOLUTION 10 ML VIAL" ERX-250000000 CDM 250 RC 51754-4250-3 NDC 10 ML inpatient 0.57 0.56 All Payors / Plans All Payors / Plans 0.57 other 0.57 0.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMINO ACID 5 %-DEXTROSE 20 % (CLINIMIX) 5 % PARENTERAL SOLUTION 1,000 ML BAG" ERX-250000000 CDM 250 RC 0143-9310-01 NDC 1000 ML inpatient 104.51 102.42 All Payors / Plans All Payors / Plans 104.51 other 104.51 104.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMINO ACID 8 % IN D14W (CLINIMIX) 8-14 % PARENTERAL SOLUTION 1,000 ML BAG" ERX-250000000 CDM 250 RC 0143-9506-01 NDC 1000 ML inpatient 137.74 134.99 All Payors / Plans All Payors / Plans 137.74 other 137.74 137.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMINO ACID 8%-D14W-ELECTROLYTES (CLINIMIX E) 8-14 % PARENTERAL SOLUTION 1,000 ML BAG" ERX-250000000 CDM 250 RC 0143-9506-10 NDC 1000 ML inpatient 141.85 139.01 All Payors / Plans All Payors / Plans 141.85 other 141.85 141.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMINO ACIDS 4.25%-LYTES-CA-D10 (CLINIMIX E) 4.25 % PARENTERAL SOLUTION 1,000 ML BAG" ERX-250000000 CDM 250 RC 0143-9507-01 NDC 1000 ML inpatient 104.54 102.45 All Payors / Plans All Payors / Plans 104.54 other 104.54 104.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMINO ACIDS 5 %-LYTES-CA-D20W (CLINIMIX E) 5 % PARENTERAL SOLUTION 1,000 ML BAG" ERX-250000000 CDM 250 RC 55150-221-10 NDC 1000 ML inpatient 105.7 103.59 All Payors / Plans All Payors / Plans 105.7 other 105.7 105.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMINOCAPROIC ACID PER 5 G ERX-250000000 CDM 250 RC 65219-445-01 NDC 20 ML inpatient 25.44 24.93 All Payors / Plans All Payors / Plans 25.44 other 25.44 25.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMIODARONE PER 30 MG ERX-250000000 CDM 250 RC 63037-100-05 NDC 9 ML inpatient 30.43 29.82 All Payors / Plans All Payors / Plans 30.43 other 30.43 30.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMIODARONE PER 30 MG ERX-250000000 CDM 250 RC 90000-002-29 NDC 6 ML inpatient 40.96 40.14 All Payors / Plans All Payors / Plans 40.96 other 40.96 40.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 63323-184-11 NDC 10 ML inpatient 20.64 20.23 All Payors / Plans All Payors / Plans 20.64 other 20.64 20.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 0009-1040-06 NDC 30 ML inpatient 35.92 35.2 All Payors / Plans All Payors / Plans 35.92 other 35.92 35.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 6371301974 NDC 10 ML inpatient 21.24 20.82 All Payors / Plans All Payors / Plans 21.24 other 21.24 21.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 6371301972 NDC 25 ML inpatient 35.77 35.05 All Payors / Plans All Payors / Plans 35.77 other 35.77 35.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAFFEINE CITRATE PER 5 MG ERX-250000000 CDM 250 RC 0132-0079-12 NDC 1.45 ML inpatient 25.96 25.44 All Payors / Plans All Payors / Plans 25.96 other 25.96 25.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM CHLORIDE 100 MG/ML (10 %) SOLUTION ERX-250000000 CDM 250 RC 58980-409-12 NDC 10 ML inpatient 39.89 39.09 All Payors / Plans All Payors / Plans 39.89 other 39.89 39.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM CHLORIDE 100 MG/ML (10 %) SOLUTION 10 ML VIAL ERX-250000000 CDM 250 RC 71288-402-30 NDC 10 ML inpatient 39.89 39.09 All Payors / Plans All Payors / Plans 39.89 other 39.89 39.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM CHLORIDE 100 MG/ML (10 %) SYRINGE ERX-250000000 CDM 250 RC 0054-0045-44 NDC 10 ML inpatient 50.03 49.03 All Payors / Plans All Payors / Plans 50.03 other 50.03 50.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM GLUCONATE PER 10 MG ERX-250000000 CDM 250 RC 42023-113-10 NDC 4.8 ML inpatient 6.01 5.89 All Payors / Plans All Payors / Plans 6.01 other 6.01 6.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBOPROST 250 MCG/ML SOLUTION ERX-250000000 CDM 250 RC 65219-184-01 NDC 1 ML inpatient 204 199.92 All Payors / Plans All Payors / Plans 204 other 204 204 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARDIOPLEGIC SOLUTION 29 MMOL/L (POTASSIUM) SOLUTION ERX-250000000 CDM 250 RC 0409-2051-05 NDC 1000 ML inpatient 196.82 192.88 All Payors / Plans All Payors / Plans 196.82 other 196.82 196.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARDIOPLEGIC SOLUTION HIGH POTASSIUM ERX-250000000 CDM 250 RC 0143-9508-01 NDC 806 ML inpatient 61.22 60 All Payors / Plans All Payors / Plans 61.22 other 61.22 61.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARDIOPLEGIC SOLUTION LOW POTASSIUM ERX-250000000 CDM 250 RC 0143-9508-10 NDC 793 ML inpatient 61.22 60 All Payors / Plans All Payors / Plans 61.22 other 61.22 61.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHONDROITIN SULF-SOD HYALURON 3 %-4 %(0.5 ML) 1 % (0.55 ML) SYRINGE ERX-250000000 CDM 250 RC 42023-114-10 NDC 1.05 ML inpatient 310.94 304.72 All Payors / Plans All Payors / Plans 310.94 other 310.94 310.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHONDROITIN SULF-SOD HYALURON 4-3 % (40-30 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 0409-2339-24 NDC 0.5 ML inpatient 202.04 198 All Payors / Plans All Payors / Plans 202.04 other 202.04 202.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) SOLUTION 20 ML VIAL ERX-250000000 CDM 250 RC 0409-2339-34 NDC 20 ML inpatient 136.83 134.09 All Payors / Plans All Payors / Plans 136.83 other 136.83 136.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CISATRACURIUM 2 MG/ML SOLUTION ERX-250000000 CDM 250 RC 69374-946-04 NDC 10 ML inpatient 104.12 102.04 All Payors / Plans All Payors / Plans 104.12 other 104.12 104.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLEVIDIPINE 0.5 MG/ML EMULSION ERX-250000000 CDM 250 RC 0409-1323-05 NDC 50 ML inpatient 235.07 230.37 All Payors / Plans All Payors / Plans 235.07 other 235.07 235.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLEVIDIPINE 25 MG/50 ML EMULSION ERX-250000000 CDM 250 RC 0409-1323-15 NDC 50 ML inpatient 208.31 204.14 All Payors / Plans All Payors / Plans 208.31 other 208.31 208.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLEVIDIPINE 25 MG/50 ML EMULSION ERX-250000000 CDM 250 RC 76329-3390-1 NDC 100 ML inpatient 359.56 352.37 All Payors / Plans All Payors / Plans 359.56 other 359.56 359.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLEVIDIPINE 50 MG/100 ML EMULSION ERX-250000000 CDM 250 RC 0409-4276-01 NDC 100 ML inpatient 414.35 406.06 All Payors / Plans All Payors / Plans 414.35 other 414.35 414.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRRT DIALYSATE 2/3 ERX-250000000 CDM 250 RC 55150-251-10 NDC 5000 ML inpatient 102.19 100.15 All Payors / Plans All Payors / Plans 102.19 other 102.19 102.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRRT DIALYSATE 4/3 ERX-250000000 CDM 250 RC 63323-201-03 NDC 5000 ML inpatient 102.19 100.15 All Payors / Plans All Payors / Plans 102.19 other 102.19 102.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility D5 %-0.45 % SODIUM CHLORIDE PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-486-27 NDC 500 ML inpatient 17.88 17.52 All Payors / Plans All Payors / Plans 17.88 other 17.88 17.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXMEDETOMIDINE 4 MCG/ML SOLUTION ERX-250000000 CDM 250 RC 76329-6300-5 NDC 5.9245 ML inpatient 64.36 63.07 All Payors / Plans All Payors / Plans 64.36 other 64.36 64.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXMEDETOMIDINE HCL 100 MCG/ML SOLUTION ERX-250000000 CDM 250 RC 55150-164-02 NDC 0.12 ML inpatient 11.27 11.04 All Payors / Plans All Payors / Plans 11.27 other 11.27 11.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXMEDETOMIDINE HCL 100 MCG/ML SOLUTION ERX-250000000 CDM 250 RC 63323-496-97 NDC 0.12 ML inpatient 30.75 30.14 All Payors / Plans All Payors / Plans 30.75 other 30.75 30.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 63323-495-09 NDC 50 ML inpatient 63.71 62.44 All Payors / Plans All Payors / Plans 63.71 other 63.71 63.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 0143-9594-25 NDC 100 ML inpatient 62.78 61.52 All Payors / Plans All Payors / Plans 62.78 other 62.78 62.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 63323-487-17 NDC 100 ML inpatient 101.42 99.39 All Payors / Plans All Payors / Plans 101.42 other 101.42 101.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXMEDETOMIDINE IN DEXTROSE 5% 400 MCG/100 ML (4 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 63323-487-37 NDC 100 ML inpatient 83.46 81.79 All Payors / Plans All Payors / Plans 83.46 other 83.46 83.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 10 % PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-488-07 NDC 500 ML inpatient 18.3 17.93 All Payors / Plans All Payors / Plans 18.3 other 18.3 18.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 10 % PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-488-37 NDC 1000 ML inpatient 18.43 18.06 All Payors / Plans All Payors / Plans 18.43 other 18.43 18.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 10 % PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-489-02 NDC 1000 ML inpatient 37.77 37.01 All Payors / Plans All Payors / Plans 37.77 other 37.77 37.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 20% 20 % PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-489-17 NDC 500 ML inpatient 47.29 46.34 All Payors / Plans All Payors / Plans 47.29 other 47.29 47.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% AND 0.45% SODIUM CHLORIDE PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 0409-3177-01 NDC 1000 ML inpatient 18.01 17.65 All Payors / Plans All Payors / Plans 18.01 other 18.01 18.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% LACTATED RINGER'S WITH KCL 20 MEQ/L 20 MEQ/L PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-482-03 NDC 1000 ML inpatient 45.05 44.15 All Payors / Plans All Payors / Plans 45.05 other 45.05 45.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5%-0.2 % SOD CHLORIDE PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-482-27 NDC 1000 ML inpatient 18 17.64 All Payors / Plans All Payors / Plans 18 other 18 18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5%-0.2 % SOD CHLORIDE PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-483-27 NDC 1000 ML inpatient 37.77 37.01 All Payors / Plans All Payors / Plans 37.77 other 37.77 37.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 50 % IN WATER (D50W) 50 % SYRINGE ERX-250000000 CDM 250 RC 0168-0357-30 NDC 25 ML inpatient 62.72 61.47 All Payors / Plans All Payors / Plans 62.72 other 62.72 62.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 50 % IN WATER (D50W) 50 % SYRINGE ERX-250000000 CDM 250 RC 62332-582-04 NDC 25 ML inpatient 65.49 64.18 All Payors / Plans All Payors / Plans 65.49 other 65.49 65.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 50% PER 500 ML ERX-250000000 CDM 250 RC 47335-992-01 NDC 3 ML inpatient 21.15 20.73 All Payors / Plans All Payors / Plans 21.15 other 21.15 21.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DEXTROSE 70% 70 % PARENTERAL SOLUTION 2,000 ML BAG" ERX-250000000 CDM 250 RC 63323-106-02 NDC 13.7 ML inpatient 0.31 0.3 All Payors / Plans All Payors / Plans 0.31 other 0.31 0.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE-SOD CITRATE-CITRIC AC 2.45-2.2 GRAM- 800 MG/100 ML SOLUTION ERX-250000000 CDM 250 RC 0338-0357-02 NDC 750 ML inpatient 81.79 80.15 All Payors / Plans All Payors / Plans 81.79 other 81.79 81.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE-SOD CITRATE-CITRIC AC 2.45-2.2 GRAM- 800 MG/100 ML SOLUTION ERX-250000000 CDM 250 RC 0990-7715-12 NDC 750 ML inpatient 63.7 62.43 All Payors / Plans All Payors / Plans 63.7 other 63.7 63.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILTIAZEM 125 MG/125 ML (1 MG/ML) SOLUTION ERX-250000000 CDM 250 RC 58160-955-09 NDC 125 ML inpatient 65.2 63.9 All Payors / Plans All Payors / Plans 65.2 other 65.2 65.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILTIAZEM 5 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0517-0374-05 NDC 3 ML inpatient 15.99 15.67 All Payors / Plans All Payors / Plans 15.99 other 15.99 15.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILTIAZEM 5 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0517-0374-01 NDC 4 ML inpatient 11.13 10.91 All Payors / Plans All Payors / Plans 11.13 other 11.13 11.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILTIAZEM 5 MG/ML SOLUTION ERX-250000000 CDM 250 RC 65649-551-02 NDC 4 ML inpatient 11.13 10.91 All Payors / Plans All Payors / Plans 11.13 other 11.13 11.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTROLYTE-A ERX-250000000 CDM 250 RC 0143-9660-01 NDC 1000 ML inpatient 50.78 49.76 All Payors / Plans All Payors / Plans 50.78 other 50.78 50.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTROLYTE-A PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 36000-033-10 NDC 1000 ML inpatient 23.07 22.61 All Payors / Plans All Payors / Plans 23.07 other 23.07 23.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENALAPRILAT 1.25 MG/ML SOLUTION ERX-250000000 CDM 250 RC 44567-221-10 NDC 0.5 ML inpatient 40.22 39.42 All Payors / Plans All Payors / Plans 40.22 other 40.22 40.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENALAPRILAT 1.25 MG/ML SOLUTION ERX-250000000 CDM 250 RC 44567-222-10 NDC 2 ML inpatient 40.22 39.42 All Payors / Plans All Payors / Plans 40.22 other 40.22 40.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPHEDRINE 50 MG/ML SOLUTION ERX-250000000 CDM 250 RC 55150-123-15 NDC 0.1 ML inpatient 3.63 3.56 All Payors / Plans All Payors / Plans 3.63 other 3.63 3.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPHEDRINE SULFATE 25 MG/5 ML (5 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 63323-328-20 NDC 1 ML inpatient 8.01 7.85 All Payors / Plans All Payors / Plans 8.01 other 8.01 8.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPHEDRINE SULFATE 25 MG/5 ML (5 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 70860-117-41 NDC 1 ML inpatient 12.33 12.08 All Payors / Plans All Payors / Plans 12.33 other 12.33 12.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPHEDRINE SULFATE 25 MG/5 ML (5 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 39822-1201-5 NDC 0.5 ML inpatient 6.17 6.05 All Payors / Plans All Payors / Plans 6.17 other 6.17 6.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOMIDATE 2 MG/ML SOLUTION ERX-250000000 CDM 250 RC 49281-575-00 NDC 10 ML inpatient 31.68 31.05 All Payors / Plans All Payors / Plans 31.68 other 31.68 31.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOMIDATE 2 MG/ML SOLUTION ERX-250000000 CDM 250 RC 70069-261-01 NDC 5 ML inpatient 31.11 30.49 All Payors / Plans All Payors / Plans 31.11 other 31.11 31.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOMIDATE 2 MG/ML SOLUTION ERX-250000000 CDM 250 RC 81298-9655-1 NDC 10 ML inpatient 31.11 30.49 All Payors / Plans All Payors / Plans 31.11 other 31.11 31.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOMIDATE 2 MG/ML SOLUTION ERX-250000000 CDM 250 RC 81298-9655-3 NDC 12 ML inpatient 35.63 34.92 All Payors / Plans All Payors / Plans 35.63 other 35.63 35.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOMIDATE 2 MG/ML SOLUTION ERX-250000000 CDM 250 RC 43066-997-10 NDC 8 ML inpatient 15.62 15.31 All Payors / Plans All Payors / Plans 15.62 other 15.62 15.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOMIDATE 2 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0338-0108-20 NDC 10 ML inpatient 15.67 15.36 All Payors / Plans All Payors / Plans 15.67 other 15.67 15.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL 10 MCG/ML SOLUTION ERX-250000000 CDM 250 RC 8290306546 NDC 100 ML inpatient 65.7 64.39 All Payors / Plans All Payors / Plans 65.7 other 65.7 65.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL 10 MCG/ML SOLUTION ERX-250000000 CDM 250 RC 0409-4888-02 NDC 100 ML inpatient 0.84 0.82 All Payors / Plans All Payors / Plans 0.84 other 0.84 0.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUMAZENIL 0.1 MG/ML SOLUTION ERX-250000000 CDM 250 RC 63323-186-01 NDC 4 ML inpatient 20.31 19.9 All Payors / Plans All Payors / Plans 20.31 other 20.31 20.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLIC ACID 5 MG/ML SOLUTION ERX-250000000 CDM 250 RC 63323-186-10 NDC 0.2 ML inpatient 0.59 0.58 All Payors / Plans All Payors / Plans 0.59 other 0.59 0.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLIC ACID 5 MG/ML SOLUTION 10 ML VIAL ERX-250000000 CDM 250 RC 0327-0001-10 NDC 0.2 ML inpatient 0.78 0.76 All Payors / Plans All Payors / Plans 0.78 other 0.78 0.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "IPRATROPIUM 21 MCG (0.03 %) SPRAY,NON-AEROSOL 30 ML CANISTER" ERX-250000000 CDM 250 RC 0143-9284-01 NDC 30 ML inpatient 142.47 139.62 All Payors / Plans All Payors / Plans 142.47 other 142.47 142.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "IPRATROPIUM 42 MCG (0.06 %) SPRAY,NON-AEROSOL 15 ML CANISTER" ERX-250000000 CDM 250 RC 55150-202-00 NDC 15 ML inpatient 142.47 139.62 All Payors / Plans All Payors / Plans 142.47 other 142.47 142.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "IPRATROPIUM 42 MCG (0.06 %) SPRAY,NON-AEROSOL 15 ML CANISTER" ERX-250000000 CDM 250 RC 67850-150-00 NDC 15 ML inpatient 62.72 61.47 All Payors / Plans All Payors / Plans 62.72 other 62.72 62.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOPROTERENOL IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 67850-150-25 NDC 12.45416667 ML inpatient 313.84 307.56 All Payors / Plans All Payors / Plans 313.84 other 313.84 313.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETAMINE 10 MG/ML SOLUTION ERX-250000000 CDM 250 RC 70095-024-01 NDC 1 ML inpatient 44.59 43.7 All Payors / Plans All Payors / Plans 44.59 other 44.59 44.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETAMINE 10 MG/ML SOLUTION 20 ML VIAL ERX-250000000 CDM 250 RC 70095-024-02 NDC 2 ML inpatient 49.95 48.95 All Payors / Plans All Payors / Plans 49.95 other 49.95 49.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETAMINE 10 MG/ML SOLUTION 20 ML VIAL ERX-250000000 CDM 250 RC 0338-1130-03 NDC 1.2 ML inpatient 44.59 43.7 All Payors / Plans All Payors / Plans 44.59 other 44.59 44.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETAMINE 100 MG/ML SOLUTION 5 ML VIAL ERX-250000000 CDM 250 RC 54643-5646-1 NDC 10 ML inpatient 79.51 77.92 All Payors / Plans All Payors / Plans 79.51 other 79.51 79.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETAMINE 50 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0941-0424-52 NDC 2 ML inpatient 30.6 29.99 All Payors / Plans All Payors / Plans 30.6 other 30.6 30.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETAMINE 50 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0941-0430-52 NDC 1 ML inpatient 30.6 29.99 All Payors / Plans All Payors / Plans 30.6 other 30.6 30.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETAMINE 50 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0225-0805-47 NDC 0.75 ML inpatient 35.82 35.1 All Payors / Plans All Payors / Plans 35.82 other 35.82 35.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 20 MG/4 ML (5 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 0641-6189-01 NDC 4 ML inpatient 36.64 35.91 All Payors / Plans All Payors / Plans 36.64 other 36.64 36.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 20 MG/4 ML (5 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 70004-825-40 NDC 2 ML inpatient 40.43 39.62 All Payors / Plans All Payors / Plans 40.43 other 40.43 40.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 20 MG/4 ML (5 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 42852-893-25 NDC 1 ML inpatient 35.91 35.19 All Payors / Plans All Payors / Plans 35.91 other 35.91 35.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE (CARDIAC) 100 MG/5 ML (2 %) SYRINGE ERX-250000000 CDM 250 RC 63323-321-10 NDC 1 ML inpatient 5.24 5.14 All Payors / Plans All Payors / Plans 5.24 other 5.24 5.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE (CARDIAC) 100 MG/5 ML (2 %) SYRINGE ERX-250000000 CDM 250 RC 0409-8183-11 NDC 2.5 ML inpatient 13.09 12.83 All Payors / Plans All Payors / Plans 13.09 other 13.09 13.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE (CARDIAC) 100 MG/5 ML (2 %) SYRINGE ERX-250000000 CDM 250 RC 0338-0669-04 NDC 2.5 ML inpatient 31.5 30.87 All Payors / Plans All Payors / Plans 31.5 other 31.5 31.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 10 MG/ML (1 %) SOLUTION ERX-250000000 CDM 250 RC 0338-0671-04 NDC 12 ML inpatient 5.97 5.85 All Payors / Plans All Payors / Plans 5.97 other 5.97 5.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 10 MG/ML (1 %) SOLUTION ERX-250000000 CDM 250 RC 0338-0675-04 NDC 20 ML inpatient 5.97 5.85 All Payors / Plans All Payors / Plans 5.97 other 5.97 5.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 10 MG/ML (1 %) SOLUTION ERX-250000000 CDM 250 RC 0338-0803-04 NDC 10 ML inpatient 5.86 5.74 All Payors / Plans All Payors / Plans 5.86 other 5.86 5.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 10 MG/ML (1 %) SOLUTION ERX-250000000 CDM 250 RC 0990-7107-09 NDC 5 ML inpatient 7.73 7.58 All Payors / Plans All Payors / Plans 7.73 other 7.73 7.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 20 MG/ML (2 %) SOLUTION ERX-250000000 CDM 250 RC 0338-0807-04 NDC 12 ML inpatient 20.8 20.38 All Payors / Plans All Payors / Plans 20.8 other 20.8 20.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 4 % SOLUTION ERX-250000000 CDM 250 RC 70004-841-40 NDC 1 ML inpatient 132.84 130.18 All Payors / Plans All Payors / Plans 132.84 other 132.84 132.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 20 MG/ML (2 %) SOLUTION ERX-250000000 CDM 250 RC 0409-7295-11 NDC 1 ML inpatient 2.95 2.89 All Payors / Plans All Payors / Plans 2.95 other 2.95 2.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 20 MG/ML (2 %) SOLUTION ERX-250000000 CDM 250 RC 65219-054-09 NDC 7 ML inpatient 25.1 24.6 All Payors / Plans All Payors / Plans 25.1 other 25.1 25.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 20 MG/ML (2 %) SOLUTION 2 ML VIAL ERX-250000000 CDM 250 RC 0143-9392-01 NDC 6.6 ML inpatient 35.74 35.03 All Payors / Plans All Payors / Plans 35.74 other 35.74 35.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 20 MG/ML (2 %) SOLUTION 5 ML VIAL ERX-250000000 CDM 250 RC 67457-198-05 NDC 5 ML inpatient 5.91 5.79 All Payors / Plans All Payors / Plans 5.91 other 5.91 5.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 39822-4200-5 NDC 10 ML inpatient 20.86 20.44 All Payors / Plans All Payors / Plans 20.86 other 20.86 20.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 66794-229-02 NDC 30 ML inpatient 21.19 20.77 All Payors / Plans All Payors / Plans 21.19 other 21.19 21.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 71839-141-10 NDC 0.2 ML inpatient 0.25 0.25 All Payors / Plans All Payors / Plans 0.25 other 0.25 0.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 67457-228-10 NDC 3 ML inpatient 3.63 3.56 All Payors / Plans All Payors / Plans 3.63 other 3.63 3.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 69374-924-05 NDC 10 ML inpatient 36.22 35.5 All Payors / Plans All Payors / Plans 36.22 other 36.22 36.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 0409-7299-73 NDC 10 ML inpatient 20.99 20.57 All Payors / Plans All Payors / Plans 20.99 other 20.99 20.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 0409-6625-14 NDC 20 ML inpatient 15.4 15.09 All Payors / Plans All Payors / Plans 15.4 other 15.4 15.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE 1 %-1:100,000 SOLUTION" ERX-250000000 CDM 250 RC 0409-6625-22 NDC 20 ML inpatient 21.24 20.82 All Payors / Plans All Payors / Plans 21.24 other 21.24 21.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE 1 %-1:100,000 SOLUTION" ERX-250000000 CDM 250 RC 51754-5001-1 NDC 5 ML inpatient 16.11 15.79 All Payors / Plans All Payors / Plans 16.11 other 16.11 16.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE 2 %-1:100,000 SOLUTION" ERX-250000000 CDM 250 RC 0409-6637-14 NDC 20 ML inpatient 25.34 24.83 All Payors / Plans All Payors / Plans 25.34 other 25.34 25.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 40 MG/ML (NEO/PED) 40 MG/ML SYRINGE ERX-250000000 CDM 250 RC 0409-6637-24 NDC 15 ML inpatient 4.77 4.67 All Payors / Plans All Payors / Plans 4.77 other 4.77 4.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 40 MG/ML (NEO/PED) 40 MG/ML SYRINGE ERX-250000000 CDM 250 RC 76329-3352-1 NDC 12 ML inpatient 4.92 4.82 All Payors / Plans All Payors / Plans 4.92 other 4.92 4.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANNITOL 20 % PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 0264-7802-00 NDC 125 ML inpatient 65.18 63.88 All Payors / Plans All Payors / Plans 65.18 other 65.18 65.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANNITOL 20 % PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 0338-0043-04 NDC 250 ML inpatient 101.36 99.33 All Payors / Plans All Payors / Plans 101.36 other 101.36 101.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLENE BLUE 5 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0338-0043-03 NDC 8 ML inpatient 250.06 245.06 All Payors / Plans All Payors / Plans 250.06 other 250.06 250.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLENE BLUE 5 MG/ML SOLUTION 10 ML AMPUL ERX-250000000 CDM 250 RC 0904-3865-75 NDC 39 ML inpatient 1000.24 980.24 All Payors / Plans All Payors / Plans 1000.24 other 1000.24 1000.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLNALTREXONE 12 MG/0.6 ML SOLUTION ERX-250000000 CDM 250 RC 0338-0048-04 NDC 0.6 ML inpatient 356.77 349.63 All Payors / Plans All Payors / Plans 356.77 other 356.77 356.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL 5 MG/5 ML SOLUTION ERX-250000000 CDM 250 RC 0338-0054-03 NDC 5 ML inpatient 0.8 0.78 All Payors / Plans All Payors / Plans 0.8 other 0.8 0.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL 5 MG/5 ML SOLUTION ERX-250000000 CDM 250 RC 63323-530-21 NDC 5 ML inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NEOMYCIN-POLYMYXIN B GU 40 MG-200,000 UNIT/ML SOLUTION 1 ML AMPUL" ERX-250000000 CDM 250 RC 63323-093-01 NDC 1 ML inpatient 49.76 48.76 All Payors / Plans All Payors / Plans 49.76 other 49.76 49.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIRSEVIMAB-ALIP 50 MG/0.5 ML SYRINGE ERX-250000000 CDM 250 RC 63323-881-01 NDC 0.5 ML inpatient 858.46 841.29 All Payors / Plans All Payors / Plans 858.46 other 858.46 858.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROPRUSSIDE 25 MG/ML SOLUTION 2 ML VIAL ERX-250000000 CDM 250 RC 52268-011-01 NDC 4 ML inpatient 124.9 122.4 All Payors / Plans All Payors / Plans 124.9 other 124.9 124.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NOREPINEPHRINE 8 MG/250 ML (32 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 0000-0000-54 NDC 250 ML inpatient 135.64 132.93 All Payors / Plans All Payors / Plans 135.64 other 135.64 135.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NOREPINEPHRINE 8 MG/250 ML (32 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 0006-5423-02 NDC 250 ML inpatient 135.64 132.93 All Payors / Plans All Payors / Plans 135.64 other 135.64 135.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NOREPINEPHRINE BITARTRATE 1 MG/ML SOLUTION 4 ML VIAL ERX-250000000 CDM 250 RC 0006-5425-15 NDC 8 ML inpatient 42.21 41.37 All Payors / Plans All Payors / Plans 42.21 other 42.21 42.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NOREPINEPHRINE IN D5W 8 MG/250 ML (32 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 70069-362-01 NDC 250 ML inpatient 132.95 130.29 All Payors / Plans All Payors / Plans 132.95 other 132.95 132.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORMAL SALINE 0.9% SOLUTION 10 ML SYRINGE ERX-250000000 CDM 250 RC 0143-9638-01 NDC 10 ML inpatient 0.11 0.11 All Payors / Plans All Payors / Plans 0.11 other 0.11 0.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORMAL SALINE 0.9% SOLUTION 10 ML VIAL ERX-250000000 CDM 250 RC 55150-173-01 NDC 1.125 ML inpatient 0.07 0.07 All Payors / Plans All Payors / Plans 0.07 other 0.07 0.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORMAL SALINE 0.9% SOLUTION 10 ML VIAL ERX-250000000 CDM 250 RC 63323-273-01 NDC 10 ML inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORMAL SALINE 0.9% SOLUTION 10 ML VIAL ERX-250000000 CDM 250 RC 60793-217-20 NDC 10 ML inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PARENTERAL AMINO ACID 10% 10 % PARENTERAL SOLUTION 500 ML FLEX CONT ERX-250000000 CDM 250 RC 60793-215-05 NDC 41 ML inpatient 10.65 10.44 All Payors / Plans All Payors / Plans 10.65 other 10.65 10.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEDIATRIC MULTIVITAMIN 80 MG-400 UNIT- 200 MCG/5 ML SOLUTION 5 ML VIAL ERX-250000000 CDM 250 RC 0338-0326-01 NDC 2.5 ML inpatient 0.48 0.47 All Payors / Plans All Payors / Plans 0.48 other 0.48 0.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PERITONEAL DIALYSATE #6 1.5% CA 2.5 MEQ/L- MG 0.5 MEQ/L SOLUTION ERX-250000000 CDM 250 RC 0338-0322-01 NDC 2000 ML inpatient 147.43 144.48 All Payors / Plans All Payors / Plans 147.43 other 147.43 147.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PERITONEAL DIALYSATE 2.5% CA 2.5 MEQ/L- MG 0.5 MEQ/L SOLUTION ERX-250000000 CDM 250 RC 61953-0014-1 NDC 1500 ML inpatient 151.33 148.3 All Payors / Plans All Payors / Plans 151.33 other 151.33 151.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PHENYLEPHRINE 0.5 % SPRAY,NON-AEROSOL 15 ML SQUEEZ BTL" ERX-250000000 CDM 250 RC 0186-0776-60 NDC 15 ML inpatient 20.46 20.05 All Payors / Plans All Payors / Plans 20.46 other 20.46 20.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPHRINE IN D5W 40 MG/250 ML (160 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 0517-9305-01 NDC 3.25 ML inpatient 140.13 137.33 All Payors / Plans All Payors / Plans 140.13 other 140.13 140.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM ACETATE 2 MEQ/ML SOLUTION 20 ML VIAL ERX-250000000 CDM 250 RC 23155-166-31 NDC 0.06 ML inpatient 0.07 0.07 All Payors / Plans All Payors / Plans 0.07 other 0.07 0.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORID-D5-0.45%NACL 10 MEQ/L PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 23155-166-41 NDC 1000 ML inpatient 15.96 15.64 All Payors / Plans All Payors / Plans 15.96 other 15.96 15.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORID-D5-0.45%NACL 20 MEQ/L PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 81284-611-00 NDC 1000 ML inpatient 11.05 10.83 All Payors / Plans All Payors / Plans 11.05 other 11.05 11.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORID-D5-0.45%NACL 40 MEQ/L PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 51754-0108-1 NDC 1000 ML inpatient 15.96 15.64 All Payors / Plans All Payors / Plans 15.96 other 15.96 15.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE-D5-0.9%NACL 20 MEQ/L PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 80830-2329-1 NDC 1000 ML inpatient 15.48 15.17 All Payors / Plans All Payors / Plans 15.48 other 15.48 15.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE-D5-0.9%NACL 20 MEQ/L PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 80830-2329-2 NDC 1000 ML inpatient 36.31 35.58 All Payors / Plans All Payors / Plans 36.31 other 36.31 36.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE-D5-0.9%NACL 40 MEQ/L PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 0143-9785-01 NDC 1000 ML inpatient 15.95 15.63 All Payors / Plans All Payors / Plans 15.95 other 15.95 15.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM PHOSPHATE IN 0.9 % NACL 15 MMOL/250 ML SOLUTION ERX-250000000 CDM 250 RC 63323-494-05 NDC 250 ML inpatient 140.27 137.46 All Payors / Plans All Payors / Plans 140.27 other 140.27 140.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM PHOSPHATES 3 MMOL/ML SOLUTION 15 ML VIAL ERX-250000000 CDM 250 RC 55150-235-10 NDC 7.3 ML inpatient 64.13 62.85 All Payors / Plans All Payors / Plans 64.13 other 64.13 64.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM PHOSPHATES 3 MMOL/ML SOLUTION 15 ML VIAL ERX-250000000 CDM 250 RC 51754-0204-4 NDC 6.9 ML inpatient 148.8 145.82 All Payors / Plans All Payors / Plans 148.8 other 148.8 148.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROCURONIUM 10 MG/ML SOLUTION ERX-250000000 CDM 250 RC 70069-271-25 NDC 10 ML inpatient 30.46 29.85 All Payors / Plans All Payors / Plans 30.46 other 30.46 30.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROCURONIUM 10 MG/ML SOLUTION ERX-250000000 CDM 250 RC 6373611151 NDC 8 ML inpatient 20.29 19.88 All Payors / Plans All Payors / Plans 20.29 other 20.29 20.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROCURONIUM 10 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0143-9386-01 NDC 5 ML inpatient 11.09 10.87 All Payors / Plans All Payors / Plans 11.09 other 11.09 11.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROCURONIUM 50 MG/5 ML (10 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 36000-306-60 NDC 5 ML inpatient 20.4 19.99 All Payors / Plans All Payors / Plans 20.4 other 20.4 20.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROCURONIUM 50 MG/5 ML (10 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 67457-940-10 NDC 5 ML inpatient 39.95 39.15 All Payors / Plans All Payors / Plans 39.95 other 39.95 39.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM ACETATE 2 MEQ/ML SOLUTION 20 ML VIAL ERX-250000000 CDM 250 RC 55150-113-10 NDC 10 ML inpatient 10.59 10.38 All Payors / Plans All Payors / Plans 10.59 other 10.59 10.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 1 MEQ/ML (8.4 %) SOLUTION ERX-250000000 CDM 250 RC 67457-351-10 NDC 50 ML inpatient 44.6 43.71 All Payors / Plans All Payors / Plans 44.6 other 44.6 44.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 1 MEQ/ML (8.4 %) SOLUTION ERX-250000000 CDM 250 RC 68084-229-01 NDC 50 ML inpatient 44.6 43.71 All Payors / Plans All Payors / Plans 44.6 other 44.6 44.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 1 MEQ/ML (8.4 %) SOLUTION 50 ML VIAL ERX-250000000 CDM 250 RC 68084-229-11 NDC 50 ML inpatient 30.46 29.85 All Payors / Plans All Payors / Plans 30.46 other 30.46 30.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 8.4 % (1 MEQ/ML) SYRINGE ERX-250000000 CDM 250 RC 55150-174-10 NDC 50 ML inpatient 64.29 63 All Payors / Plans All Payors / Plans 64.29 other 64.29 64.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 8.4 % (1 MEQ/ML) SYRINGE ERX-250000000 CDM 250 RC 78206-118-01 NDC 50 ML inpatient 64.29 63 All Payors / Plans All Payors / Plans 64.29 other 64.29 64.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 8.4 % (1 MEQ/ML) SYRINGE ERX-250000000 CDM 250 RC 0641-6007-01 NDC 50 ML inpatient 80.92 79.3 All Payors / Plans All Payors / Plans 80.92 other 80.92 80.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 0.45% 0.45 % PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-465-01 NDC 1000 ML inpatient 32.28 31.63 All Payors / Plans All Payors / Plans 32.28 other 32.28 32.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 0.45% 0.45 % PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 0409-1610-50 NDC 1000 ML inpatient 18.01 17.65 All Payors / Plans All Payors / Plans 18.01 other 18.01 18.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 0.45% 0.45 % PARENTERAL SOLUTION 500 ML BAG ERX-250000000 CDM 250 RC 50742-447-45 NDC 475 ML inpatient 17.8 17.44 All Payors / Plans All Payors / Plans 17.8 other 17.8 17.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SODIUM CHLORIDE 0.65 % AEROSOL,SPRAY 44 ML SQUEEZ BTL" ERX-250000000 CDM 250 RC 63323-172-60 NDC 44 ML inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SODIUM CHLORIDE 0.9 % SOLUTION 1,000 ML BOTTLE" ERX-250000000 CDM 250 RC 0143-9983-03 NDC 500 ML inpatient 9.04 8.86 All Payors / Plans All Payors / Plans 9.04 other 9.04 9.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 3% 3 % PARENTERAL SOLUTION 500 ML BAG ERX-250000000 CDM 250 RC 0264-3103-11 NDC 500 ML inpatient 18.28 17.91 All Payors / Plans All Payors / Plans 18.28 other 18.28 18.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 3% 3 % PARENTERAL SOLUTION 500 ML FLEX CONT ERX-250000000 CDM 250 RC 0264-3105-11 NDC 500 ML inpatient 18.39 18.02 All Payors / Plans All Payors / Plans 18.39 other 18.39 18.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 4 MEQ/ML SOLUTION 30 ML VIAL ERX-250000000 CDM 250 RC 0338-3503-41 NDC 40 ML inpatient 25.75 25.24 All Payors / Plans All Payors / Plans 25.75 other 25.75 25.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM PHOSPHATE 3 MMOL/ML SOLUTION 15 ML VIAL ERX-250000000 CDM 250 RC 0338-3508-41 NDC 0.18 ML inpatient 144.75 141.86 All Payors / Plans All Payors / Plans 144.75 other 144.75 144.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SODIUM, POTASSIUM, AND MAGNESIUM SULFATES 17.5-3.13-1.6 GRAM RECON SOLN 177 ML BOTTLE" ERX-250000000 CDM 250 RC 0781-3210-46 NDC 177 ML inpatient 104.86 102.76 All Payors / Plans All Payors / Plans 104.86 other 104.86 104.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STANDARD NEONATAL TPN ERX-250000000 CDM 250 RC 44567-703-01 NDC 250 ML inpatient 104.7 102.61 All Payors / Plans All Payors / Plans 104.7 other 104.7 104.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUGAMMADEX 100 MG/ML SOLUTION ERX-250000000 CDM 250 RC 63323-476-37 NDC 2 ML inpatient 327.45 320.9 All Payors / Plans All Payors / Plans 327.45 other 327.45 327.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUGAMMADEX 100 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0409-2300-01 NDC 2 ML inpatient 203.14 199.08 All Payors / Plans All Payors / Plans 203.14 other 203.14 203.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML SOLUTION 10 ML VIAL ERX-250000000 CDM 250 RC 25021-114-87 NDC 25 ML inpatient 106.88 104.74 All Payors / Plans All Payors / Plans 106.88 other 106.88 106.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SOLUTION ERX-250000000 CDM 250 RC 25021-192-82 NDC 0.5 ML inpatient 21.01 20.59 All Payors / Plans All Payors / Plans 21.01 other 21.01 21.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SOLUTION ERX-250000000 CDM 250 RC 16729-288-38 NDC 0.5 ML inpatient 20.7 20.29 All Payors / Plans All Payors / Plans 20.7 other 20.7 20.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SOLUTION ERX-250000000 CDM 250 RC 63323-103-65 NDC 0.5 ML inpatient 30.93 30.31 All Payors / Plans All Payors / Plans 30.93 other 30.93 30.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THROMBIN(HUMAN)-FIBRIN-CALCIUM 500 UNIT-80 MG /ML (10 ML) SYRINGE ERX-250000000 CDM 250 RC 0143-9621-01 NDC 10 ML inpatient 1197.91 1173.95 All Payors / Plans All Payors / Plans 1197.91 other 1197.91 1197.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "TRACE ELEMENT ZN-CU-MN-SE 1,000MCG-60MCG- 3 MCG-6 MCG/ML SOLUTION 1 ML VIAL" ERX-250000000 CDM 250 RC 70121-1238-1 NDC 0.5 ML inpatient 41.95 41.11 All Payors / Plans All Payors / Plans 41.95 other 41.95 41.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRACE ELEMENTS ZN-CU-MN-SE 3 MG-0.3 MG-55 MCG-60 MCG/ML SOLUTION 1 ML VIAL ERX-250000000 CDM 250 RC 0078-0248-61 NDC 1 ML inpatient 102.15 100.11 All Payors / Plans All Payors / Plans 102.15 other 102.15 102.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) SOLUTION 10 ML VIAL" ERX-250000000 CDM 250 RC 0078-0246-61 NDC 10 ML inpatient 15.35 15.04 All Payors / Plans All Payors / Plans 15.35 other 15.35 15.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) SOLUTION 10 ML VIAL" ERX-250000000 CDM 250 RC 0054-8179-25 NDC 10 ML inpatient 15.35 15.04 All Payors / Plans All Payors / Plans 15.35 other 15.35 15.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) SOLUTION 10 ML VIAL" ERX-250000000 CDM 250 RC 67457-421-00 NDC 10 ML inpatient 30.85 30.23 All Payors / Plans All Payors / Plans 30.85 other 30.85 30.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "TRANEXAMIC ACID IN NACL 1,000 MG/100 ML (10 MG/ML) PIGGYBACK" ERX-250000000 CDM 250 RC 67457-422-00 NDC 100 ML inpatient 36.33 35.6 All Payors / Plans All Payors / Plans 36.33 other 36.33 36.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "TRANEXAMIC ACID IN NACL 1,000 MG/100 ML (10 MG/ML) PIGGYBACK" ERX-250000000 CDM 250 RC 0338-0551-18 NDC 100 ML inpatient 39.74 38.95 All Payors / Plans All Payors / Plans 39.74 other 39.74 39.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "TRANEXAMIC ACID IN NACL 1,000 MG/100 ML (10 MG/ML) PIGGYBACK" ERX-250000000 CDM 250 RC 0338-9147-30 NDC 100 ML inpatient 39.74 38.95 All Payors / Plans All Payors / Plans 39.74 other 39.74 39.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALPROATE 500 MG/5 ML (100 MG/ML) SOLUTION ERX-250000000 CDM 250 RC 0409-7100-69 NDC 5 ML inpatient 25.94 25.42 All Payors / Plans All Payors / Plans 25.94 other 25.94 25.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALPROATE 500 MG/5 ML (100 MG/ML) SOLUTION ERX-250000000 CDM 250 RC 0409-7100-04 NDC 5 ML inpatient 10.96 10.74 All Payors / Plans All Payors / Plans 10.96 other 10.96 10.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERAPAMIL 2.5 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0338-0125-03 NDC 1.6 ML inpatient 23.3 22.83 All Payors / Plans All Payors / Plans 23.3 other 23.3 23.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERAPAMIL 2.5 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0338-0125-04 NDC 1 ML inpatient 20.44 20.03 All Payors / Plans All Payors / Plans 20.44 other 20.44 20.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDIGOTINDISULFONATE 8 MG/ML (0.8 %) SOLUTION ERX-250000000 CDM 250 RC 0088-2160-30 NDC 5 ML inpatient 701.15 687.13 All Payors / Plans All Payors / Plans 701.15 other 701.15 701.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IODINE STRONG 5 % SOLUTION ERX-250000000 CDM 250 RC 50268-478-11 NDC 1 ML inpatient 137.93 135.17 All Payors / Plans All Payors / Plans 137.93 other 137.93 137.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILTIAZEM 100 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 62332-062-30 NDC 1 UN inpatient 49.63 48.64 All Payors / Plans All Payors / Plans 49.63 other 49.63 49.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DINOPROSTONE 10 MG INSERT, EXTENDED RELEASE" ERX-250000000 CDM 250 RC 70748-130-06 NDC 1 UN inpatient 483.43 473.76 All Payors / Plans All Payors / Plans 483.43 other 483.43 483.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DINOPROSTONE 10 MG INSERT, EXTENDED RELEASE" ERX-250000000 CDM 250 RC 50268-476-11 NDC 1 UN inpatient 483.43 473.76 All Payors / Plans All Payors / Plans 483.43 other 483.43 483.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXYCYCLINE 100 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 59651-180-30 NDC 1 UN inpatient 61.94 60.7 All Payors / Plans All Payors / Plans 61.94 other 61.94 61.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXYCYCLINE 100 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 68084-859-01 NDC 1 UN inpatient 61.02 59.8 All Payors / Plans All Payors / Plans 61.02 other 61.02 61.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXYCYCLINE 100 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 68084-859-11 NDC 1 UN inpatient 81.4 79.77 All Payors / Plans All Payors / Plans 81.4 other 81.4 81.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "GELATIN SPONGE,ABSORBABLE SYRINGE" ERX-250000000 CDM 250 RC 0904-7124-61 NDC 1 UN inpatient 67.95 66.59 All Payors / Plans All Payors / Plans 67.95 other 67.95 67.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "GELATIN SPONGE,ABSORB-PORCINE 100 SPONGE 6 EACH PACKET" ERX-250000000 CDM 250 RC 51079-821-01 NDC 1 UN inpatient 144.87 141.97 All Payors / Plans All Payors / Plans 144.87 other 144.87 144.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "GELATIN SPONGE,ABSORB-PORCINE 12-7 MM SPONGE" ERX-250000000 CDM 250 RC 60687-657-11 NDC 1 UN inpatient 61.17 59.95 All Payors / Plans All Payors / Plans 61.17 other 61.17 61.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLYCERIN SUPPOSITORY ERX-250000000 CDM 250 RC 0121-4799-05 NDC 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLYCERIN SUPPOSITORY ERX-250000000 CDM 250 RC 60687-249-40 NDC 0.5 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MENINGOCOCCAL A / C / Y AND W-135 DIPHTHERIA CONJUGATE 10-5 MCG/0.5 ML KIT ERX-250000000 CDM 250 RC 0904-6352-61 NDC 1 UN inpatient 310.73 304.52 All Payors / Plans All Payors / Plans 310.73 other 310.73 310.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAFCILLIN 1 GRAM RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 0904-6353-61 NDC 0.64 UN inpatient 22.9 22.44 All Payors / Plans All Payors / Plans 22.9 other 22.9 22.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAFCILLIN 2 GRAM RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 60687-497-11 NDC 1 UN inpatient 39.57 38.78 All Payors / Plans All Payors / Plans 39.57 other 39.57 39.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAFCILLIN 2 GRAM RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 42292-039-01 NDC 1 UN inpatient 36.29 35.56 All Payors / Plans All Payors / Plans 36.29 other 36.29 36.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAFCILLIN 2 GRAM RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 60687-508-11 NDC 1 UN inpatient 30.92 30.3 All Payors / Plans All Payors / Plans 30.92 other 30.92 30.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAFCILLIN 2 GRAM RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 51079-443-01 NDC 1 UN inpatient 35.73 35.02 All Payors / Plans All Payors / Plans 35.73 other 35.73 35.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PANTOPRAZOLE 40 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 42292-041-01 NDC 1 UN inpatient 10.81 10.59 All Payors / Plans All Payors / Plans 10.81 other 10.81 10.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PANTOPRAZOLE 40 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 42292-041-20 NDC 1 UN inpatient 31.27 30.64 All Payors / Plans All Payors / Plans 31.27 other 31.27 31.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PANTOPRAZOLE 40 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 0904-6956-61 NDC 1 UN inpatient 10.61 10.4 All Payors / Plans All Payors / Plans 10.61 other 10.61 10.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PANTOPRAZOLE 40 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 51079-445-01 NDC 1 UN inpatient 20.89 20.47 All Payors / Plans All Payors / Plans 20.89 other 20.89 20.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PANTOPRAZOLE 40 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 60687-530-11 NDC 1 UN inpatient 20.8 20.38 All Payors / Plans All Payors / Plans 20.8 other 20.8 20.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PANTOPRAZOLE 40 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 0904-6957-61 NDC 1 UN inpatient 10.53 10.32 All Payors / Plans All Payors / Plans 10.53 other 10.53 10.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PANTOPRAZOLE 40 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 60687-541-11 NDC 1 UN inpatient 10.53 10.32 All Payors / Plans All Payors / Plans 10.53 other 10.53 10.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POLYMYXIN B 500,000 UNIT RECON SOLN 1 EACH VIAL" ERX-250000000 CDM 250 RC 60687-552-11 NDC 1 UN inpatient 21.1 20.68 All Payors / Plans All Payors / Plans 21.1 other 21.1 21.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility REMIFENTANIL 2 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 51079-444-01 NDC 1 UN inpatient 240.5 235.69 All Payors / Plans All Payors / Plans 240.5 other 240.5 240.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility REMIFENTANIL 2 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 51079-444-20 NDC 0.5 UN inpatient 246.67 241.74 All Payors / Plans All Payors / Plans 246.67 other 246.67 246.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "THROMBIN (BOVINE) 20,000 UNIT RECON SOLN" ERX-250000000 CDM 250 RC 60687-453-11 NDC 0.5 UN inpatient 243.05 238.19 All Payors / Plans All Payors / Plans 243.05 other 243.05 243.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "THROMBIN (BOVINE) 5,000 UNIT RECON SOLN" ERX-250000000 CDM 250 RC 51079-440-01 NDC 1 UN inpatient 150.02 147.02 All Payors / Plans All Payors / Plans 150.02 other 150.02 150.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "THROMBIN (RECOMBINANT) 20,000 UNIT RECON SOLN" ERX-250000000 CDM 250 RC 51079-440-20 NDC 1 UN inpatient 639.57 626.78 All Payors / Plans All Payors / Plans 639.57 other 639.57 639.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "THROMBIN (RECOMBINANT) 5,000 UNIT RECON SOLN" ERX-250000000 CDM 250 RC 60687-464-11 NDC 1 UN inpatient 195.38 191.47 All Payors / Plans All Payors / Plans 195.38 other 195.38 195.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TICAGRELOR 60 MG TABLET ERX-250000000 CDM 250 RC 51079-441-01 NDC 1 UN inpatient 15.83 15.51 All Payors / Plans All Payors / Plans 15.83 other 15.83 15.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TICAGRELOR 90 MG TABLET ERX-250000000 CDM 250 RC 51079-441-20 NDC 1 UN inpatient 15.83 15.51 All Payors / Plans All Payors / Plans 15.83 other 15.83 15.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VECURONIUM 10 MG RECON SOLN ERX-250000000 CDM 250 RC 0904-6952-61 NDC 1 UN inpatient 15.44 15.13 All Payors / Plans All Payors / Plans 15.44 other 15.44 15.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDOCYANINE GREEN 25 MG RECON SOLN ERX-250000000 CDM 250 RC 70100-424-02 NDC 0.1 UN inpatient 321.27 314.84 All Payors / Plans All Payors / Plans 321.27 other 321.27 321.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDOCYANINE GREEN 25 MG RECON SOLN ERX-250000000 CDM 250 RC 48433-230-15 NDC 1 UN inpatient 321.27 314.84 All Payors / Plans All Payors / Plans 321.27 other 321.27 321.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE HCL IN 0.9 % NACL 4 MG/250 ML (16 MCG/ML) SOLUTION ERX-636000000 CDM 636 RC 36000-048-24 NDC 250 ML inpatient 185.82 182.1 All Payors / Plans All Payors / Plans 185.82 other 185.82 185.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE HCL IN 0.9 % NACL 4 MG/250 ML (16 MCG/ML) SOLUTION ERX-636000000 CDM 636 RC 0264-9594-10 NDC 250 ML inpatient 185.82 182.1 All Payors / Plans All Payors / Plans 185.82 other 185.82 185.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RABIES IMMUNE GLOBULIN PER 150 INT'L UNITS ERX-636000000 CDM 90377 CPT 636 RC 60687-704-11 NDC JZ 1.4 ML inpatient 584.73 573.04 All Payors / Plans All Payors / Plans 584.73 other 584.73 584.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RABIES IMMUNE GLOBULIN PER 150 INT'L UNITS ERX-636000000 CDM 90377 CPT 636 RC 0904-7007-61 NDC JZ 10 ML inpatient 2934.46 2875.77 All Payors / Plans All Payors / Plans 2934.46 other 2934.46 2934.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML SYRINGE" ERX-636000000 CDM 90620 CPT 636 RC 65162-698-90 NDC JZ 0.5 ML inpatient 417.85 409.49 All Payors / Plans All Payors / Plans 417.85 other 417.85 417.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HAEMOPHILUS B CONJUGATE 10 MCG/0.5 ML RECON SOLN ERX-636000000 CDM 90648 CPT 636 RC 55150-198-30 NDC JZ 1 UN inpatient 61.85 60.61 All Payors / Plans All Payors / Plans 61.85 other 61.85 61.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INFLUENZA TRIVALENT (6 MOS UP) 45 MCG (15 MCG X 3)/0.5 ML SYRINGE ERX-636000000 CDM 90656 CPT 636 RC 60687-373-21 NDC JZ 0.5 ML inpatient 85.18 83.48 All Payors / Plans All Payors / Plans 85.18 other 85.18 85.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RABIES VACCINE PER 1 ML ERX-636000000 CDM 90675 CPT 636 RC 81284-315-05 NDC JZ 1 UN inpatient 715.27 700.96 All Payors / Plans All Payors / Plans 715.27 other 715.27 715.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PNEUMOCOCCAL CONJUGATE PCV20 0.5 ML SYRINGE ERX-636000000 CDM 90677 CPT 636 RC 50268-398-50 NDC JZ 0.5 ML inpatient 610.96 598.74 All Payors / Plans All Payors / Plans 610.96 other 610.96 610.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INFLUENZA QUADRIVALENT 60 MCG (15 MCG X 4)/0.5 ML SYRINGE ERX-636000000 CDM 90686 CPT 636 RC 60687-373-11 NDC JZ 0.5 ML inpatient 84.32 82.63 All Payors / Plans All Payors / Plans 84.32 other 84.32 84.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MEASLES, MUMPS & RUBELLA VAC PER 0.5 ML" ERX-636000000 CDM 90707 CPT 636 RC 63323-623-61 NDC JZ 1 UN inpatient 204.79 200.69 All Payors / Plans All Payors / Plans 204.79 other 204.79 204.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TETANUS AND DIPHTHERIA TOXIN 5-2 LF UNIT/0.5 ML SYRINGE ERX-636000000 CDM 90714 CPT 636 RC 0904-7109-61 NDC JZ 0.5 ML inpatient 139.64 136.85 All Payors / Plans All Payors / Plans 139.64 other 139.64 139.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML SYRINGE" ERX-636000000 CDM 90715 CPT 636 RC 0536-1211-95 NDC JZ 0.5 ML inpatient 141.06 138.24 All Payors / Plans All Payors / Plans 141.06 other 141.06 141.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML SYRINGE" ERX-636000000 CDM 90715 CPT 636 RC 61314-014-05 NDC JZ 0.5 ML inpatient 141.06 138.24 All Payors / Plans All Payors / Plans 141.06 other 141.06 141.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TETANUS-DIPHTH-ACELL PERTUSSIS PER 0.5 ML ERX-636000000 CDM 90715 CPT 636 RC 60687-439-11 NDC JZ 0.5 ML inpatient 148.92 145.94 All Payors / Plans All Payors / Plans 148.92 other 148.92 148.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DTAP-HEPATITIS B RECOMBINANT-IPV 10 MCG-25LF-25 MCG-10LF/0.5 ML SYRINGE ERX-636000000 CDM 90723 CPT 636 RC 0904-5921-61 NDC JZ 0.5 ML inpatient 193.46 189.59 All Payors / Plans All Payors / Plans 193.46 other 193.46 193.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML SYRINGE ERX-636000000 CDM 90744 CPT 636 RC 60687-451-11 NDC JZ 0.5 ML inpatient 84.42 82.73 All Payors / Plans All Payors / Plans 84.42 other 84.42 84.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML SYRINGE ERX-636000000 CDM 90744 CPT 636 RC 64380-737-06 NDC JZ 0.5 ML inpatient 84.42 82.73 All Payors / Plans All Payors / Plans 84.42 other 84.42 84.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML SYRINGE ERX-250000000 CDM 90746 CPT 250 RC 49884-465-64 NDC JZ 1 ML inpatient 149.1 146.12 All Payors / Plans All Payors / Plans 149.1 other 149.1 149.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "WATER FOR INJECTION, STERILE SOLUTION" ERX-636000000 CDM A4216 CPT 636 RC 0904-7245-68 NDC JZ 0.83 ML inpatient 0.25 0.25 All Payors / Plans All Payors / Plans 0.25 other 0.25 0.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "WATER FOR INJECTION, STERILE SOLUTION" ERX-636000000 CDM A4216 CPT 636 RC 67877-734-60 NDC JZ 0.9 ML inpatient 0.53 0.52 All Payors / Plans All Payors / Plans 0.53 other 0.53 0.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "WATER FOR INJECTION, STERILE SOLUTION 10 ML VIAL" ERX-636000000 CDM A4216 CPT 636 RC 67877-733-60 NDC JZ 10 ML inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "WATER FOR INJECTION, STERILE SOLUTION 10 ML VIAL" ERX-636000000 CDM A4216 CPT 636 RC 04910-0381-64 NDC JZ 10 ML inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "WATER FOR INJECTION, STERILE SOLUTION 10 ML VIAL" ERX-636000000 CDM A4216 CPT 636 RC 0121-1154-30 NDC JZ 10 ML inpatient 5.86 5.74 All Payors / Plans All Payors / Plans 5.86 other 5.86 5.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "WATER FOR INJECTION, STERILE SOLUTION 20 ML VIAL" ERX-636000000 CDM A4216 CPT 636 RC 45963-439-65 NDC JZ 20 ML inpatient 6.02 5.9 All Payors / Plans All Payors / Plans 6.02 other 6.02 6.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "WATER FOR INJECTION, STERILE SOLUTION 5 ML VIAL" ERX-636000000 CDM A4216 CPT 636 RC 62135-003-47 NDC JZ 5 ML inpatient 11.13 10.91 All Payors / Plans All Payors / Plans 11.13 other 11.13 11.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "WATER FOR INJECTION, STERILE SOLUTION 50 ML VIAL" ERX-636000000 CDM A4216 CPT 636 RC 57237-274-24 NDC JZ 1.68 ML inpatient 0.37 0.36 All Payors / Plans All Payors / Plans 0.37 other 0.37 0.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "STERILE WATER PARENTERAL SOLUTION 2,000 ML BAG" ERX-636000000 CDM A4217 CPT 636 RC 16714-309-01 NDC 35.43 ML inpatient 0.57 0.56 All Payors / Plans All Payors / Plans 0.57 other 0.57 0.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STERILE WATER SOLUTION ERX-636000000 CDM A4217 CPT 636 RC 63323-203-01 NDC 3 ML inpatient 0.2 0.2 All Payors / Plans All Payors / Plans 0.2 other 0.2 0.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "STERILE WATER SOLUTION 1,000 ML BOTTLE" ERX-636000000 CDM A4217 CPT 636 RC 63323-203-20 NDC 10 ML inpatient 0.18 0.18 All Payors / Plans All Payors / Plans 0.18 other 0.18 0.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STERILE WATER SOLUTION 500 ML BOTTLE ERX-636000000 CDM A4217 CPT 636 RC 55150-370-25 NDC 10 ML inpatient 0.36 0.35 All Payors / Plans All Payors / Plans 0.36 other 0.36 0.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "STERILE WATER PARENTERAL SOLUTION 1,000 ML BAG" ERX-636000000 CDM A4217 CPT 636 RC 45802-465-64 NDC JZ 27.5 ML inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUTEROL 1 (ONE) 90 MCG/PUFF INHALER 8 G INHALER ERX-637000000 CDM A9270 CPT 637 RC 0338-0202-01 NDC GY 8 GR inpatient 102.01 99.97 All Payors / Plans All Payors / Plans 102.01 other 102.01 102.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMMONIUM LACTATE 12 % LOTION 225 G BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0338-1145-03 NDC GY 225 GR inpatient 63.88 62.6 All Payors / Plans All Payors / Plans 63.88 other 63.88 63.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BACITRACIN 500 UNIT/GRAM OINTMENT 14 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0338-1148-03 NDC GY 14 GR inpatient 15.76 15.44 All Payors / Plans All Payors / Plans 15.76 other 15.76 15.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BACITRACIN 500 UNIT/GRAM OINTMENT 14 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0409-4346-73 NDC GY 14 GR inpatient 6.05 5.93 All Payors / Plans All Payors / Plans 6.05 other 6.05 6.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BACITRACIN 500 UNIT/GRAM OINTMENT 3.5 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 63323-616-09 NDC GY 3.5 GR inpatient 314.57 308.28 All Payors / Plans All Payors / Plans 314.57 other 314.57 314.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BECLOMETHASONE 40 MCG/ACTUATION HFA AEROSOL BREATH ACTIVATED 10.6 G AER BR.ACT ERX-637000000 CDM A9270 CPT 637 RC 67457-153-03 NDC GY 10.6 GR inpatient 457.03 447.89 All Payors / Plans All Payors / Plans 457.03 other 457.03 457.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BENZOCAINE 20 % AEROSOL,SPRAY 57 G CAN" ERX-637000000 CDM A9270 CPT 637 RC 15082-001-10 NDC GY 0.285 GR inpatient 0.25 0.25 All Payors / Plans All Payors / Plans 0.25 other 0.25 0.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZOCAINE-MENTHOL 20-0.5 % AEROSOL 78 G CANISTER ERX-637000000 CDM A9270 CPT 637 RC 63323-466-37 NDC GY 78 GR inpatient 26.33 25.8 All Payors / Plans All Payors / Plans 26.33 other 26.33 26.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZOCAINE-MENTHOL 20-0.5 % AEROSOL 85 G CANISTER ERX-637000000 CDM A9270 CPT 637 RC 0409-1746-10 NDC GY 85 GR inpatient 26.17 25.65 All Payors / Plans All Payors / Plans 26.17 other 26.17 26.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BETAMETHASONE DIPROPIONATE 0.05 % CREAM 45 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 63323-468-37 NDC GY 45 GR inpatient 202.25 198.21 All Payors / Plans All Payors / Plans 202.25 other 202.25 202.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN 2 % CREAM 40 G TUBE/KIT ERX-637000000 CDM A9270 CPT 637 RC 0409-1749-10 NDC GY 40 GR inpatient 195.9 191.98 All Payors / Plans All Payors / Plans 195.9 other 195.9 195.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOTRIMAZOLE 1 % CREAM 28 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 63323-462-03 NDC GY 28 GR inpatient 10.88 10.66 All Payors / Plans All Payors / Plans 10.88 other 10.88 10.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOTRIMAZOLE 1 % CREAM 30 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 63323-407-03 NDC GY 30 GR inpatient 10.47 10.26 All Payors / Plans All Payors / Plans 10.47 other 10.47 10.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOTRIMAZOLE 2 % CREAM 21 G TUBE/KIT ERX-637000000 CDM A9270 CPT 637 RC 0517-6710-10 NDC GY 21 GR inpatient 25.99 25.47 All Payors / Plans All Payors / Plans 25.99 other 25.99 25.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % CREAM 15 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0517-6710-01 NDC GY 15 GR inpatient 35.64 34.93 All Payors / Plans All Payors / Plans 35.64 other 35.64 35.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COLLAGENASE 250 UNIT/GRAM OINTMENT 30 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0409-1631-10 NDC GY 30 GR inpatient 660.57 647.36 All Payors / Plans All Payors / Plans 660.57 other 660.57 660.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CONJUGATED ESTROGENS 0.625 MG/GRAM CREAM 30 G TUBE/KIT ERX-637000000 CDM A9270 CPT 637 RC 44567-620-01 NDC GY 30 GR inpatient 803.37 787.3 All Payors / Plans All Payors / Plans 803.37 other 803.37 803.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 15G ORAL 40 % GEL ERX-637000000 CDM A9270 CPT 637 RC 44567-621-01 NDC GY 0.4 GR inpatient 9.5 9.31 All Payors / Plans All Payors / Plans 9.5 other 9.5 9.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 15G ORAL 40 % GEL ERX-637000000 CDM A9270 CPT 637 RC 44567-621-24 NDC GY 15 GR inpatient 9.53 9.34 All Payors / Plans All Payors / Plans 9.53 other 9.53 9.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIBUCAINE 1 % OINTMENT 28 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0143-9180-01 NDC GY 28 GR inpatient 15.9 15.58 All Payors / Plans All Payors / Plans 15.9 other 15.9 15.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERYTHROMYCIN 1 (ONE) 1 G TUBE 1 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0143-9184-01 NDC GY 1 GR inpatient 39.7 38.91 All Payors / Plans All Payors / Plans 39.7 other 39.7 39.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERYTHROMYCIN 5 MG/GRAM (0.5 %) OINTMENT ERX-637000000 CDM A9270 CPT 637 RC 0009-0856-08 NDC GY 1 GR inpatient 39.5 38.71 All Payors / Plans All Payors / Plans 39.5 other 39.5 39.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERYTHROMYCIN 5 MG/GRAM (0.5 %) OINTMENT ERX-637000000 CDM A9270 CPT 637 RC 69374-984-10 NDC GY 1 GR inpatient 49.67 48.68 All Payors / Plans All Payors / Plans 49.67 other 49.67 49.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERYTHROMYCIN 5 MG/GRAM (0.5 %) OINTMENT ERX-637000000 CDM A9270 CPT 637 RC 0000-0000-59 NDC GY 1 GR inpatient 30.93 30.31 All Payors / Plans All Payors / Plans 30.93 other 30.93 30.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERYTHROMYCIN 5 MG/GRAM (0.5 %) OINTMENT 1 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0000-0000-58 NDC GY 1 GR inpatient 40.14 39.34 All Payors / Plans All Payors / Plans 40.14 other 40.14 40.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOCINONIDE 0.05 % CREAM 60 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 8065183150 NDC GY 60 GR inpatient 155.52 152.41 All Payors / Plans All Payors / Plans 155.52 other 155.52 155.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUTICASONE HFA 110 MCG/ACTUATION HFA AEROSOL INHALER 12 G AER W/ADAP ERX-637000000 CDM A9270 CPT 637 RC 8065183905 NDC GY 0.0002 GR inpatient 0.12 0.12 All Payors / Plans All Payors / Plans 0.12 other 0.12 0.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUTICASONE HFA 44 MCG/ACTUATION HFA AEROSOL INHALER 10.6 G AER W/ADAP ERX-637000000 CDM A9270 CPT 637 RC 70069-151-01 NDC GY 10.6 GR inpatient 430.16 421.56 All Payors / Plans All Payors / Plans 430.16 other 430.16 430.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUTICASONE HFA 44 MCG/ACTUATION HFA AEROSOL INHALER 10.6 G AER W/ADAP ERX-637000000 CDM A9270 CPT 637 RC 0703-2056-01 NDC GY 0.0001 GR inpatient 0.12 0.12 All Payors / Plans All Payors / Plans 0.12 other 0.12 0.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN 0.1 % CREAM 15 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 10122-610-10 NDC GY 15 GR inpatient 85.65 83.94 All Payors / Plans All Payors / Plans 85.65 other 85.65 85.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN 0.1 % CREAM 15 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 10122-610-01 NDC GY 15 GR inpatient 138.94 136.16 All Payors / Plans All Payors / Plans 138.94 other 138.94 138.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN 0.1 % CREAM 15 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 10122-611-01 NDC GY 15 GR inpatient 143.19 140.33 All Payors / Plans All Payors / Plans 143.19 other 143.19 143.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 1 % CREAM 28.35 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 10122-611-10 NDC GY 28 GR inpatient 15.63 15.32 All Payors / Plans All Payors / Plans 15.63 other 15.63 15.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 2.5 % CREAM 30 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0338-9553-24 NDC GY 30 GR inpatient 10.91 10.69 All Payors / Plans All Payors / Plans 10.91 other 10.91 10.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 2.5 % CREAM 30 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0000-0000-10 NDC GY 30 GR inpatient 15.69 15.38 All Payors / Plans All Payors / Plans 15.69 other 15.69 15.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 2.5 % OINTMENT 28.35 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 2289-1012-65 NDC GY 28.35 GR inpatient 16.02 15.7 All Payors / Plans All Payors / Plans 16.02 other 16.02 16.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOCONAZOLE 2 % CREAM 15 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0338-0085-03 NDC GY 15 GR inpatient 132.18 129.54 All Payors / Plans All Payors / Plans 132.18 other 132.18 132.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LANOLIN 100 % CREAM 7 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 42023-187-10 NDC GY 7 GR inpatient 15.24 14.94 All Payors / Plans All Payors / Plans 15.24 other 15.24 15.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 4 % GEL 10 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 16729-239-30 NDC GY 10 GR inpatient 45.5 44.59 All Payors / Plans All Payors / Plans 45.5 other 45.5 45.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 5 % OINTMENT 35.44 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 71288-505-03 NDC GY 35.44 GR inpatient 253.66 248.59 All Payors / Plans All Payors / Plans 253.66 other 253.66 253.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE HCL (BULK) 100 % POWDER ERX-637000000 CDM A9270 CPT 637 RC 42023-186-20 NDC GY 3 GR inpatient 10.56 10.35 All Payors / Plans All Payors / Plans 10.56 other 10.56 10.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MENTHOL-ZINC OXIDE 0.44-20.6 % OINTMENT IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 0338-9557-12 NDC GY 3.5 GR inpatient 1.87 1.83 All Payors / Plans All Payors / Plans 1.87 other 1.87 1.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYL SALICYLATE-MENTHOL 29-7.6 % OINTMENT 99.2 G JAR ERX-637000000 CDM A9270 CPT 637 RC 55150-297-01 NDC GY 99.2 GR inpatient 26.19 25.67 All Payors / Plans All Payors / Plans 26.19 other 26.19 26.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICONAZOLE 2 % CREAM 14 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 44567-603-24 NDC GY 14 GR inpatient 21.15 20.73 All Payors / Plans All Payors / Plans 21.15 other 21.15 21.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICONAZOLE 2 % CREAM 45 G TUBE/KIT ERX-637000000 CDM A9270 CPT 637 RC 0338-0023-03 NDC GY 45 GR inpatient 20.61 20.2 All Payors / Plans All Payors / Plans 20.61 other 20.61 20.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MUPIROCIN 2 % OINTMENT 22 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0338-0023-04 NDC GY 22 GR inpatient 15.49 15.18 All Payors / Plans All Payors / Plans 15.49 other 15.49 15.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MUPIROCIN 2 % OINTMENT 22 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0990-7930-09 NDC GY 22 GR inpatient 16.16 15.84 All Payors / Plans All Payors / Plans 16.16 other 16.16 16.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MUPIROCIN 2 % OINTMENT 22 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0990-7935-19 NDC GY 22 GR inpatient 15.8 15.48 All Payors / Plans All Payors / Plans 15.8 other 15.8 15.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MUPIROCIN 2 % OINTMENT 22 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0338-0085-04 NDC GY 22 GR inpatient 25.63 25.12 All Payors / Plans All Payors / Plans 25.63 other 25.63 25.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5MG-400 UNIT- 5,000 UNIT/GRAM OINTMENT 28.4 G TUBE" ERX-637000000 CDM A9270 CPT 637 RC 0990-7111-09 NDC GY 28.4 GR inpatient 10.94 10.72 All Payors / Plans All Payors / Plans 10.94 other 10.94 10.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5 MG/G-10,000 UNIT/G-0.1 % OINTMENT 3.5 G TUBE" ERX-637000000 CDM A9270 CPT 637 RC 0338-0077-04 NDC GY 3.5 GR inpatient 81.59 79.96 All Payors / Plans All Payors / Plans 81.59 other 81.59 81.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROGLYCERIN 2 % OINTMENT ERX-637000000 CDM A9270 CPT 637 RC 0990-7924-09 NDC GY 0.5 GR inpatient 4.43 4.34 All Payors / Plans All Payors / Plans 4.43 other 4.43 4.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NITROGLYCERIN 400 MCG/SPRAY SPRAY,NON-AEROSOL 12 G BOTTLE" ERX-637000000 CDM A9270 CPT 637 RC 0409-7517-16 NDC GY 12 GR inpatient 426.74 418.21 All Payors / Plans All Payors / Plans 426.74 other 426.74 426.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/GRAM CREAM 30 G TUBE" ERX-637000000 CDM A9270 CPT 637 RC 76329-3302-1 NDC GY 30 GR inpatient 31.21 30.59 All Payors / Plans All Payors / Plans 31.21 other 31.21 31.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/GRAM OINTMENT 15 G TUBE" ERX-637000000 CDM A9270 CPT 637 RC 0409-6648-02 NDC GY 15 GR inpatient 16.16 15.84 All Payors / Plans All Payors / Plans 16.16 other 16.16 16.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/GRAM POWDER 15 G SQUEEZ BTL" ERX-637000000 CDM A9270 CPT 637 RC 0338-0719-06 NDC GY 15 GR inpatient 25.94 25.42 All Payors / Plans All Payors / Plans 25.94 other 25.94 25.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/GRAM POWDER 15 G SQUEEZ BTL" ERX-637000000 CDM A9270 CPT 637 RC 14537-817-75 NDC GY 15 GR inpatient 45.21 44.31 All Payors / Plans All Payors / Plans 45.21 other 45.21 45.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/GRAM POWDER 15 G SQUEEZ BTL" ERX-637000000 CDM A9270 CPT 637 RC 14537-967-75 NDC GY 15 GR inpatient 39.88 39.08 All Payors / Plans All Payors / Plans 39.88 other 39.88 39.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % OINTMENT 28 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0409-4350-13 NDC GY 28 GR inpatient 31.18 30.56 All Payors / Plans All Payors / Plans 31.18 other 31.18 31.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POVIDONE-IODINE 10 % OINTMENT ERX-637000000 CDM A9270 CPT 637 RC 63037-119-05 NDC GY 1 GR inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POVIDONE-IODINE 10 % OINTMENT ERX-637000000 CDM A9270 CPT 637 RC 0641-6013-01 NDC GY 1 GR inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SILVER SULFADIAZINE 1 % CREAM 50 G JAR ERX-637000000 CDM A9270 CPT 637 RC 70860-301-05 NDC GY 50 GR inpatient 35.98 35.26 All Payors / Plans All Payors / Plans 35.98 other 35.98 35.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRETINOIN 0.05 % CREAM 20 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 70860-301-41 NDC GY 20 GR inpatient 82.68 81.03 All Payors / Plans All Payors / Plans 82.68 other 82.68 82.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRIAMCINOLONE 0.1 % CREAM 15 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 55566-2800-0 NDC GY 15 GR inpatient 15.74 15.43 All Payors / Plans All Payors / Plans 15.74 other 15.74 15.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRIAMCINOLONE 0.1 % CREAM 80 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 55566-2800-1 NDC GY 80 GR inpatient 31.11 30.49 All Payors / Plans All Payors / Plans 31.11 other 31.11 31.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRIAMCINOLONE 0.5 % CREAM 15 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0143-9381-01 NDC GY 15 GR inpatient 49.67 48.68 All Payors / Plans All Payors / Plans 49.67 other 49.67 49.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VITAMIN A & D WITH LANOLIN OINTMENT 42.5 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 63323-130-02 NDC GY 42.5 GR inpatient 15.24 14.94 All Payors / Plans All Payors / Plans 15.24 other 15.24 15.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WHITE PETROLATUM 41 % OINTMENT 80 G JAR ERX-637000000 CDM A9270 CPT 637 RC 67457-437-00 NDC GY 80 GR inpatient 30.85 30.23 All Payors / Plans All Payors / Plans 30.85 other 30.85 30.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WHITE PETROLATUM-MINERAL OIL 94-3 % OINTMENT 3.5 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 65219-389-02 NDC GY 3.5 GR inpatient 36.05 35.33 All Payors / Plans All Payors / Plans 36.05 other 36.05 36.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WHITE PETROLATUM-MINERAL OIL-LANOLIN-CERESIN CREAM 113 G JAR ERX-637000000 CDM A9270 CPT 637 RC 0338-0221-04 NDC GY 113 GR inpatient 10.91 10.69 All Payors / Plans All Payors / Plans 10.91 other 10.91 10.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZINC OXIDE-COD LIVER OIL 40 % PASTE 28 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0143-9786-01 NDC GY 28 GR inpatient 15.81 15.49 All Payors / Plans All Payors / Plans 15.81 other 15.81 15.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZINC OXIDE-COD LIVER OIL 40 % PASTE 57 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0143-9786-10 NDC GY 28 GR inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "FLUTICASONE PROPIONATE 50 MCG/ACTUATION SPRAY,SUSPENSION 16 G AER W/ADAP" ERX-637000000 CDM A9270 CPT 637 RC 16714-037-25 NDC GY 16000 ME inpatient 25.94 25.42 All Payors / Plans All Payors / Plans 25.94 other 25.94 25.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "FLUTICASONE PROPIONATE 50 MCG/ACTUATION SPRAY,SUSPENSION 16 G AER W/ADAP" ERX-637000000 CDM A9270 CPT 637 RC 14789-250-10 NDC GY 16000 ME inpatient 20.74 20.33 All Payors / Plans All Payors / Plans 20.74 other 20.74 20.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 160 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 45802-730-32 NDC GY 15.99015385 ML inpatient 13.78 13.5 All Payors / Plans All Payors / Plans 13.78 other 13.78 13.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 160 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0406-0484-23 NDC GY 10.15 ML inpatient 4.92 4.82 All Payors / Plans All Payors / Plans 4.92 other 4.92 4.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 160 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0904-6663-61 NDC GY 3.3 ML inpatient 2.64 2.59 All Payors / Plans All Payors / Plans 2.64 other 2.64 2.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 160 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 29033-030-01 NDC GY 5 ML inpatient 2.64 2.59 All Payors / Plans All Payors / Plans 2.64 other 2.64 2.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 325 MG/10.15 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 60687-578-11 NDC GY 10.15 ML inpatient 3.47 3.4 All Payors / Plans All Payors / Plans 3.47 other 3.47 3.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACTIVATED CHARCOAL 50 GRAM/240 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 7985404097 NDC GY 240 ML inpatient 83.22 81.56 All Payors / Plans All Payors / Plans 83.22 other 83.22 83.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACTIVATED CHARCOAL-SORBITOL 50 GRAM/240 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0574-0521-76 NDC GY 240 ML inpatient 83.44 81.77 All Payors / Plans All Payors / Plans 83.44 other 83.44 83.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0574-0520-76 NDC GY 30 ML inpatient 6.72 6.59 All Payors / Plans All Payors / Plans 6.72 other 6.72 6.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0904-5789-61 NDC GY 30 ML inpatient 0.3 0.29 All Payors / Plans All Payors / Plans 0.3 other 0.3 0.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 72578-002-01 NDC GY 30 ML inpatient 0.36 0.35 All Payors / Plans All Payors / Plans 0.36 other 0.36 0.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 68084-109-11 NDC GY 28 ML inpatient 8.57 8.4 All Payors / Plans All Payors / Plans 8.57 other 8.57 8.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 31722-935-02 NDC GY 30 ML inpatient 9.19 9.01 All Payors / Plans All Payors / Plans 9.19 other 9.19 9.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0173-0682-24 NDC GY 30 ML inpatient 8.85 8.67 All Payors / Plans All Payors / Plans 8.85 other 8.85 8.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0904-7041-61 NDC GY 30 ML inpatient 0.28 0.27 All Payors / Plans All Payors / Plans 0.28 other 0.28 0.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 1 (ONE) 100 ML BOTTLE 100 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 16714-576-02 NDC GY 100 ML inpatient 25.63 25.12 All Payors / Plans All Payors / Plans 25.63 other 25.63 25.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 125 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 51079-205-01 NDC GY 10 ML inpatient 0.42 0.41 All Payors / Plans All Payors / Plans 0.42 other 0.42 0.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 250 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 51079-205-20 NDC GY 7.5 ML inpatient 0.44 0.43 All Payors / Plans All Payors / Plans 0.44 other 0.44 0.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 250 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 0904-6572-61 NDC GY 9.5 ML inpatient 0.31 0.3 All Payors / Plans All Payors / Plans 0.31 other 0.31 0.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 250 MG/5 ML SUSPENSION FOR RECONSTITUTION 80 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 51079-206-01 NDC GY 80 ML inpatient 10.94 10.72 All Payors / Plans All Payors / Plans 10.94 other 10.94 10.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 400 MG/5 ML SUSPENSION FOR RECONSTITUTION 100 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0228-2027-10 NDC GY 100 ML inpatient 35.95 35.23 All Payors / Plans All Payors / Plans 35.95 other 35.95 35.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 400 MG/5 ML SUSPENSION FOR RECONSTITUTION 100 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0781-1061-01 NDC GY 100 ML inpatient 20.69 20.28 All Payors / Plans All Payors / Plans 20.69 other 20.69 20.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 59762-3719-1 NDC GY 4.9 ML inpatient 20.37 19.96 All Payors / Plans All Payors / Plans 20.37 other 20.37 20.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 600-42.9 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 0781-1077-01 NDC GY 4 ML inpatient 10.67 10.46 All Payors / Plans All Payors / Plans 10.67 other 10.67 10.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 1 MG/ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0781-1079-01 NDC GY 5 ML inpatient 39.82 39.02 All Payors / Plans All Payors / Plans 39.82 other 39.82 39.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARTIFICIAL TEARS(HYPROMELLOSE) 0.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0121-1761-30 NDC GY 15 ML inpatient 132.44 129.79 All Payors / Plans All Payors / Plans 132.44 other 132.44 132.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARTIFICIAL TEARS(HYPROMELLOSE) 0.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0536-1293-83 NDC GY 15 ML inpatient 105.87 103.75 All Payors / Plans All Payors / Plans 105.87 other 105.87 105.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATOVAQUONE 750 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0536-1317-83 NDC GY 5 ML inpatient 18.89 18.51 All Payors / Plans All Payors / Plans 18.89 other 18.89 18.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATOVAQUONE 750 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0904-7325-62 NDC GY 5 ML inpatient 18.4 18.03 All Payors / Plans All Payors / Plans 18.4 other 18.4 18.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE 1 % DROPS 2 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0904-7325-73 NDC GY 2 ML inpatient 83.72 82.05 All Payors / Plans All Payors / Plans 83.72 other 83.72 83.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE 1 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 17856-0630-1 NDC GY 5 ML inpatient 185.03 181.33 All Payors / Plans All Payors / Plans 185.03 other 185.03 185.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE 1 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 57896-629-12 NDC GY 5 ML inpatient 106.14 104.02 All Payors / Plans All Payors / Plans 106.14 other 106.14 106.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN 100 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 0254-3012-78 NDC GY 5.15 ML inpatient 26.14 25.62 All Payors / Plans All Payors / Plans 26.14 other 26.14 26.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN 200 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 0591-2312-45 NDC GY 2.11 ML inpatient 36.05 35.33 All Payors / Plans All Payors / Plans 36.05 other 36.05 36.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN 200 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 50268-069-11 NDC GY 25 ML inpatient 117.89 115.53 All Payors / Plans All Payors / Plans 117.89 other 117.89 117.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN 200 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 0574-0292-01 NDC GY 1.65 ML inpatient 0.83 0.81 All Payors / Plans All Payors / Plans 0.83 other 0.83 0.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALANCED SALT SOLN NO.1 IRRIG. SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0245-0144-89 NDC GY 250 ML inpatient 196.22 192.3 All Payors / Plans All Payors / Plans 196.22 other 196.22 196.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALANCED SALT SOLUTION SOLUTION 15 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0245-0147-89 NDC GY 10 ML inpatient 30.94 30.32 All Payors / Plans All Payors / Plans 30.94 other 30.94 30.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALANCED SALT SOLUTION SOLUTION 500 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0904-6993-61 NDC GY 500 ML inpatient 61.36 60.13 All Payors / Plans All Payors / Plans 61.36 other 61.36 61.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BISMUTH SUBSALICYLATE 262 MG/15 ML SUSPENSION 118 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 63739-051-10 NDC GY 118 ML inpatient 10.79 10.57 All Payors / Plans All Payors / Plans 10.79 other 10.79 10.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRILLIANT BLUE 0.025 % SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 50268-037-11 NDC GY 0.5 ML inpatient 148.87 145.89 All Payors / Plans All Payors / Plans 148.87 other 148.87 148.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRIMONIDINE 0.15 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 70756-201-11 NDC GY 5 ML inpatient 201.39 197.36 All Payors / Plans All Payors / Plans 201.39 other 201.39 201.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BRINZOLAMIDE 1 % DROPS,SUSPENSION 10 ML DROP BTL" ERX-637000000 CDM A9270 CPT 637 RC 60687-433-11 NDC GY 10 ML inpatient 678.13 664.57 All Payors / Plans All Payors / Plans 678.13 other 678.13 678.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 60687-444-11 NDC GY 2.31 ML inpatient 16.65 16.32 All Payors / Plans All Payors / Plans 16.65 other 16.65 16.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALAMINE-ZINC OXIDE 8-8 % LOTION 177 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0904-6371-61 NDC GY 177 ML inpatient 10.58 10.37 All Payors / Plans All Payors / Plans 10.58 other 10.58 10.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CALCITONIN 200 UNIT/ACTUATION SPRAY,NON-AEROSOL 3.7 ML SQUEEZ BTL" ERX-637000000 CDM A9270 CPT 637 RC 60687-496-01 NDC GY 3.7 ML inpatient 183.87 180.19 All Payors / Plans All Payors / Plans 183.87 other 183.87 183.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CALCIUM CARBONATE 500 MG/5 ML (1,250 MG/5 ML) SUSPENSION" ERX-637000000 CDM A9270 CPT 637 RC 60687-496-11 NDC GY 2 ML inpatient 8.68 8.51 All Payors / Plans All Payors / Plans 8.68 other 8.68 8.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBAMIDE PEROXIDE 6.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0904-6369-61 NDC GY 15 ML inpatient 10.56 10.35 All Payors / Plans All Payors / Plans 10.56 other 10.56 10.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBAMIDE PEROXIDE 6.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0378-5209-77 NDC GY 15 ML inpatient 15.23 14.93 All Payors / Plans All Payors / Plans 15.23 other 15.23 15.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBOXYMETHYLCELLULOSE 0.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0904-6370-61 NDC GY 15 ML inpatient 38.24 37.48 All Payors / Plans All Payors / Plans 38.24 other 38.24 38.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFDINIR 125 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 45802-419-54 NDC GY 3.9 ML inpatient 10.5 10.29 All Payors / Plans All Payors / Plans 10.5 other 10.5 10.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFDINIR 250 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 0781-6157-46 NDC GY 6 ML inpatient 15.32 15.01 All Payors / Plans All Payors / Plans 15.32 other 15.32 15.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEPHALEXIN 125 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 0781-6039-46 NDC GY 3.8 ML inpatient 0.57 0.56 All Payors / Plans All Payors / Plans 0.57 other 0.57 0.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CETIRIZINE 5 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 16714-298-01 NDC GY 5 ML inpatient 6.99 6.85 All Payors / Plans All Payors / Plans 6.99 other 6.99 6.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORHEXIDINE 0.12 % MOUTHWASH ERX-637000000 CDM A9270 CPT 637 RC 0093-4155-73 NDC GY 15 ML inpatient 3.39 3.32 All Payors / Plans All Payors / Plans 3.39 other 3.39 3.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORHEXIDINE 0.12 % MOUTHWASH ERX-637000000 CDM A9270 CPT 637 RC 65862-707-01 NDC GY 15 ML inpatient 3.39 3.32 All Payors / Plans All Payors / Plans 3.39 other 3.39 3.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORHEXIDINE 0.12 % MOUTHWASH ERX-637000000 CDM A9270 CPT 637 RC 65862-707-80 NDC GY 15 ML inpatient 5.04 4.94 All Payors / Plans All Payors / Plans 5.04 other 5.04 5.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORHEXIDINE 0.12 % MOUTHWASH ERX-637000000 CDM A9270 CPT 637 RC 0143-9887-01 NDC GY 15 ML inpatient 4.95 4.85 All Payors / Plans All Payors / Plans 4.95 other 4.95 4.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHOLECALCIFEROL 10 MCG/ML (400 UNIT/ML) DROPS ERX-637000000 CDM A9270 CPT 637 RC 65862-071-01 NDC GY 1 ML inpatient 0.33 0.32 All Payors / Plans All Payors / Plans 0.33 other 0.33 0.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHOLECALCIFEROL 10 MCG/ML (400 UNIT/ML) DROPS ERX-637000000 CDM A9270 CPT 637 RC 16714-299-03 NDC GY 1 ML inpatient 0.22 0.22 All Payors / Plans All Payors / Plans 0.22 other 0.22 0.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN 0.3 % DROPS 2.5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0781-1874-31 NDC GY 2.5 ML inpatient 21.01 20.59 All Payors / Plans All Payors / Plans 21.01 other 21.01 21.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % DROPS,SUSPENSION 7.5 ML DROP BTL" ERX-637000000 CDM A9270 CPT 637 RC 59651-026-75 NDC GY 7.5 ML inpatient 255.75 250.64 All Payors / Plans All Payors / Plans 255.75 other 255.75 255.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % DROPS,SUSPENSION 7.5 ML DROP BTL" ERX-637000000 CDM A9270 CPT 637 RC 0093-2274-34 NDC GY 7.5 ML inpatient 357.87 350.71 All Payors / Plans All Payors / Plans 357.87 other 357.87 357.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN 75 MG/5 ML RECON SOLN ERX-637000000 CDM A9270 CPT 637 RC 0781-1831-01 NDC GY 6.9 ML inpatient 10.48 10.27 All Payors / Plans All Payors / Plans 10.48 other 10.48 10.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN PALMITATE HCL 75 MG/5 ML RECON SOLN ERX-637000000 CDM A9270 CPT 637 RC 65862-502-20 NDC GY 15 ML inpatient 5.03 4.93 All Payors / Plans All Payors / Plans 5.03 other 5.03 5.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CODEINE-GUAIFENESIN 10-100 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 0093-8675-78 NDC GY 5 ML inpatient 9.1 8.92 All Payors / Plans All Payors / Plans 9.1 other 9.1 9.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPOUND VEHICLE SUSP SF NO.20 SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0781-1852-01 NDC GY 3 ML inpatient 0.22 0.22 All Payors / Plans All Payors / Plans 0.22 other 0.22 0.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPOUNDING VEHICLE SYRUP NO23 SYRUP ERX-637000000 CDM A9270 CPT 637 RC 65862-503-01 NDC GY 2.5 ML inpatient 0.2 0.2 All Payors / Plans All Payors / Plans 0.2 other 0.2 0.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOPENTOLATE 1 % DROPS 2 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 81964-221-14 NDC GY 2 ML inpatient 62.8 61.54 All Payors / Plans All Payors / Plans 62.8 other 62.8 62.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE ERX-637000000 CDM A9270 CPT 637 RC 54092-383-01 NDC GY 1.45 ML inpatient 0.31 0.3 All Payors / Plans All Payors / Plans 0.31 other 0.31 0.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE 0.1 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 54092-381-01 NDC GY 5 ML inpatient 154.17 151.09 All Payors / Plans All Payors / Plans 154.17 other 154.17 154.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE 1 MG/ML DROPS 30 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0781-2145-01 NDC GY 8 ML inpatient 30.8 30.18 All Payors / Plans All Payors / Plans 30.8 other 30.8 30.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML SYRUP ERX-637000000 CDM A9270 CPT 637 RC 51991-620-33 NDC GY 5 ML inpatient 6.58 6.45 All Payors / Plans All Payors / Plans 6.58 other 6.58 6.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML SYRUP ERX-637000000 CDM A9270 CPT 637 RC 60687-112-11 NDC GY 10 ML inpatient 5.06 4.96 All Payors / Plans All Payors / Plans 5.06 other 5.06 5.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML SYRUP ERX-637000000 CDM A9270 CPT 637 RC 0003-0893-31 NDC GY 5 ML inpatient 4.15 4.07 All Payors / Plans All Payors / Plans 4.15 other 4.15 4.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 15 GRAM/59 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 0003-0894-31 NDC GY 59 ML inpatient 4.82 4.72 All Payors / Plans All Payors / Plans 4.82 other 4.82 4.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) SOLUTION" ERX-637000000 CDM A9270 CPT 637 RC 0781-2321-06 NDC GY 1 ML inpatient 2.66 2.61 All Payors / Plans All Payors / Plans 2.66 other 2.66 2.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICLOFENAC 0.1 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 68462-583-40 NDC GY 5 ML inpatient 30.55 29.94 All Payors / Plans All Payors / Plans 30.55 other 30.55 30.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE 10 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 60505-0404-5 NDC GY 10 ML inpatient 10.7 10.49 All Payors / Plans All Payors / Plans 10.7 other 10.7 10.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE 10 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 60687-179-01 NDC GY 5 ML inpatient 7.02 6.88 All Payors / Plans All Payors / Plans 7.02 other 7.02 7.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE 12.5 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 60687-179-11 NDC GY 2.5 ML inpatient 0.62 0.61 All Payors / Plans All Payors / Plans 0.62 other 0.62 0.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE 12.5 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 60687-191-11 NDC GY 30 ML inpatient 0.29 0.28 All Payors / Plans All Payors / Plans 0.29 other 0.29 0.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE 12.5 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 50268-087-11 NDC GY 2.95 ML inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE 12.5 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 60687-157-11 NDC GY 30 ML inpatient 0.62 0.61 All Payors / Plans All Payors / Plans 0.62 other 0.62 0.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE PER 50 MG ERX-637000000 CDM A9270 CPT 637 RC 50268-088-11 NDC GY 5 ML inpatient 5.03 4.93 All Payors / Plans All Payors / Plans 5.03 other 5.03 5.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE-LIDO-AL HYDROX-MAG HYDROX-SIMETHICONE 119 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 50268-088-15 NDC GY 119 ML inpatient 232.41 227.76 All Payors / Plans All Payors / Plans 232.41 other 232.41 232.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOCUSATE 50 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 60687-168-11 NDC GY 10 ML inpatient 5.02 4.92 All Payors / Plans All Payors / Plans 5.02 other 5.02 5.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOCUSATE 50 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 63739-070-10 NDC GY 10 ML inpatient 5.02 4.92 All Payors / Plans All Payors / Plans 5.02 other 5.02 5.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOCUSATE 50 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 0065-0408-72 NDC GY 10 ML inpatient 3.36 3.29 All Payors / Plans All Payors / Plans 3.36 other 3.36 3.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DORZOLAMIDE 2 % DROPS 10 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0998-0408-15 NDC GY 10 ML inpatient 44.81 43.91 All Payors / Plans All Payors / Plans 44.81 other 44.81 44.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DORZOLAMIDE 2 % DROPS 10 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0904052361 NDC GY 10 ML inpatient 63.24 61.98 All Payors / Plans All Payors / Plans 63.24 other 63.24 63.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML DROPS 10 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 51991-360-60 NDC GY 10 ML inpatient 36.47 35.74 All Payors / Plans All Payors / Plans 36.47 other 36.47 36.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML DROPS 10 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0574-7034-12 NDC GY 10 ML inpatient 85.91 84.19 All Payors / Plans All Payors / Plans 85.91 other 85.91 85.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ERGOCALCIFEROL 200 MCG/ML (8,000 UNIT/ML) DROPS" ERX-637000000 CDM A9270 CPT 637 RC 0113-0416-78 NDC GY 6 ML inpatient 3.66 3.59 All Payors / Plans All Payors / Plans 3.66 other 3.66 3.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FAMOTIDINE 40 MG/5 ML (8 MG/ML) SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 66553-001-01 NDC GY 2.5 ML inpatient 10.67 10.46 All Payors / Plans All Payors / Plans 10.67 other 10.67 10.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FAMOTIDINE 40 MG/5 ML (8 MG/ML) SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 57896-921-01 NDC GY 2.5 ML inpatient 10.35 10.14 All Payors / Plans All Payors / Plans 10.35 other 10.35 10.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FERRIC SUBSULFATE 0.2 TO 0.22 GRAM/ML SOLUTION WITH APPLICATOR ERX-637000000 CDM A9270 CPT 637 RC 70677-0071-1 NDC GY 1 ML inpatient 61.47 60.24 All Payors / Plans All Payors / Plans 61.47 other 61.47 61.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FERROUS SULFATE 15 MG IRON (75 MG)/ML DROPS ERX-637000000 CDM A9270 CPT 637 RC 0904-4040-73 NDC GY 0.5 ML inpatient 0.18 0.18 All Payors / Plans All Payors / Plans 0.18 other 0.18 0.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ELIXIR ERX-637000000 CDM A9270 CPT 637 RC 0904-6794-80 NDC GY 5 ML inpatient 0.21 0.21 All Payors / Plans All Payors / Plans 0.21 other 0.21 0.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUCONAZOLE 40 MG/ML SUSPENSION FOR RECONSTITUTION 35 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 63739-434-02 NDC GY 2.5 ML inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOXETINE 20 MG/5 ML (4 MG/ML) SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 66553-002-01 NDC GY 5 ML inpatient 1.47 1.44 All Payors / Plans All Payors / Plans 1.47 other 1.47 1.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE 40 MG/4 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 49483-481-10 NDC GY 0.48 ML inpatient 7.78 7.62 All Payors / Plans All Payors / Plans 7.78 other 7.78 7.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 250 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 63739-212-02 NDC GY 10 ML inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 250 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 65162-596-06 NDC GY 2 ML inpatient 0.19 0.19 All Payors / Plans All Payors / Plans 0.19 other 0.19 0.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN 0.3 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 29300-410-01 NDC GY 5 ML inpatient 30.61 30 All Payors / Plans All Payors / Plans 30.61 other 30.61 30.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUAIFENESIN 100 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 51079-759-01 NDC GY 10 ML inpatient 6.68 6.55 All Payors / Plans All Payors / Plans 6.68 other 6.68 6.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUAIFENESIN 100 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 51079-684-01 NDC GY 10 ML inpatient 10.03 9.83 All Payors / Plans All Payors / Plans 10.03 other 10.03 10.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 60687-567-11 NDC GY 5 ML inpatient 9.59 9.4 All Payors / Plans All Payors / Plans 9.59 other 9.59 9.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 100 MG/60 ML ENEMA ERX-637000000 CDM A9270 CPT 637 RC 0904-6908-04 NDC GY 60 ML inpatient 28.78 28.2 All Payors / Plans All Payors / Plans 28.78 other 28.78 28.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE 2 MG/ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 51079-208-01 NDC GY 5 ML inpatient 17.67 17.32 All Payors / Plans All Payors / Plans 17.67 other 17.67 17.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYPROMELLOSE 2.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 51079-208-20 NDC GY 15 ML inpatient 131.5 128.87 All Payors / Plans All Payors / Plans 131.5 other 131.5 131.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 100 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0904-6291-61 NDC GY 5.3 ML inpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 100 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 68084-098-01 NDC GY 4.2 ML inpatient 1.44 1.41 All Payors / Plans All Payors / Plans 1.44 other 1.44 1.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 100 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0904-6292-61 NDC GY 3.8 ML inpatient 2.59 2.54 All Payors / Plans All Payors / Plans 2.59 other 2.59 2.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 100 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 60687-534-40 NDC GY 4.2 ML inpatient 1.79 1.75 All Payors / Plans All Payors / Plans 1.79 other 1.79 1.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 100 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 63739-203-01 NDC GY 3.6 ML inpatient 2.65 2.6 All Payors / Plans All Payors / Plans 2.65 other 2.65 2.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN GLARGINE (U-100) 100 UNIT/ML (3 ML) INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 60505-6226-0 NDC GY 3 ML inpatient 104.34 102.25 All Payors / Plans All Payors / Plans 104.34 other 104.34 104.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN GLARGINE PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 0065-0817-01 NDC GY 0.03 ML inpatient 0.29 0.28 All Payors / Plans All Payors / Plans 0.29 other 0.29 0.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN GLARGINE PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 60219-1749-3 NDC GY 0.35 ML inpatient 15.98 15.66 All Payors / Plans All Payors / Plans 15.98 other 15.98 15.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO (HUMAN) PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 70710-1457-1 NDC GY 0.1 ML inpatient 0.16 0.16 All Payors / Plans All Payors / Plans 0.16 other 0.16 0.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO (HUMAN) PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 0069-3120-19 NDC GY 0.01 ML inpatient 0.14 0.14 All Payors / Plans All Payors / Plans 0.14 other 0.14 0.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO (HUMAN) PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 59762-3120-1 NDC GY 0.02 ML inpatient 0.19 0.19 All Payors / Plans All Payors / Plans 0.19 other 0.19 0.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO (U-100) 100 UNIT/ML INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 59762-3140-1 NDC GY 3 ML inpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO (U-100) 100 UNIT/ML INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 0069-4061-89 NDC GY 0.05 ML inpatient 0.47 0.46 All Payors / Plans All Payors / Plans 0.47 other 0.47 0.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO (U-100) 100 UNIT/ML INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 0904-7350-06 NDC GY 3 ML inpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO (U-100) 100 UNIT/ML INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 60687-742-11 NDC GY 3 ML inpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO PROTAMIN-LISPRO 100 UNIT/ML (75-25) INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 65862-641-69 NDC GY 3 ML inpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO PROTAMIN-LISPRO 100 UNIT/ML (75-25) INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 0472-1105-34 NDC GY 3 ML inpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN NPH ISOPH U-100 HUMAN 100 UNIT/ML (3 ML) INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 45802-060-01 NDC GY 3 ML inpatient 154.86 151.76 All Payors / Plans All Payors / Plans 154.86 other 154.86 154.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN NPH ISOPH U-100 HUMAN 100 UNIT/ML (3 ML) INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 0574-4022-35 NDC GY 3 ML inpatient 82.84 81.18 All Payors / Plans All Payors / Plans 82.84 other 82.84 82.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN REGULAR HUMAN PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 45802-060-00 NDC GY 0.02 ML inpatient 0.14 0.14 All Payors / Plans All Payors / Plans 0.14 other 0.14 0.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN REGULAR HUMAN PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 0904-8804-67 NDC GY 0.05 ML inpatient 0.19 0.19 All Payors / Plans All Payors / Plans 0.19 other 0.19 0.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN REGULAR HUMAN PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 0904-6475-61 NDC GY 0.05 ML inpatient 0.18 0.18 All Payors / Plans All Payors / Plans 0.18 other 0.18 0.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN REGULAR HUMAN PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 63739-479-10 NDC GY 4 ML inpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOCONAZOLE 2 % SHAMPOO 120 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 68084-855-11 NDC GY 120 ML inpatient 62.72 61.47 All Payors / Plans All Payors / Plans 62.72 other 62.72 62.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC 0.5 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0065-0800-50 NDC GY 5 ML inpatient 26.09 25.57 All Payors / Plans All Payors / Plans 26.09 other 26.09 26.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC 0.5 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0065-0795-15 NDC GY 5 ML inpatient 30.37 29.76 All Payors / Plans All Payors / Plans 30.37 other 30.37 30.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACTULOSE 10 GRAM/15 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0065-0795-50 NDC GY 15 ML inpatient 2.71 2.66 All Payors / Plans All Payors / Plans 2.71 other 2.71 2.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACTULOSE 10 GRAM/15 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 59310-302-40 NDC GY 300 ML inpatient 20.26 19.85 All Payors / Plans All Payors / Plans 20.26 other 20.26 20.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACTULOSE 10 GRAM/15 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0283-0679-02 NDC GY 300 ML inpatient 17.42 17.07 All Payors / Plans All Payors / Plans 17.42 other 17.42 17.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LAMIVUDINE 10 MG/ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 63824-732-16 NDC GY 0.57 ML inpatient 0.3 0.29 All Payors / Plans All Payors / Plans 0.3 other 0.3 0.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LANSOPRAZOLE ERX-637000000 CDM A9270 CPT 637 RC 0904-6255-49 NDC GY 2.5 ML inpatient 25.36 24.85 All Payors / Plans All Payors / Plans 25.36 other 25.36 25.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LATANOPROST 0.005 % DROPS 2.5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 16864-680-01 NDC GY 2.5 ML inpatient 25.54 25.03 All Payors / Plans All Payors / Plans 25.54 other 25.54 25.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LATANOPROST 0.005 % DROPS 2.5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 16864-680-03 NDC GY 2.5 ML inpatient 40.17 39.37 All Payors / Plans All Payors / Plans 40.17 other 40.17 40.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETIRACETAM 500 MG/5 ML (5 ML) SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0904-7153-61 NDC GY 5 ML inpatient 8.93 8.75 All Payors / Plans All Payors / Plans 8.93 other 8.93 8.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETIRACETAM 500 MG/5 ML (5 ML) SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 68084-214-11 NDC GY 5 ML inpatient 9.6 9.41 All Payors / Plans All Payors / Plans 9.6 other 9.6 9.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 2 % JELLY IN APPLICATOR ERX-637000000 CDM A9270 CPT 637 RC 68084-388-01 NDC GY 5 ML inpatient 15.22 14.92 All Payors / Plans All Payors / Plans 15.22 other 15.22 15.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 2 % JELLY IN APPLICATOR ERX-637000000 CDM A9270 CPT 637 RC 68084-388-11 NDC GY 5 ML inpatient 14.87 14.57 All Payors / Plans All Payors / Plans 14.87 other 14.87 14.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 2 % JELLY IN APPLICATOR ERX-637000000 CDM A9270 CPT 637 RC 69315-137-01 NDC GY 5 ML inpatient 17.07 16.73 All Payors / Plans All Payors / Plans 17.07 other 17.07 17.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 2 % SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 68084-389-11 NDC GY 10 ML inpatient 20.68 20.27 All Payors / Plans All Payors / Plans 20.68 other 20.68 20.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 2 % SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0713-0659-37 NDC GY 5 ML inpatient 25.8 25.28 All Payors / Plans All Payors / Plans 25.8 other 25.8 25.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 2 % SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 61958-2501-1 NDC GY 5 ML inpatient 25.8 25.28 All Payors / Plans All Payors / Plans 25.8 other 25.8 25.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 2 % SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0574-7050-12 NDC GY 10 ML inpatient 50.6 49.59 All Payors / Plans All Payors / Plans 50.6 other 50.6 50.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 2 % SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0904-6407-61 NDC GY 10 ML inpatient 6.04 5.92 All Payors / Plans All Payors / Plans 6.04 other 6.04 6.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 4 % (40 MG/ML) SOLUTION 50 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0149003904 NDC GY 50 ML inpatient 105.31 103.2 All Payors / Plans All Payors / Plans 105.31 other 105.31 105.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 4 % (40 MG/ML) SOLUTION 50 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 29300-126-01 NDC GY 50 ML inpatient 133.07 130.41 All Payors / Plans All Payors / Plans 133.07 other 133.07 133.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE-EPI-TETRACAINE 4-0.18-0.5 % SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 50268-127-11 NDC GY 3 ML inpatient 10.18 9.98 All Payors / Plans All Payors / Plans 10.18 other 10.18 10.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOPERAMIDE 1 MG/7.5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 68803-722-25 NDC GY 15 ML inpatient 0.51 0.5 All Payors / Plans All Payors / Plans 0.51 other 0.51 0.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGIC MOUTHWASH #3 90 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 60505-0564-1 NDC GY 90 ML inpatient 10.75 10.54 All Payors / Plans All Payors / Plans 10.75 other 10.75 10.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM CITRATE SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0781-6014-70 NDC GY 296 ML inpatient 5.03 4.93 All Payors / Plans All Payors / Plans 5.03 other 5.03 5.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM CITRATE SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0574-0106-03 NDC GY 148 ML inpatient 6.97 6.83 All Payors / Plans All Payors / Plans 6.97 other 6.97 6.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM CITRATE SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0574-9855-10 NDC GY 296 ML inpatient 6.97 6.83 All Payors / Plans All Payors / Plans 6.97 other 6.97 6.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM HYDROXIDE 400 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 50268-131-11 NDC GY 30 ML inpatient 3.42 3.35 All Payors / Plans All Payors / Plans 3.42 other 3.42 3.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM HYDROXIDE 400 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 50268-132-11 NDC GY 30 ML inpatient 3.35 3.28 All Payors / Plans All Payors / Plans 3.35 other 3.35 3.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM HYDROXIDE 400 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 42858-501-03 NDC GY 30 ML inpatient 3.35 3.28 All Payors / Plans All Payors / Plans 3.35 other 3.35 3.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM HYDROXIDE 400 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 50268-145-11 NDC GY 30 ML inpatient 5.09 4.99 All Payors / Plans All Payors / Plans 5.09 other 5.09 5.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHADONE 10 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 50268-145-15 NDC GY 10 ML inpatient 10.17 9.97 All Payors / Plans All Payors / Plans 10.17 other 10.17 10.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHADONE 10 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 60687-351-11 NDC GY 10 ML inpatient 18.66 18.29 All Payors / Plans All Payors / Plans 18.66 other 18.66 18.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE 5 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0904-6635-61 NDC GY 5 ML inpatient 9.62 9.43 All Payors / Plans All Payors / Plans 9.62 other 9.62 9.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM 10 MG/5 ML (2 MG/ML) SYRUP ERX-637000000 CDM A9270 CPT 637 RC 68084-697-11 NDC GY 2.91 ML inpatient 11.51 11.28 All Payors / Plans All Payors / Plans 11.51 other 11.51 11.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM 10 MG/5 ML (2 MG/ML) SYRUP ERX-637000000 CDM A9270 CPT 637 RC 42806-425-01 NDC GY 3 ML inpatient 11.51 11.28 All Payors / Plans All Payors / Plans 11.51 other 11.51 11.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 10 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 68084-708-95 NDC GY 2.5 ML inpatient 3.45 3.38 All Payors / Plans All Payors / Plans 3.45 other 3.45 3.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MOXIFLOXACIN 0.5 % DROPS 3 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0904-7084-04 NDC GY 3 ML inpatient 45.61 44.7 All Payors / Plans All Payors / Plans 45.61 other 45.61 45.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MOXIFLOXACIN 0.5 % DROPS 3 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 16729-443-10 NDC GY 3 ML inpatient 64.63 63.34 All Payors / Plans All Payors / Plans 64.63 other 64.63 64.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MYLANTA, LIDOCAINE VISCOUS, DICYCLOMINE" ERX-637000000 CDM A9270 CPT 637 RC 16729-202-16 NDC GY 50 ML inpatient 18.62 18.25 All Payors / Plans All Payors / Plans 18.62 other 18.62 18.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAPHAZOLINE-PHENIRAMINE 0.025-0.3 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 51079-986-01 NDC GY 15 ML inpatient 39.73 38.94 All Payors / Plans All Payors / Plans 39.73 other 39.73 39.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NEOMYCIN-POLYMYXIN-DEXAMETHASONE 3.5MG/ML-10,000 UNIT/ML-0.1 % DROPS,SUSPENSION 5 ML DROP BTL" ERX-637000000 CDM A9270 CPT 637 RC 51079-985-01 NDC GY 5 ML inpatient 63.26 61.99 All Payors / Plans All Payors / Plans 63.26 other 63.26 63.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% DROPS,SUSPENSION 10 ML DROP BTL" ERX-637000000 CDM A9270 CPT 637 RC 0904-6938-06 NDC GY 10 ML inpatient 156.15 153.03 All Payors / Plans All Payors / Plans 156.15 other 156.15 156.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NEOMYCIN-POLYMYXIN-HC 3.5-10,000-10 MG-UNIT-MG/ML DROPS,SUSPENSION 7.5 ML DROP BTL" ERX-637000000 CDM A9270 CPT 637 RC 50268-553-11 NDC GY 7.5 ML inpatient 332.48 325.83 All Payors / Plans All Payors / Plans 332.48 other 332.48 332.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEVIRAPINE 50 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 50268-553-13 NDC GY 1.7 ML inpatient 10.17 9.97 All Payors / Plans All Payors / Plans 10.17 other 10.17 10.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIMODIPINE 60 MG/10 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 69367-203-01 NDC GY 10 ML inpatient 102.86 100.8 All Payors / Plans All Payors / Plans 102.86 other 102.86 102.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/ML SUSPENSION" ERX-637000000 CDM A9270 CPT 637 RC 4601701816 NDC GY 5 ML inpatient 4.11 4.03 All Payors / Plans All Payors / Plans 4.11 other 4.11 4.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/ML SUSPENSION" ERX-637000000 CDM A9270 CPT 637 RC 51754-0501-3 NDC GY 30 ML inpatient 31.03 30.41 All Payors / Plans All Payors / Plans 31.03 other 31.03 31.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/ML SUSPENSION" ERX-637000000 CDM A9270 CPT 637 RC 0904-2533-21 NDC GY 5 ML inpatient 2.68 2.63 All Payors / Plans All Payors / Plans 2.68 other 2.68 2.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/ML SUSPENSION" ERX-637000000 CDM A9270 CPT 637 RC 60505-0823-6 NDC GY 5 ML inpatient 10.78 10.56 All Payors / Plans All Payors / Plans 10.78 other 10.78 10.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OFLOXACIN 0.3 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 60687-345-11 NDC GY 5 ML inpatient 84.9 83.2 All Payors / Plans All Payors / Plans 84.9 other 84.9 84.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 8 MG ERX-637000000 CDM A9270 CPT 637 RC 64380-723-06 NDC GY 1.05 ML inpatient 10.9 10.68 All Payors / Plans All Payors / Plans 10.9 other 10.9 10.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 8 MG ERX-637000000 CDM A9270 CPT 637 RC 0054-0088-26 NDC GY 5 ML inpatient 10.17 9.97 All Payors / Plans All Payors / Plans 10.17 other 10.17 10.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 8 MG ERX-637000000 CDM A9270 CPT 637 RC 68084-479-11 NDC GY 5 ML inpatient 15.65 15.34 All Payors / Plans All Payors / Plans 15.65 other 15.65 15.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OSELTAMIVIR 6 MG/ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 66553-004-01 NDC GY 10 ML inpatient 6.07 5.95 All Payors / Plans All Payors / Plans 6.07 other 6.07 6.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXCARBAZEPINE ERX-637000000 CDM A9270 CPT 637 RC 70677-0137-1 NDC GY 10 ML inpatient 20.29 19.88 All Payors / Plans All Payors / Plans 20.29 other 20.29 20.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE 5 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0904188361 NDC GY 5 ML inpatient 14.23 13.95 All Payors / Plans All Payors / Plans 14.23 other 14.23 14.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OXYMETAZOLINE 0.05 % SPRAY,NON-AEROSOL 30 ML SQUEEZ BTL" ERX-637000000 CDM A9270 CPT 637 RC 0121-4766-05 NDC GY 30 ML inpatient 15.42 15.11 All Payors / Plans All Payors / Plans 15.42 other 15.42 15.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OXYMETAZOLINE 0.05 % SPRAY,NON-AEROSOL 30 ML SQUEEZ BTL" ERX-637000000 CDM A9270 CPT 637 RC 0904-7106-61 NDC GY 30 ML inpatient 15.43 15.12 All Payors / Plans All Payors / Plans 15.43 other 15.43 15.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OXYMETAZOLINE 0.05 % SPRAY,NON-AEROSOL 30 ML SQUEEZ BTL" ERX-637000000 CDM A9270 CPT 637 RC 0904-6172-61 NDC GY 30 ML inpatient 10.19 9.99 All Payors / Plans All Payors / Plans 10.19 other 10.19 10.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OXYMETAZOLINE 0.05 % SPRAY,NON-AEROSOL 30 ML SQUEEZ BTL" ERX-637000000 CDM A9270 CPT 637 RC 51672-4123-1 NDC GY 30 ML inpatient 10.83 10.61 All Payors / Plans All Payors / Plans 10.83 other 10.83 10.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEDIATRIC MULTIVIT NO.189-IRON 11 MG IRON/ML DROPS ERX-637000000 CDM A9270 CPT 637 RC 0832-6024-11 NDC GY 1 ML inpatient 0.27 0.26 All Payors / Plans All Payors / Plans 0.27 other 0.27 0.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEDIATRIC MULTIVITAMIN LIQUID ERX-637000000 CDM A9270 CPT 637 RC 60687-594-11 NDC GY 15 ML inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PENICILLIN V POTASSIUM 250 MG/5 ML RECON SOLN ERX-637000000 CDM A9270 CPT 637 RC 0904-6627-35 NDC GY 5 ML inpatient 0.47 0.46 All Payors / Plans All Payors / Plans 0.47 other 0.47 0.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PERMETHRIN 1 % LIQUID 59 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 70677-1154-1 NDC GY 59 ML inpatient 16.12 15.8 All Payors / Plans All Payors / Plans 16.12 other 16.12 16.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PHENOL 1.4 % AEROSOL,SPRAY 177 ML BOTTLE" ERX-637000000 CDM A9270 CPT 637 RC 0093-9701-01 NDC GY 177 ML inpatient 21.15 20.73 All Payors / Plans All Payors / Plans 21.15 other 21.15 21.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPHRINE 2.5 % DROPS 2 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0378-0085-01 NDC GY 2 ML inpatient 139.43 136.64 All Payors / Plans All Payors / Plans 139.43 other 139.43 139.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POLYETHYLENE GLYCOL 236-22.74-6.74 -5.86 GRAM RECON SOLN ERX-637000000 CDM A9270 CPT 637 RC 0904-7257-61 NDC GY 2000 ML inpatient 62.08 60.84 All Payors / Plans All Payors / Plans 62.08 other 62.08 62.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE 20 MEQ/15 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 0904-7501-61 NDC GY 15 ML inpatient 5.87 5.75 All Payors / Plans All Payors / Plans 5.87 other 5.87 5.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM IODIDE 1 GRAM/ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 60687-661-11 NDC GY 0.1 ML inpatient 2 1.96 All Payors / Plans All Payors / Plans 2 other 2 2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAMOXINE-CAMPHOR-ZINC ACETATE LOTION 177 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 16729-078-01 NDC GY 177 ML inpatient 15.35 15.04 All Payors / Plans All Payors / Plans 15.35 other 15.35 15.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISOLONE 15 MG/5 ML (5 ML) SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 51079-978-01 NDC GY 4.3 ML inpatient 7.78 7.62 All Payors / Plans All Payors / Plans 7.78 other 7.78 7.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PREDNISOLONE ACETATE 1 % DROPS,SUSPENSION 5 ML DROP BTL" ERX-637000000 CDM A9270 CPT 637 RC 0904-6238-61 NDC GY 5 ML inpatient 105.07 102.97 All Payors / Plans All Payors / Plans 105.07 other 105.07 105.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROMETHAZINE-DM 6.25-15 MG/5 ML SYRUP ERX-637000000 CDM A9270 CPT 637 RC 60687-836-11 NDC GY 5 ML inpatient 4.65 4.56 All Payors / Plans All Payors / Plans 4.65 other 4.65 4.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPARACAINE 0.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0023-0798-15 NDC GY 15 ML inpatient 146.46 143.53 All Payors / Plans All Payors / Plans 146.46 other 146.46 146.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPARACAINE 0.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0904-6302-61 NDC GY 15 ML inpatient 105.97 103.85 All Payors / Plans All Payors / Plans 105.97 other 105.97 105.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SALIVA STIMULANT COMB. NO.3 SPRAY,NON-AEROSOL 44.3 ML BOTTLE" ERX-637000000 CDM A9270 CPT 637 RC 68382-094-01 NDC GY 44.3 ML inpatient 25.34 24.83 All Payors / Plans All Payors / Plans 25.34 other 25.34 25.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SENNOSIDES 8.8 MG/5 ML SYRUP ERX-637000000 CDM A9270 CPT 637 RC 0093-7296-01 NDC GY 2.5 ML inpatient 5.84 5.72 All Payors / Plans All Payors / Plans 5.84 other 5.84 5.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIMPLE SYRUP SYRUP ERX-637000000 CDM A9270 CPT 637 RC 0904-6303-61 NDC GY 0.415 ML inpatient 0.12 0.12 All Payors / Plans All Payors / Plans 0.12 other 0.12 0.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0904-7308-61 NDC GY 15 ML inpatient 11.23 11.01 All Payors / Plans All Payors / Plans 11.23 other 11.23 11.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM HYPOCHLORITE 0.125 % SOLUTION 473 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0904-6300-61 NDC GY 473 ML inpatient 60.75 59.54 All Payors / Plans All Payors / Plans 60.75 other 60.75 60.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM HYPOCHLORITE 0.25 % SOLUTION 473 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0904-7305-61 NDC GY 473 ML inpatient 62.78 61.52 All Payors / Plans All Payors / Plans 62.78 other 62.78 62.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM HYPOCHLORITE 0.25 % SOLUTION 473 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 68382-092-01 NDC GY 473 ML inpatient 60.75 59.54 All Payors / Plans All Payors / Plans 60.75 other 60.75 60.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM PHOSPHATES 19-7 GRAM/118 ML ENEMA ERX-637000000 CDM A9270 CPT 637 RC 0904-6301-61 NDC GY 133 ML inpatient 10.25 10.05 All Payors / Plans All Payors / Plans 10.25 other 10.25 10.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM PHOSPHATES 9.5-3.5 GRAM/59 ML ENEMA ERX-637000000 CDM A9270 CPT 637 RC 68084-854-01 NDC GY 33 ML inpatient 10.29 10.08 All Payors / Plans All Payors / Plans 10.29 other 10.29 10.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM PHOSPHATES 9.5-3.5 GRAM/59 ML ENEMA ERX-637000000 CDM A9270 CPT 637 RC 68084-854-11 NDC GY 66 ML inpatient 10.24 10.04 All Payors / Plans All Payors / Plans 10.24 other 10.24 10.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCRALFATE 100 MG/ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 68462-163-01 NDC GY 10 ML inpatient 14 13.72 All Payors / Plans All Payors / Plans 14 other 14 14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCRALFATE 100 MG/ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 72888-035-01 NDC GY 10 ML inpatient 14.49 14.2 All Payors / Plans All Payors / Plans 14.49 other 14.49 14.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCRALFATE 100 MG/ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 65862-218-60 NDC GY 10 ML inpatient 14.75 14.46 All Payors / Plans All Payors / Plans 14.75 other 14.75 14.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCRALFATE 100 MG/ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 68180-723-04 NDC GY 10 ML inpatient 14.18 13.9 All Payors / Plans All Payors / Plans 14.18 other 14.18 14.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCRALFATE 100 MG/ML SUSPENSION 10 ML CUP ERX-637000000 CDM A9270 CPT 637 RC 0093-3160-06 NDC GY 20 ML inpatient 22.76 22.3 All Payors / Plans All Payors / Plans 22.76 other 22.76 22.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFACETAMIDE 1 (ONE) 15 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 60687-699-11 NDC GY 15 ML inpatient 137.45 134.7 All Payors / Plans All Payors / Plans 137.45 other 137.45 137.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFACETAMIDE 10 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 67877-543-60 NDC GY 15 ML inpatient 150.98 147.96 All Payors / Plans All Payors / Plans 150.98 other 150.98 150.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 60687-272-11 NDC GY 20 ML inpatient 22.49 22.04 All Payors / Plans All Payors / Plans 22.49 other 22.49 22.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 60687-272-94 NDC GY 20 ML inpatient 10.95 10.73 All Payors / Plans All Payors / Plans 10.95 other 10.95 10.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TETRACAINE HCL (PF) 0.5 % DROPS 4 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 16714-401-02 NDC GY 4 ML inpatient 38.58 37.81 All Payors / Plans All Payors / Plans 38.58 other 38.58 38.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TETRAHYDROZOLINE 0.05 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0904-6502-61 NDC GY 15 ML inpatient 6.04 5.92 All Payors / Plans All Payors / Plans 6.04 other 6.04 6.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIMOLOL 0.5 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0904-6503-61 NDC GY 5 ML inpatient 35.87 35.15 All Payors / Plans All Payors / Plans 35.87 other 35.87 35.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOBRAMYCIN 0.3 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 50268-169-15 NDC GY 5 ML inpatient 21.13 20.71 All Payors / Plans All Payors / Plans 21.13 other 21.13 21.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % DROPS,SUSPENSION 10 ML DROP BTL" ERX-637000000 CDM A9270 CPT 637 RC 0093-4175-73 NDC GY 10 ML inpatient 410.91 402.69 All Payors / Plans All Payors / Plans 410.91 other 410.91 410.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROPICAMIDE 0.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 60687-152-01 NDC GY 15 ML inpatient 85.91 84.19 All Payors / Plans All Payors / Plans 85.91 other 85.91 85.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROPICAMIDE 1 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 60687-152-11 NDC GY 15 ML inpatient 35.77 35.05 All Payors / Plans All Payors / Plans 35.77 other 35.77 35.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROPICAMIDE 1 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 50268-152-11 NDC GY 15 ML inpatient 31.62 30.99 All Payors / Plans All Payors / Plans 31.62 other 31.62 31.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALPROATE 250 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 60687-163-11 NDC GY 7.6 ML inpatient 0.35 0.34 All Payors / Plans All Payors / Plans 0.35 other 0.35 0.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALPROIC ACID 250 MG/5 ML (5 ML) SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 68180-122-01 NDC GY 5 ML inpatient 4.15 4.07 All Payors / Plans All Payors / Plans 4.15 other 4.15 4.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 25 MG/ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 0904-6717-60 NDC GY 5 ML inpatient 2.14 2.1 All Payors / Plans All Payors / Plans 2.14 other 2.14 2.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 50 MG/ML RECON SOLN ERX-637000000 CDM A9270 CPT 637 RC 0904-6717-61 NDC GY 2.5 ML inpatient 15.46 15.15 All Payors / Plans All Payors / Plans 15.46 other 15.46 15.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZIDOVUDINE PER 100 MG ERX-637000000 CDM A9270 CPT 637 RC 51079-597-01 NDC GY 1.15 ML inpatient 0.21 0.21 All Payors / Plans All Payors / Plans 0.21 other 0.21 0.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 120 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 68180-981-01 NDC GY 0.1458 UN inpatient 0.28 0.27 All Payors / Plans All Payors / Plans 0.28 other 0.28 0.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 120 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 0904-6797-61 NDC GY 1 UN inpatient 1.87 1.83 All Payors / Plans All Payors / Plans 1.87 other 1.87 1.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 325 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 0054-8526-25 NDC GY 0.5 UN inpatient 1.32 1.29 All Payors / Plans All Payors / Plans 1.32 other 1.32 1.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 325 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 0054-2527-25 NDC GY 1 UN inpatient 2.64 2.59 All Payors / Plans All Payors / Plans 2.64 other 2.64 2.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0054-8527-25 NDC GY 1 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 650 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 68084-655-11 NDC GY 0.5 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN-CODEINE 300-30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 1093991144 NDC GY 1 UN inpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAZOLAMIDE 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-690-01 NDC GY 1 UN inpatient 8.74 8.57 All Payors / Plans All Payors / Plans 8.74 other 8.74 8.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ACETAZOLAMIDE 500 MG CAPSULE, EXTENDED RELEASE" ERX-637000000 CDM A9270 CPT 637 RC 0904-6007-61 NDC GY 1 UN inpatient 4.36 4.27 All Payors / Plans All Payors / Plans 4.36 other 4.36 4.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ACETAZOLAMIDE 500 MG CAPSULE, EXTENDED RELEASE" ERX-637000000 CDM A9270 CPT 637 RC 69315-904-05 NDC GY 1 UN inpatient 11.16 10.94 All Payors / Plans All Payors / Plans 11.16 other 11.16 11.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETYLCYSTEINE 600 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904-6008-61 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACYCLOVIR 200 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 13107-084-05 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACYCLOVIR 200 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0093-3427-01 NDC GY 2 UN inpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACYCLOVIR 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 13107-085-01 NDC GY 0.5 UN inpatient 2.72 2.67 All Payors / Plans All Payors / Plans 2.72 other 2.72 2.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBENDAZOLE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-649-11 NDC GY 2 UN inpatient 77.74 76.19 All Payors / Plans All Payors / Plans 77.74 other 77.74 77.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOPURINOL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-346-11 NDC GY 1 UN inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOPURINOL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-505-11 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOPURINOL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-686-10 NDC GY 1 UN inpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOPURINOL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-468-30 NDC GY 1 UN inpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOPURINOL 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68180-468-01 NDC GY 1 UN inpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOPURINOL 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0591-0369-01 NDC GY 1 UN inpatient 1.87 1.83 All Payors / Plans All Payors / Plans 1.87 other 1.87 1.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALPRAZOLAM 0.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-747-11 NDC GY 1 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALPRAZOLAM 0.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63402-302-30 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALPRAZOLAM 0.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7356-61 NDC GY 0.5 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALPRAZOLAM 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63402-304-30 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALPRAZOLAM 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72205-208-30 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALVIMOPAN 12 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0603-1393-64 NDC GY 1 UN inpatient 124.34 121.85 All Payors / Plans All Payors / Plans 124.34 other 124.34 124.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALVIMOPAN 12 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 6858500575 NDC GY 1 UN inpatient 121.38 118.95 All Payors / Plans All Payors / Plans 121.38 other 121.38 121.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMANTADINE 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 69452-390-98 NDC GY 1 UN inpatient 4.11 4.03 All Payors / Plans All Payors / Plans 4.11 other 4.11 4.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMILORIDE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70677-1111-1 NDC GY 1 UN inpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMIODARONE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70677-1112-1 NDC GY 2 UN inpatient 3.88 3.8 All Payors / Plans All Payors / Plans 3.88 other 3.88 3.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMIODARONE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0121-0431-30 NDC GY 1 UN inpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMIODARONE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-196-01 NDC GY 1 UN inpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMIODARONE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-196-10 NDC GY 2 UN inpatient 2.08 2.04 All Payors / Plans All Payors / Plans 2.08 other 2.08 2.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMITRIPTYLINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 66689-053-01 NDC GY 1 UN inpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMITRIPTYLINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 1000670028 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMITRIPTYLINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6516-61 NDC GY 1 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMITRIPTYLINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-775-01 NDC GY 0.5 UN inpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMLODIPINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-775-11 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMLODIPINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0049-2110-66 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMLODIPINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7376-61 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMLODIPINE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-730-11 NDC GY 1 UN inpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMLODIPINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0555-0779-02 NDC GY 1 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMLODIPINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59762-0056-1 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 250 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 60687-105-11 NDC GY 2 UN inpatient 1.83 1.79 All Payors / Plans All Payors / Plans 1.83 other 1.83 1.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 500 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0555-0872-02 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 250-125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7236-61 NDC GY 2 UN inpatient 10.09 9.89 All Payors / Plans All Payors / Plans 10.09 other 10.09 10.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 500-125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0832-1112-60 NDC GY 1 UN inpatient 4.98 4.88 All Payors / Plans All Payors / Plans 4.98 other 4.98 4.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 500-125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6505-61 NDC GY 1 UN inpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 500-125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 4687600050 NDC GY 1 UN inpatient 1.98 1.94 All Payors / Plans All Payors / Plans 1.98 other 1.98 1.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 875-125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69918-560-30 NDC GY 1 UN inpatient 1.94 1.9 All Payors / Plans All Payors / Plans 1.94 other 1.94 1.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 875-125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0023-5853-18 NDC GY 1 UN inpatient 2.02 1.98 All Payors / Plans All Payors / Plans 2.02 other 2.02 2.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 875-125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68382-435-28 NDC GY 1 UN inpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMPHETAMINE-DEXTROAMPHETAMINE XR 10 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 0904-7162-61 NDC GY 1 UN inpatient 15.49 15.18 All Payors / Plans All Payors / Plans 15.49 other 15.49 15.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMPHETAMINE-DEXTROAMPHETAMINE XR 5 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 65862-008-01 NDC GY 1 UN inpatient 15.49 15.18 All Payors / Plans All Payors / Plans 15.49 other 15.49 15.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN 500 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 70010-063-01 NDC GY 1 UN inpatient 1.96 1.92 All Payors / Plans All Payors / Plans 1.96 other 1.96 1.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANASTROZOLE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-143-11 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANASTROZOLE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0054-0710-20 NDC GY 1 UN inpatient 2.76 2.7 All Payors / Plans All Payors / Plans 2.76 other 2.76 2.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APIXABAN 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-5771-23 NDC GY 1 UN inpatient 4.96 4.86 All Payors / Plans All Payors / Plans 4.96 other 4.96 4.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APIXABAN 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6530-61 NDC GY 1 UN inpatient 4.96 4.86 All Payors / Plans All Payors / Plans 4.96 other 4.96 4.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APREPITANT PER 5 MG ERX-637000000 CDM A9270 CPT 637 RC 0054-3556-63 NDC GY 1 UN inpatient 33.45 32.78 All Payors / Plans All Payors / Plans 33.45 other 33.45 33.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APREPITANT PER 5 MG ERX-637000000 CDM A9270 CPT 637 RC 66689-712-16 NDC GY 1 UN inpatient 68.99 67.61 All Payors / Plans All Payors / Plans 68.99 other 68.99 68.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-5755-23 NDC GY 1 UN inpatient 13.93 13.65 All Payors / Plans All Payors / Plans 13.93 other 13.93 13.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0574-0791-01 NDC GY 1 UN inpatient 13.93 13.65 All Payors / Plans All Payors / Plans 13.93 other 13.93 13.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62559-241-01 NDC GY 1 UN inpatient 14.99 14.69 All Payors / Plans All Payors / Plans 14.99 other 14.99 14.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 23155-071-01 NDC GY 1 UN inpatient 8.89 8.71 All Payors / Plans All Payors / Plans 8.89 other 8.89 8.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-680-11 NDC GY 1 UN inpatient 11.07 10.85 All Payors / Plans All Payors / Plans 11.07 other 11.07 11.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 23155-070-01 NDC GY 1 UN inpatient 2.54 2.49 All Payors / Plans All Payors / Plans 2.54 other 2.54 2.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 4116700879 NDC GY 1 UN inpatient 2.54 2.49 All Payors / Plans All Payors / Plans 2.54 other 2.54 2.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0054-0639-05 NDC GY 1 UN inpatient 10.15 9.95 All Payors / Plans All Payors / Plans 10.15 other 10.15 10.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-823-11 NDC GY 1 UN inpatient 10.39 10.18 All Payors / Plans All Payors / Plans 10.39 other 10.39 10.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ASCORBIC ACID (VITAMIN C) 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62175-310-37 NDC GY 0.5 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASENAPINE MALEATE 10 MG TABLET, SUBLINGUAL" ERX-637000000 CDM A9270 CPT 637 RC 0406-0127-01 NDC GY 1 UN inpatient 9.06 8.88 All Payors / Plans All Payors / Plans 9.06 other 9.06 9.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ASPIRIN 300 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 68084-805-11 NDC GY 1 UN inpatient 4.07 3.99 All Payors / Plans All Payors / Plans 4.07 other 4.07 4.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ASPIRIN 325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-888-01 NDC GY 1 UN inpatient 0.88 0.86 All Payors / Plans All Payors / Plans 0.88 other 0.88 0.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ASPIRIN 325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-886-01 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN 325 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 0121-1576-10 NDC GY 1 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN 325 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 0185-5600-01 NDC GY 1 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN 81 MG TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 69292-566-01 NDC GY 4 UN inpatient 4.14 4.06 All Payors / Plans All Payors / Plans 4.14 other 4.14 4.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN 81 MG TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 51079-023-01 NDC GY 4 UN inpatient 3.51 3.44 All Payors / Plans All Payors / Plans 3.51 other 3.51 3.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN 81 MG TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 51079-024-01 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN 81 MG TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 51079-801-20 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN 81 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 51079-171-03 NDC GY 1 UN inpatient 0.88 0.86 All Payors / Plans All Payors / Plans 0.88 other 0.88 0.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN 81 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 60687-413-11 NDC GY 1 UN inpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN-DIPYRIDAMOLE 25-200 MG CAPSULE, ER MULTIPHASE 12 HR" ERX-637000000 CDM A9270 CPT 637 RC 55111-469-01 NDC GY 1 UN inpatient 3.54 3.47 All Payors / Plans All Payors / Plans 3.54 other 3.54 3.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATENOLOL 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6322-06 NDC GY 0.5 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATENOLOL 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6322-61 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATENOLOL 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-169-01 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATOMOXETINE 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 51079-169-20 NDC GY 1 UN inpatient 7.05 6.91 All Payors / Plans All Payors / Plans 7.05 other 7.05 7.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATOMOXETINE 40 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 60687-390-11 NDC GY 1 UN inpatient 9.55 9.36 All Payors / Plans All Payors / Plans 9.55 other 9.55 9.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATORVASTATIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6323-61 NDC GY 1 UN inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATORVASTATIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-541-11 NDC GY 1 UN inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATORVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-402-11 NDC GY 1 UN inpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATORVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62584-267-11 NDC GY 1 UN inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATORVASTATIN 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72888-006-01 NDC GY 1 UN inpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0378-0018-01 NDC GY 1 UN inpatient 9.82 9.62 All Payors / Plans All Payors / Plans 9.82 other 9.82 9.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-255-01 NDC GY 1 UN inpatient 2.57 2.52 All Payors / Plans All Payors / Plans 2.57 other 2.57 2.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-255-20 NDC GY 1 UN inpatient 2.66 2.61 All Payors / Plans All Payors / Plans 2.66 other 2.66 2.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 57237-100-99 NDC GY 1 UN inpatient 2.76 2.7 All Payors / Plans All Payors / Plans 2.76 other 2.76 2.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BACITRACIN 500 UNIT/GRAM PACKET ERX-637000000 CDM A9270 CPT 637 RC 62584-266-01 NDC GY 1 UN inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BACITRACIN ZINC 500 UNIT/GRAM OINTMENT IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 62584-266-11 NDC GY 1 UN inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BACLOFEN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7156-61 NDC GY 1 UN inpatient 1.89 1.85 All Payors / Plans All Payors / Plans 1.89 other 1.89 1.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BACLOFEN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50111-334-01 NDC GY 1 UN inpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BACLOFEN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-550-11 NDC GY 1 UN inpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZOCAINE-MENTHOL 15-2.6 MG LOZENGE ERX-637000000 CDM A9270 CPT 637 RC 0093-8739-01 NDC GY 1 UN inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZOCAINE-MENTHOL 15-3.6 MG LOZENGE ERX-637000000 CDM A9270 CPT 637 RC 62559-820-01 NDC GY 1 UN inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZONATATE 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50742-240-01 NDC GY 1 UN inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZONATATE 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 65197-103-05 NDC GY 1 UN inpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZTROPINE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51672-2035-6 NDC GY 1 UN inpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZTROPINE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68094-764-59 NDC GY 1 UN inpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZTROPINE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68094-764-62 NDC GY 0.5 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZTROPINE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6817-61 NDC GY 0.5 UN inpatient 1.98 1.94 All Payors / Plans All Payors / Plans 1.98 other 1.98 1.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BICTEGRAVIR-EMTRICITABINE-TENOFOVIR ALAFENAMIDE 50-200-25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0245-0212-89 NDC GY 1 UN inpatient 132.15 129.51 All Payors / Plans All Payors / Plans 132.15 other 132.15 132.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BISACODYL 10 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 0904-6818-61 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BISACODYL 5 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 49884-257-01 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BISOPROLOL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-204-11 NDC GY 0.5 UN inpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BISOPROLOL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6519-61 NDC GY 1 UN inpatient 4.19 4.11 All Payors / Plans All Payors / Plans 4.19 other 4.19 4.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BROMOCRIPTINE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-086-01 NDC GY 1 UN inpatient 3.33 3.26 All Payors / Plans All Payors / Plans 3.33 other 3.33 3.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUDESONIDE EC 3 MG CAPSULE,DELAYED,EXTEND.RELEASE" ERX-637000000 CDM A9270 CPT 637 RC 51079-087-01 NDC GY 1 UN inpatient 2.55 2.5 All Payors / Plans All Payors / Plans 2.55 other 2.55 2.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUMETANIDE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-735-01 NDC GY 1 UN inpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUMETANIDE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59762-5008-2 NDC GY 1 UN inpatient 5.04 4.94 All Payors / Plans All Payors / Plans 5.04 other 5.04 5.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPRENORPHINE 2 MG TABLET, SUBLINGUAL" ERX-637000000 CDM A9270 CPT 637 RC 60687-746-01 NDC GY 2 UN inpatient 3.72 3.65 All Payors / Plans All Payors / Plans 3.72 other 3.72 3.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPRENORPHINE-NALOXONE 8-2 MG TABLET, SUBLINGUAL" ERX-637000000 CDM A9270 CPT 637 RC 60687-746-11 NDC GY 1 UN inpatient 9.97 9.77 All Payors / Plans All Payors / Plans 9.97 other 9.97 9.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPRENORPHINE-NALOXONE 8-2 MG TABLET, SUBLINGUAL" ERX-637000000 CDM A9270 CPT 637 RC 70954-444-10 NDC GY 1 UN inpatient 9.98 9.78 All Payors / Plans All Payors / Plans 9.98 other 9.98 9.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPROPION 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 43386-160-12 NDC GY 1 UN inpatient 5.02 4.92 All Payors / Plans All Payors / Plans 5.02 other 5.02 5.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPROPION 75 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-621-11 NDC GY 1 UN inpatient 3.32 3.25 All Payors / Plans All Payors / Plans 3.32 other 3.32 3.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPROPION SR 100 MG TABLET SUSTAINED-RELEASE 12 HR ERX-637000000 CDM A9270 CPT 637 RC 0904-6808-06 NDC GY 1 UN inpatient 2.64 2.59 All Payors / Plans All Payors / Plans 2.64 other 2.64 2.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPROPION SR 150 MG TABLET SUSTAINED-RELEASE 12 HR ERX-637000000 CDM A9270 CPT 637 RC 0904-6808-61 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPROPION SR 150 MG TABLET SUSTAINED-RELEASE 12 HR ERX-637000000 CDM A9270 CPT 637 RC 29300-220-19 NDC GY 1 UN inpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPROPION XL 150 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 50268-574-11 NDC GY 1 UN inpatient 3.49 3.42 All Payors / Plans All Payors / Plans 3.49 other 3.49 3.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPROPION XL 150 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 68094-045-01 NDC GY 2 UN inpatient 2.3 2.25 All Payors / Plans All Payors / Plans 2.3 other 2.3 2.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUSPIRONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0121-0904-05 NDC GY 1 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUSPIRONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-8315-01 NDC GY 1 UN inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUSPIRONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-8315-23 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-8330-01 NDC GY 1 UN inpatient 3.41 3.34 All Payors / Plans All Payors / Plans 3.41 other 3.41 3.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-8330-23 NDC GY 1 UN inpatient 4.12 4.04 All Payors / Plans All Payors / Plans 4.12 other 4.12 4.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0054-0235-24 NDC GY 1 UN inpatient 4.12 4.04 All Payors / Plans All Payors / Plans 4.12 other 4.12 4.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60505-0582-4 NDC GY 1 UN inpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAFFEINE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68180-422-01 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCITRIOL 0.25 MCG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0536466110 NDC GY 1 UN inpatient 2.74 2.69 All Payors / Plans All Payors / Plans 2.74 other 2.74 2.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCITRIOL 0.25 MCG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904549261 NDC GY 1 UN inpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM ACETATE 667 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 7733386125 NDC GY 1 UN inpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM ACETATE(PHOSPHAT BIND) 667 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 7985440050 NDC GY 1 UN inpatient 4.92 4.82 All Payors / Plans All Payors / Plans 4.92 other 4.92 4.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CALCIUM CARBONATE 200 MG CALCIUM (500 MG) TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 0093-1010-42 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CALCIUM CARBONATE 200 MG CALCIUM (500 MG) TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 45802-112-22 NDC GY 1 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CALCIUM CARBONATE 500 MG CALCIUM (1,250 MG) TABLET" ERX-637000000 CDM A9270 CPT 637 RC 51672-1312-0 NDC GY 1 UN inpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAPTOPRIL 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-180-22 NDC GY 1 UN inpatient 4.21 4.13 All Payors / Plans All Payors / Plans 4.21 other 4.21 4.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBAMAZEPINE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69623-802-76 NDC GY 1 UN inpatient 2.01 1.97 All Payors / Plans All Payors / Plans 2.01 other 2.01 2.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBAMAZEPINE XR 100 MG TABLET EXTENDED RELEASE 12 HR ERX-637000000 CDM A9270 CPT 637 RC 50228-465-01 NDC GY 1 UN inpatient 1.08 1.06 All Payors / Plans All Payors / Plans 1.08 other 1.08 1.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBAMAZEPINE XR 400 MG TABLET EXTENDED RELEASE 12 HR ERX-637000000 CDM A9270 CPT 637 RC 60687-630-11 NDC GY 1 UN inpatient 5.05 4.95 All Payors / Plans All Payors / Plans 5.05 other 5.05 5.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBAMAZEPINE XR 400 MG TABLET EXTENDED RELEASE 12 HR ERX-637000000 CDM A9270 CPT 637 RC 50228-466-01 NDC GY 1 UN inpatient 11.33 11.1 All Payors / Plans All Payors / Plans 11.33 other 11.33 11.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 10-100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7070-07 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 25-100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 82625-8802-1 NDC GY 2 UN inpatient 3.68 3.61 All Payors / Plans All Payors / Plans 3.68 other 3.68 3.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 25-100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-1170-03 NDC GY 2 UN inpatient 2.11 2.07 All Payors / Plans All Payors / Plans 2.11 other 2.11 2.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 25-100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7036-04 NDC GY 1 UN inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 25-100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-291-11 NDC GY 1 UN inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 25-100 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 68094-853-62 NDC GY 1 UN inpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 25-100 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 0065-0085-15 NDC GY 1 UN inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 25-250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-594-11 NDC GY 1 UN inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 25-250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65162-188-10 NDC GY 1 UN inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 12.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-595-11 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 12.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-403-10 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-190-01 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7190-04 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 31722-587-30 NDC GY 1 UN inpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 3.125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7189-04 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 3.125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0093-1177-01 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 3.125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0713-0268-31 NDC GY 1 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 6.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 61314-631-36 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 6.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 61314-630-06 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 6.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 24208-635-62 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 6.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 61314-641-75 NDC GY 1 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 6.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-057-24 NDC GY 1 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFDINIR 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 8068105700 NDC GY 1 UN inpatient 10.45 10.24 All Payors / Plans All Payors / Plans 10.45 other 10.45 10.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFDINIR 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50268-584-11 NDC GY 1 UN inpatient 8.92 8.74 All Payors / Plans All Payors / Plans 8.92 other 8.92 8.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFDINIR 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 43598-447-71 NDC GY 1 UN inpatient 2.74 2.69 All Payors / Plans All Payors / Plans 2.74 other 2.74 2.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFUROXIME 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 43598-447-74 NDC GY 1 UN inpatient 9.56 9.37 All Payors / Plans All Payors / Plans 9.56 other 9.56 9.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFUROXIME 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60505-708-90 NDC GY 1 UN inpatient 9.56 9.37 All Payors / Plans All Payors / Plans 9.56 other 9.56 9.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFUROXIME 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0135-0466-02 NDC GY 1 UN inpatient 3.45 3.38 All Payors / Plans All Payors / Plans 3.45 other 3.45 3.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CELECOXIB 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0536-1362-06 NDC GY 1 UN inpatient 3.42 3.35 All Payors / Plans All Payors / Plans 3.42 other 3.42 3.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CELECOXIB 200 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0766785840 NDC GY 1 UN inpatient 4.28 4.19 All Payors / Plans All Payors / Plans 4.28 other 4.28 4.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CELECOXIB 200 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 49348-573-08 NDC GY 1 UN inpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEPHALEXIN 250 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 60505-7063-0 NDC GY 2 UN inpatient 2.25 2.21 All Payors / Plans All Payors / Plans 2.25 other 2.25 2.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEPHALEXIN 250 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 43598-446-71 NDC GY 1 UN inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEPHALEXIN 500 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904-7229-61 NDC GY 1 UN inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEPHALEXIN 500 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904-7208-06 NDC GY 1 UN inpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEPHALEXIN 500 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50268-597-11 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CETIRIZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-597-15 NDC GY 1 UN inpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CETIRIZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-597-11 NDC GY 1 UN inpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CETIRIZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-598-15 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CETIRIZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-598-11 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CETIRIZINE-PSEUDOEPHEDRINE 5-120 MG TABLET EXTENDED RELEASE 12 HR ERX-637000000 CDM A9270 CPT 637 RC 50268-599-11 NDC GY 1 UN inpatient 2.54 2.49 All Payors / Plans All Payors / Plans 2.54 other 2.54 2.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORDIAZEPOXIDE 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50268-599-15 NDC GY 1 UN inpatient 2.04 2 All Payors / Plans All Payors / Plans 2.04 other 2.04 2.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORDIAZEPOXIDE 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 23155-512-11 NDC GY 1 UN inpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORDIAZEPOXIDE 5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 24338-260-10 NDC GY 1 UN inpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORDIAZEPOXIDE 5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50268-624-11 NDC GY 1 UN inpatient 2.63 2.58 All Payors / Plans All Payors / Plans 2.63 other 2.63 2.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORPROMAZINE PER 10 MG ERX-637000000 CDM A9270 CPT 637 RC 0904-7026-61 NDC GY 1 UN inpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORPROMAZINE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 50268-623-11 NDC GY 1 UN inpatient 9.42 9.23 All Payors / Plans All Payors / Plans 9.42 other 9.42 9.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORPROMAZINE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 60687-472-11 NDC GY 1 UN inpatient 4.16 4.08 All Payors / Plans All Payors / Plans 4.16 other 4.16 4.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORTHALIDONE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70756-411-11 NDC GY 1 UN inpatient 6.84 6.7 All Payors / Plans All Payors / Plans 6.84 other 6.84 6.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORTHALIDONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0378-9102-16 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHOLECALCIFEROL 10 MCG (400 UNIT) TABLET ERX-637000000 CDM A9270 CPT 637 RC 43598-436-11 NDC GY 1 UN inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CHOLECALCIFEROL 25 MCG (1,000 UNIT) TABLET" ERX-637000000 CDM A9270 CPT 637 RC 59762-3304-3 NDC GY 1 UN inpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CHOLECALCIFEROL 25 MCG (1,000 UNIT) TABLET" ERX-637000000 CDM A9270 CPT 637 RC 68462-639-25 NDC GY 1 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHOLESTYRAMINE 4 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 0378-9112-16 NDC GY 1 UN inpatient 3.33 3.26 All Payors / Plans All Payors / Plans 3.33 other 3.33 3.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHOLESTYRAMINE 4 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 0378-9116-16 NDC GY 1 UN inpatient 8.62 8.45 All Payors / Plans All Payors / Plans 8.62 other 8.62 8.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHOLESTYRAMINE 4 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 0281-0326-08 NDC GY 1 UN inpatient 3.52 3.45 All Payors / Plans All Payors / Plans 3.52 other 3.52 3.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CILOSTAZOL 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 45802-210-02 NDC GY 2 UN inpatient 5.52 5.41 All Payors / Plans All Payors / Plans 5.52 other 5.52 5.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CINACALCET 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-304-50 NDC GY 1 UN inpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CINACALCET 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0555-9049-58 NDC GY 1 UN inpatient 23.45 22.98 All Payors / Plans All Payors / Plans 23.45 other 23.45 23.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0555-9049-79 NDC GY 2 UN inpatient 2.01 1.97 All Payors / Plans All Payors / Plans 2.01 other 2.01 2.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0093-0810-01 NDC GY 2 UN inpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-281-11 NDC GY 0.5 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0093-0811-05 NDC GY 1 UN inpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CITALOPRAM 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-604-11 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CITALOPRAM 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 45802-059-11 NDC GY 0.5 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CITALOPRAM 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 45802-048-35 NDC GY 0.5 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CITALOPRAM 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0574-2008-15 NDC GY 1 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLARITHROMYCIN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0832-0465-15 NDC GY 1 UN inpatient 8.87 8.69 All Payors / Plans All Payors / Plans 8.87 other 8.87 8.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN 150 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 68308-152-15 NDC GY 2 UN inpatient 2.02 1.98 All Payors / Plans All Payors / Plans 2.02 other 2.02 2.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN 150 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0121-0868-05 NDC GY 2 UN inpatient 2.1 2.06 All Payors / Plans All Payors / Plans 2.1 other 2.1 2.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CLONAZEPAM 0.25 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 0121-1045-16 NDC GY 2 UN inpatient 5.12 5.02 All Payors / Plans All Payors / Plans 5.12 other 5.12 5.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CLONAZEPAM 0.25 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 0904-7276-41 NDC GY 1 UN inpatient 3.42 3.35 All Payors / Plans All Payors / Plans 3.42 other 3.42 3.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONAZEPAM 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 17856-1045-1 NDC GY 1 UN inpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONAZEPAM 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 24208-434-05 NDC GY 1 UN inpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONAZEPAM 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60505-3113-0 NDC GY 1 UN inpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONAZEPAM 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-740-11 NDC GY 1 UN inpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONAZEPAM 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60505-3110-0 NDC GY 2 UN inpatient 3.76 3.68 All Payors / Plans All Payors / Plans 3.76 other 3.76 3.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONAZEPAM 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-723-01 NDC GY 1 UN inpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-723-11 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 43598-165-30 NDC GY 1 UN inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69543-382-90 NDC GY 1 UN inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.1 MG/24 HR PATCH WEEKLY ERX-637000000 CDM A9270 CPT 637 RC 60505-3276-3 NDC GY 1 UN inpatient 22.12 21.68 All Payors / Plans All Payors / Plans 22.12 other 22.12 22.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 49884-320-55 NDC GY 1 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55111-262-79 NDC GY 1 UN inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55111-262-81 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.2 MG/24 HR PATCH WEEKLY ERX-637000000 CDM A9270 CPT 637 RC 60505-3275-0 NDC GY 1 UN inpatient 28.96 28.38 All Payors / Plans All Payors / Plans 28.96 other 28.96 28.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.3 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-390-10 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.3 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-157-13 NDC GY 1 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.3 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0054-0064-47 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.3 MG/24 HR PATCH WEEKLY ERX-637000000 CDM A9270 CPT 637 RC 16714-671-02 NDC GY 1 UN inpatient 34.4 33.71 All Payors / Plans All Payors / Plans 34.4 other 34.4 34.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.3 MG/24 HR PATCH WEEKLY ERX-637000000 CDM A9270 CPT 637 RC 57237-077-10 NDC GY 1 UN inpatient 36.46 35.73 All Payors / Plans All Payors / Plans 36.46 other 36.46 36.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOPIDOGREL 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65162-691-79 NDC GY 1 UN inpatient 14.11 13.83 All Payors / Plans All Payors / Plans 14.11 other 14.11 14.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOPIDOGREL 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-157-40 NDC GY 1 UN inpatient 14.11 13.83 All Payors / Plans All Payors / Plans 14.11 other 14.11 14.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOPIDOGREL 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 64380-797-01 NDC GY 1 UN inpatient 16.56 16.23 All Payors / Plans All Payors / Plans 16.56 other 16.56 16.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOPIDOGREL 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72205-042-11 NDC GY 1 UN inpatient 18.02 17.66 All Payors / Plans All Payors / Plans 18.02 other 18.02 18.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOPIDOGREL 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68180-678-01 NDC GY 1 UN inpatient 16.46 16.13 All Payors / Plans All Payors / Plans 16.46 other 16.46 16.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOPIDOGREL 75 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72205-044-11 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COLCHICINE 0.6 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0228-2067-10 NDC GY 1 UN inpatient 9.49 9.3 All Payors / Plans All Payors / Plans 9.49 other 9.49 9.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COLCHICINE 0.6 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62584-812-11 NDC GY 1 UN inpatient 9.66 9.47 All Payors / Plans All Payors / Plans 9.66 other 9.66 9.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CYANOCOBALAMIN 1,000 MCG TABLET" ERX-637000000 CDM A9270 CPT 637 RC 62584-813-11 NDC GY 0.5 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CYANOCOBALAMIN 1,000 MCG TABLET" ERX-637000000 CDM A9270 CPT 637 RC 65162-649-78 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CYANOCOBALAMIN 1,000 MCG TABLET" ERX-637000000 CDM A9270 CPT 637 RC 0904-7262-61 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CYANOCOBALAMIN 1,000 MCG TABLET" ERX-637000000 CDM A9270 CPT 637 RC 0904-7263-61 NDC GY 0.5 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYANOCOBALAMIN 100 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51991-293-01 NDC GY 1 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOBENZAPRINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-138-01 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOBENZAPRINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0832-0038-89 NDC GY 0.5 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOBENZAPRINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7027-61 NDC GY 0.5 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOBENZAPRINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-670-11 NDC GY 1 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOSPORINE 0.05 % DROPPERETTE ERX-637000000 CDM A9270 CPT 637 RC 0406-8515-23 NDC GY 1 UN inpatient 19.31 18.92 All Payors / Plans All Payors / Plans 19.31 other 19.31 19.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOSPORINE 0.05 % DROPPERETTE ERX-637000000 CDM A9270 CPT 637 RC 0406-8530-23 NDC GY 1 UN inpatient 9.4 9.21 All Payors / Plans All Payors / Plans 9.4 other 9.4 9.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYPROHEPTADINE 4 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-0552-23 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DABIGATRAN ETEXILATE 150 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904-6966-61 NDC GY 1 UN inpatient 9.53 9.34 All Payors / Plans All Payors / Plans 9.53 other 9.53 9.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DAPAGLIFLOZIN PROPANEDIOL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 42858-001-10 NDC GY 2 UN inpatient 42.21 41.37 All Payors / Plans All Payors / Plans 42.21 other 42.21 42.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DAPAGLIFLOZIN PROPANEDIOL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-354-11 NDC GY 2 UN inpatient 42.29 41.44 All Payors / Plans All Payors / Plans 42.29 other 42.29 42.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DARUNAVIR 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6828-05 NDC GY 1 UN inpatient 14.21 13.93 All Payors / Plans All Payors / Plans 14.21 other 14.21 14.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DESMOPRESSIN 0.1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59011-410-10 NDC GY 1 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DESVENLAFAXINE 50 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 59011-410-20 NDC GY 1 UN inpatient 2.54 2.49 All Payors / Plans All Payors / Plans 2.54 other 2.54 2.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-0512-23 NDC GY 1 UN inpatient 2.01 1.97 All Payors / Plans All Payors / Plans 2.01 other 2.01 2.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-0512-62 NDC GY 1 UN inpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DEXMETHYLPHENIDATE XR 10 MG CAPSULE,ER BIPHASIC 50-50" ERX-637000000 CDM A9270 CPT 637 RC 0904-6761-30 NDC GY 1 UN inpatient 9.03 8.85 All Payors / Plans All Payors / Plans 9.03 other 9.03 9.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DEXMETHYLPHENIDATE XR 5 MG CAPSULE,ER BIPHASIC 50-50" ERX-637000000 CDM A9270 CPT 637 RC 0904-7427-30 NDC GY 1 UN inpatient 11.18 10.96 All Payors / Plans All Payors / Plans 11.18 other 11.18 11.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DEXMETHYLPHENIDATE XR 5 MG CAPSULE,ER BIPHASIC 50-50" ERX-637000000 CDM A9270 CPT 637 RC 45802-410-59 NDC GY 1 UN inpatient 4.25 4.17 All Payors / Plans All Payors / Plans 4.25 other 4.25 4.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70677-1037-1 NDC GY 1 UN inpatient 3.42 3.35 All Payors / Plans All Payors / Plans 3.42 other 3.42 3.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65162-280-03 NDC GY 2 UN inpatient 3.64 3.57 All Payors / Plans All Payors / Plans 3.64 other 3.64 3.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIAZEPAM 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50458-550-01 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIAZEPAM 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6936-61 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIAZEPAM 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0032-0047-70 NDC GY 1 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIAZEPAM 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0032-0046-70 NDC GY 1 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICLOFENAC EPOLAMINE 1.3 % PATCH 12 HOUR ERX-637000000 CDM A9270 CPT 637 RC 50268-585-11 NDC GY 1 UN inpatient 36.36 35.63 All Payors / Plans All Payors / Plans 36.36 other 36.36 36.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904-6474-61 NDC GY 1 UN inpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 51079-051-01 NDC GY 1 UN inpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE PER 20 MG ERX-637000000 CDM A9270 CPT 637 RC 63739-564-10 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE PER 20 MG ERX-637000000 CDM A9270 CPT 637 RC 0904-5676-61 NDC GY 0.5 UN inpatient 1.89 1.85 All Payors / Plans All Payors / Plans 1.89 other 1.89 1.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIGOXIN 125 MCG (0.125 MG) TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-888-10 NDC GY 1 UN inpatient 2.74 2.69 All Payors / Plans All Payors / Plans 2.74 other 2.74 2.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIGOXIN 125 MCG (0.125 MG) TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-963-10 NDC GY 1 UN inpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIGOXIN 125 MCG (0.125 MG) TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-045-11 NDC GY 1 UN inpatient 2.77 2.71 All Payors / Plans All Payors / Plans 2.77 other 2.77 2.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIGOXIN 250 MCG (0.25 MG) TABLET ERX-637000000 CDM A9270 CPT 637 RC 0087040501 NDC GY 1 UN inpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILTIAZEM 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7985408009 NDC GY 1 UN inpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILTIAZEM 60 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0093-1172-01 NDC GY 1 UN inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DILTIAZEM CD 120 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 16714-234-01 NDC GY 1 UN inpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DILTIAZEM CD 120 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 0093-4127-73 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DILTIAZEM CD 180 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 6373612002 NDC GY 1 UN inpatient 1.92 1.88 All Payors / Plans All Payors / Plans 1.92 other 1.92 1.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DILTIAZEM CD 180 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 0904-6599-61 NDC GY 1 UN inpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DILTIAZEM CD 240 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 68084-607-11 NDC GY 1 UN inpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DILTIAZEM CD 240 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 65162-681-10 NDC GY 1 UN inpatient 2.02 1.98 All Payors / Plans All Payors / Plans 2.02 other 2.02 2.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DILTIAZEM CD 240 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 65162-682-10 NDC GY 1 UN inpatient 1.82 1.78 All Payors / Plans All Payors / Plans 1.82 other 1.82 1.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DILTIAZEM SR 60 MG CAPSULE,EXTENDED RELEASE 12 HR" ERX-637000000 CDM A9270 CPT 637 RC 0143-1458-01 NDC GY 1 UN inpatient 9.67 9.48 All Payors / Plans All Payors / Plans 9.67 other 9.67 9.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE PER 50 MG ERX-637000000 CDM A9270 CPT 637 RC 0143-1495-01 NDC GY 1 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE PER 50 MG ERX-637000000 CDM A9270 CPT 637 RC 16571-672-01 NDC GY 1 UN inpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 75826-138-10 NDC GY 1 UN inpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DISULFIRAM 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7811201104 NDC GY 1.5 UN inpatient 13.6 13.33 All Payors / Plans All Payors / Plans 13.6 other 13.6 13.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX 125 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 0573-2871-93 NDC GY 1 UN inpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIVALPROEX 250 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 70756-629-25 NDC GY 1 UN inpatient 3.4 3.33 All Payors / Plans All Payors / Plans 3.4 other 3.4 3.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIVALPROEX 250 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0071-0369-40 NDC GY 1 UN inpatient 3.41 3.34 All Payors / Plans All Payors / Plans 3.41 other 3.41 3.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX 250 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 0904-6187-61 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX 250 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 65862-692-01 NDC GY 2 UN inpatient 1.92 1.88 All Payors / Plans All Payors / Plans 1.92 other 1.92 1.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX 250 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 60687-156-95 NDC GY 1 UN inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIVALPROEX 500 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 69097-999-02 NDC GY 1 UN inpatient 4.06 3.98 All Payors / Plans All Payors / Plans 4.06 other 4.06 4.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIVALPROEX 500 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 68084-928-95 NDC GY 1 UN inpatient 3.41 3.34 All Payors / Plans All Payors / Plans 3.41 other 3.41 3.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIVALPROEX 500 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0378-0127-01 NDC GY 1 UN inpatient 4.21 4.13 All Payors / Plans All Payors / Plans 4.21 other 4.21 4.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX 500 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 0904-7096-61 NDC GY 1 UN inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX 500 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 0904-6931-81 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX 500 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 0904-6931-86 NDC GY 0.5 UN inpatient 0.55 0.54 All Payors / Plans All Payors / Plans 0.55 other 0.55 0.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX 500 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 62559-157-17 NDC GY 2 UN inpatient 2.19 2.15 All Payors / Plans All Payors / Plans 2.19 other 2.19 2.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX SPRINKLE 125 MG CAPSULE, DELAYED REL SPRINKLE" ERX-637000000 CDM A9270 CPT 637 RC 10572-100-01 NDC GY 1 UN inpatient 2.76 2.7 All Payors / Plans All Payors / Plans 2.76 other 2.76 2.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX SPRINKLE 125 MG CAPSULE, DELAYED REL SPRINKLE" ERX-637000000 CDM A9270 CPT 637 RC 52268-100-01 NDC GY 1 UN inpatient 2.76 2.7 All Payors / Plans All Payors / Plans 2.76 other 2.76 2.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOCUSATE SODIUM 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 51801-013-30 NDC GY 1 UN inpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOCUSATE SODIUM 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 51801-011-30 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOCUSATE SODIUM 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 51801-012-30 NDC GY 1 UN inpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOFETILIDE 125 MCG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0245-5317-01 NDC GY 1 UN inpatient 19.85 19.45 All Payors / Plans All Payors / Plans 19.85 other 19.85 19.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOFETILIDE 125 MCG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0245-5317-89 NDC GY 1 UN inpatient 2.78 2.72 All Payors / Plans All Payors / Plans 2.78 other 2.78 2.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOFETILIDE 250 MCG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0245-5319-89 NDC GY 2 UN inpatient 3.68 3.61 All Payors / Plans All Payors / Plans 3.68 other 3.68 3.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOLUTEGRAVIR 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-973-10 NDC GY 1 UN inpatient 78.77 77.19 All Payors / Plans All Payors / Plans 78.77 other 78.77 78.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DONEPEZIL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-472-01 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXAZOSIN 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0121-0948-16 NDC GY 1 UN inpatient 2.55 2.5 All Payors / Plans All Payors / Plans 2.55 other 2.55 2.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXAZOSIN 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-850-33 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXAZOSIN 8 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 75834-280-30 NDC GY 1 UN inpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXEPIN 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 6025800601 NDC GY 1 UN inpatient 2.68 2.63 All Payors / Plans All Payors / Plans 2.68 other 2.68 2.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXEPIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 7135101012 NDC GY 3 UN inpatient 5.58 5.47 All Payors / Plans All Payors / Plans 5.58 other 5.58 5.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXYCYCLINE 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 7135101099 NDC GY 1 UN inpatient 4.9 4.8 All Payors / Plans All Payors / Plans 4.9 other 4.9 4.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXYCYCLINE 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0536-1271-80 NDC GY 1 UN inpatient 4.84 4.74 All Payors / Plans All Payors / Plans 4.84 other 4.84 4.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXYCYCLINE 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 52380-0126-2 NDC GY 1 UN inpatient 4.1 4.02 All Payors / Plans All Payors / Plans 4.1 other 4.1 4.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRONABINOL PER 2.5 MG ERX-637000000 CDM A9270 CPT 637 RC 68462-330-90 NDC GY 1 UN inpatient 10.87 10.65 All Payors / Plans All Payors / Plans 10.87 other 10.87 10.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRONABINOL PER 2.5 MG ERX-637000000 CDM A9270 CPT 637 RC 60687-581-11 NDC GY 2 UN inpatient 21.73 21.3 All Payors / Plans All Payors / Plans 21.73 other 21.73 21.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DULOXETINE 20 MG CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 49348-610-36 NDC GY 1 UN inpatient 2.78 2.72 All Payors / Plans All Payors / Plans 2.78 other 2.78 2.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DULOXETINE 20 MG CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 65862-830-30 NDC GY 2 UN inpatient 6.63 6.5 All Payors / Plans All Payors / Plans 6.63 other 6.63 6.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DULOXETINE 20 MG CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 60687-178-11 NDC GY 1 UN inpatient 3.32 3.25 All Payors / Plans All Payors / Plans 3.32 other 3.32 3.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DULOXETINE 30 MG CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 51079-630-01 NDC GY 1 UN inpatient 2.72 2.67 All Payors / Plans All Payors / Plans 2.72 other 2.72 2.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DULOXETINE 60 MG CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 59762-5310-1 NDC GY 1 UN inpatient 2.68 2.63 All Payors / Plans All Payors / Plans 2.68 other 2.68 2.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DULOXETINE 60 MG CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 68084-996-11 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DULOXETINE 60 MG CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 51079-631-01 NDC GY 1 UN inpatient 2.71 2.66 All Payors / Plans All Payors / Plans 2.71 other 2.71 2.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DULOXETINE 60 MG CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 51079-631-20 NDC GY 1 UN inpatient 2.77 2.71 All Payors / Plans All Payors / Plans 2.77 other 2.77 2.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DUTASTERIDE 0.5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 51079-632-01 NDC GY 1 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EMPAGLIFLOZIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 17856-0759-5 NDC GY 1 UN inpatient 21.36 20.93 All Payors / Plans All Payors / Plans 21.36 other 21.36 21.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EMPAGLIFLOZIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60758-119-05 NDC GY 1 UN inpatient 21.21 20.79 All Payors / Plans All Payors / Plans 21.21 other 21.21 21.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EMPAGLIFLOZIN 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7001-61 NDC GY 0.5 UN inpatient 10.68 10.47 All Payors / Plans All Payors / Plans 10.68 other 10.68 10.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-506-01 NDC GY 1 UN inpatient 3.49 3.42 All Payors / Plans All Payors / Plans 3.49 other 3.49 3.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENALAPRIL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-506-11 NDC GY 1 UN inpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENALAPRIL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-473-11 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENALAPRIL 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6992-61 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENALAPRIL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-484-01 NDC GY 2 UN inpatient 1.85 1.81 All Payors / Plans All Payors / Plans 1.85 other 1.85 1.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPLERENONE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-484-11 NDC GY 2 UN inpatient 9.72 9.53 All Payors / Plans All Payors / Plans 9.72 other 9.72 9.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPLERENONE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7000-61 NDC GY 1 UN inpatient 2.21 2.17 All Payors / Plans All Payors / Plans 2.21 other 2.21 2.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPLERENONE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-495-01 NDC GY 2 UN inpatient 20.61 20.2 All Payors / Plans All Payors / Plans 20.61 other 20.61 20.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ERGOCALCIFEROL 1,250 MCG (50,000 UNIT) CAPSULE" ERX-637000000 CDM A9270 CPT 637 RC 60687-495-11 NDC GY 1 UN inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ERGOCALCIFEROL 1,250 MCG (50,000 UNIT) CAPSULE" ERX-637000000 CDM A9270 CPT 637 RC 4329255515 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERYTHROMYCIN BASE 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7733371510 NDC GY 1 UN inpatient 14.37 14.08 All Payors / Plans All Payors / Plans 14.37 other 14.37 14.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ESCITALOPRAM 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7733371525 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ESTRADIOL 0.1 MG/24 HR PATCH WEEKLY ERX-637000000 CDM A9270 CPT 637 RC 68084-202-11 NDC GY 1 UN inpatient 65.37 64.06 All Payors / Plans All Payors / Plans 65.37 other 65.37 65.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ESTRADIOL 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-685-11 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ESTRADIOL 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59746-115-06 NDC GY 1 UN inpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETHAMBUTOL 400 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-684-11 NDC GY 3 UN inpatient 8.23 8.07 All Payors / Plans All Payors / Plans 8.23 other 8.23 8.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EZETIMIBE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6461-61 NDC GY 1 UN inpatient 10.76 10.54 All Payors / Plans All Payors / Plans 10.76 other 10.76 10.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EZETIMIBE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0713-0526-06 NDC GY 1 UN inpatient 10.08 9.88 All Payors / Plans All Payors / Plans 10.08 other 10.08 10.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EZETIMIBE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 45802-759-00 NDC GY 1 UN inpatient 10.83 10.61 All Payors / Plans All Payors / Plans 10.83 other 10.83 10.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EZETIMIBE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7304-61 NDC GY 1 UN inpatient 10.83 10.61 All Payors / Plans All Payors / Plans 10.83 other 10.83 10.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FAMOTIDINE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70436-155-41 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FAMOTIDINE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-709-11 NDC GY 1 UN inpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FAMOTIDINE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0998-0016-15 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FAMOTIDINE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 24208-730-06 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENOFIBRATE 145 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-662-11 NDC GY 1 UN inpatient 9.03 8.85 All Payors / Plans All Payors / Plans 9.03 other 9.03 9.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENOFIBRATE 145 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-662-15 NDC GY 1 UN inpatient 3.5 3.43 All Payors / Plans All Payors / Plans 3.5 other 3.5 3.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENOFIBRATE 48 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-587-11 NDC GY 1 UN inpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENOFIBRATE 48 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0378-0183-01 NDC GY 1 UN inpatient 3.46 3.39 All Payors / Plans All Payors / Plans 3.46 other 3.46 3.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL 12 MCG/HR PATCH 72 HOUR ERX-637000000 CDM A9270 CPT 637 RC 0603-5484-21 NDC GY 1 UN inpatient 62.08 60.84 All Payors / Plans All Payors / Plans 62.08 other 62.08 62.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL 25 MCG/HR PATCH 72 HOUR ERX-637000000 CDM A9270 CPT 637 RC 0591-5557-01 NDC GY 1 UN inpatient 25.67 25.16 All Payors / Plans All Payors / Plans 25.67 other 25.67 25.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL 75 MCG/HR PATCH 72 HOUR ERX-637000000 CDM A9270 CPT 637 RC 60687-215-11 NDC GY 1 UN inpatient 49.61 48.62 All Payors / Plans All Payors / Plans 49.61 other 49.61 49.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FERROUS GLUCONATE 324 MG (38 MG IRON) TABLET ERX-637000000 CDM A9270 CPT 637 RC 0527-4117-37 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FERROUS SULFATE 325 MG (65 MG IRON) TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-226-11 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FERROUS SULFATE 325 MG (65 MG IRON) TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-5053-59 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "FIBRINOGEN-THROMBIN 4.8 X 4.8 CM ADHESIVE PATCH,MEDICATED" ERX-637000000 CDM A9270 CPT 637 RC 0904-6990-61 NDC GY 1 UN inpatient 789.82 774.02 All Payors / Plans All Payors / Plans 789.82 other 789.82 789.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FIDAXOMICIN 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70954-484-10 NDC GY 1 UN inpatient 240.21 235.41 All Payors / Plans All Payors / Plans 240.21 other 240.21 240.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FINASTERIDE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6622-61 NDC GY 1 UN inpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FINASTERIDE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-494-11 NDC GY 1 UN inpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FINASTERIDE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 5026885911 NDC GY 1 UN inpatient 1.92 1.88 All Payors / Plans All Payors / Plans 1.92 other 1.92 1.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLECAINIDE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 5026885811 NDC GY 1 UN inpatient 3.49 3.42 All Payors / Plans All Payors / Plans 3.49 other 3.49 3.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLECAINIDE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-632-11 NDC GY 1 UN inpatient 2.02 1.98 All Payors / Plans All Payors / Plans 2.02 other 2.02 2.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUCONAZOLE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-633-11 NDC GY 1 UN inpatient 4.15 4.07 All Payors / Plans All Payors / Plans 4.15 other 4.15 4.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUCONAZOLE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6638-61 NDC GY 1 UN inpatient 6.67 6.54 All Payors / Plans All Payors / Plans 6.67 other 6.67 6.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUCONAZOLE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-630-11 NDC GY 1 UN inpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUCONAZOLE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-327-01 NDC GY 1 UN inpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUDROCORTISONE 0.1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-327-11 NDC GY 1 UN inpatient 2.54 2.49 All Payors / Plans All Payors / Plans 2.54 other 2.54 2.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUDROCORTISONE 0.1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6803-61 NDC GY 0.5 UN inpatient 2.72 2.67 All Payors / Plans All Payors / Plans 2.72 other 2.72 2.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUORESCEIN 1 MG STRIP ERX-637000000 CDM A9270 CPT 637 RC 0904-6804-61 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUORESCEIN 1 MG STRIP ERX-637000000 CDM A9270 CPT 637 RC 0904-6801-61 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOXETINE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 43598-505-30 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOXETINE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 60687-266-11 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOXETINE 20 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0006-0227-61 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOXETINE 20 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 68382-144-06 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOXETINE 20 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 65862-475-01 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOXETINE 20 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 68382-146-01 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOXETINE 20 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 60687-549-11 NDC GY 1 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUPHENAZINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-560-11 NDC GY 1 UN inpatient 9.51 9.32 All Payors / Plans All Payors / Plans 9.51 other 9.51 9.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUPHENAZINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0013-5301-17 NDC GY 1 UN inpatient 9.52 9.33 All Payors / Plans All Payors / Plans 9.52 other 9.52 9.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUVOXAMINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-586-11 NDC GY 2 UN inpatient 3.72 3.65 All Payors / Plans All Payors / Plans 3.72 other 3.72 3.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLIC ACID 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65649-303-03 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLIC ACID 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-271-11 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLIC ACID 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 49884-311-52 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7362-61 NDC GY 1 UN inpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 49884-315-52 NDC GY 0.5 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59746-020-22 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE 80 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6360-61 NDC GY 1 UN inpatient 1.94 1.9 All Payors / Plans All Payors / Plans 1.94 other 1.94 1.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904-7363-61 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904-6361-61 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904-7364-61 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50458-580-01 NDC GY 1 UN inpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50458-578-01 NDC GY 1 UN inpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50458-578-10 NDC GY 1 UN inpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 400 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50458-578-30 NDC GY 1 UN inpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GEMFIBROZIL 600 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50458-577-01 NDC GY 1 UN inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GEMFIBROZIL 600 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50458-579-10 NDC GY 1 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIMEPIRIDE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6373-61 NDC GY 1 UN inpatient 1.84 1.8 All Payors / Plans All Payors / Plans 1.84 other 1.84 1.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIMEPIRIDE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-741-11 NDC GY 1 UN inpatient 1.94 1.9 All Payors / Plans All Payors / Plans 1.94 other 1.94 1.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIMEPIRIDE 4 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6374-61 NDC GY 1 UN inpatient 2.59 2.54 All Payors / Plans All Payors / Plans 2.59 other 2.59 2.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIPIZIDE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-743-11 NDC GY 0.5 UN inpatient 1.94 1.9 All Payors / Plans All Payors / Plans 1.94 other 1.94 1.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIPIZIDE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6779-61 NDC GY 0.5 UN inpatient 1.96 1.92 All Payors / Plans All Payors / Plans 1.96 other 1.96 1.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIPIZIDE 10 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 60687-245-01 NDC GY 2 UN inpatient 1.96 1.92 All Payors / Plans All Payors / Plans 1.96 other 1.96 1.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIPIZIDE 2.5 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 60687-245-11 NDC GY 1 UN inpatient 3.51 3.44 All Payors / Plans All Payors / Plans 3.51 other 3.51 3.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIPIZIDE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-710-11 NDC GY 1 UN inpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "GLYCERIN-WITCH HAZEL 12.5-50 % PADS, MEDICATED 40 EACH BOX" ERX-637000000 CDM A9270 CPT 637 RC 60687-256-01 NDC GY 40 UN inpatient 11.34 11.11 All Payors / Plans All Payors / Plans 11.34 other 11.34 11.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLYCOPYRROLATE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-256-11 NDC GY 1 UN inpatient 3.33 3.26 All Payors / Plans All Payors / Plans 3.33 other 3.33 3.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUAIFENESIN 600 MG TABLET EXTENDED RELEASE 12HR ERX-637000000 CDM A9270 CPT 637 RC 0904-6781-61 NDC GY 1 UN inpatient 2.56 2.51 All Payors / Plans All Payors / Plans 2.56 other 2.56 2.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUAIFENESIN 600 MG TABLET EXTENDED RELEASE 12HR ERX-637000000 CDM A9270 CPT 637 RC 50268-711-11 NDC GY 1 UN inpatient 2.65 2.6 All Payors / Plans All Payors / Plans 2.65 other 2.65 2.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUAIFENESIN 600 MG TABLET EXTENDED RELEASE 12HR ERX-637000000 CDM A9270 CPT 637 RC 70377-009-11 NDC GY 1 UN inpatient 2.65 2.6 All Payors / Plans All Payors / Plans 2.65 other 2.65 2.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUANFACINE 1 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0904-6778-61 NDC GY 1 UN inpatient 1.93 1.89 All Payors / Plans All Payors / Plans 1.93 other 1.93 1.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUANFACINE 2 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 16714-988-01 NDC GY 0.5 UN inpatient 0.48 0.47 All Payors / Plans All Payors / Plans 0.48 other 0.48 0.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUAR GUM PACKET ERX-637000000 CDM A9270 CPT 637 RC 0078-0659-20 NDC GY 1 UN inpatient 32.47 31.82 All Payors / Plans All Payors / Plans 32.47 other 32.47 32.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HALOPERIDOL 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0078-0777-20 NDC GY 1 UN inpatient 1.96 1.92 All Payors / Plans All Payors / Plans 1.96 other 1.96 1.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HALOPERIDOL 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0078-0696-20 NDC GY 1 UN inpatient 2.66 2.61 All Payors / Plans All Payors / Plans 2.66 other 2.66 2.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HALOPERIDOL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 4858200155 NDC GY 1 UN inpatient 1.82 1.78 All Payors / Plans All Payors / Plans 1.82 other 1.82 1.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0591-2258-54 NDC GY 1 UN inpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 45802-580-01 NDC GY 1 UN inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50742-505-04 NDC GY 1 UN inpatient 8.94 8.76 All Payors / Plans All Payors / Plans 8.94 other 8.94 8.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60505-3438-3 NDC GY 1 UN inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72319-006-02 NDC GY 1 UN inpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6522-61 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7252-61 NDC GY 1 UN inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 48433-219-05 NDC GY 1 UN inpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 57896-303-01 NDC GY 2 UN inpatient 2.2 2.16 All Payors / Plans All Payors / Plans 2.2 other 2.2 2.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-622-01 NDC GY 2 UN inpatient 2.13 2.09 All Payors / Plans All Payors / Plans 2.13 other 2.13 2.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-622-11 NDC GY 2 UN inpatient 2.46 2.41 All Payors / Plans All Payors / Plans 2.46 other 2.46 2.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-432-02 NDC GY 1 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6924-61 NDC GY 1 UN inpatient 1.85 1.81 All Payors / Plans All Payors / Plans 1.85 other 1.85 1.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 16714-611-04 NDC GY 1 UN inpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCHLOROTHIAZIDE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-231-11 NDC GY 0.5 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCHLOROTHIAZIDE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-242-01 NDC GY 0.5 UN inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCHLOROTHIAZIDE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-242-11 NDC GY 0.5 UN inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6707-06 NDC GY 1 UN inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6707-82 NDC GY 1 UN inpatient 1.93 1.89 All Payors / Plans All Payors / Plans 1.93 other 1.93 1.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-720-11 NDC GY 1 UN inpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-328-33 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-930-08 NDC GY 1 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-717-11 NDC GY 0.5 UN inpatient 4.93 4.83 All Payors / Plans All Payors / Plans 4.93 other 4.93 4.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 12870-0001-1 NDC GY 0.5 UN inpatient 4.93 4.83 All Payors / Plans All Payors / Plans 4.93 other 4.93 4.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 25 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 43598-210-55 NDC GY 1 UN inpatient 20.37 19.96 All Payors / Plans All Payors / Plans 20.37 other 20.37 20.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69618-033-01 NDC GY 1 UN inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 77333-812-25 NDC GY 0.5 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0395266116 NDC GY 1 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-571-10 NDC GY 1 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-511-11 NDC GY 0.5 UN inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-572-10 NDC GY 1 UN inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYCHLOROQUINE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-512-01 NDC GY 1 UN inpatient 4.14 4.06 All Payors / Plans All Payors / Plans 4.14 other 4.14 4.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYUREA 500 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 68084-512-11 NDC GY 1 UN inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYUREA 500 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63739-573-10 NDC GY 2 UN inpatient 5.42 5.31 All Payors / Plans All Payors / Plans 5.42 other 5.42 5.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0006-0277-01 NDC GY 1 UN inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE PAMOATE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 0006-0221-01 NDC GY 1 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE PAMOATE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 0486112501 NDC GY 1 UN inpatient 1.82 1.78 All Payors / Plans All Payors / Plans 1.82 other 1.82 1.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE PAMOATE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 0904-7261-61 NDC GY 1 UN inpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE PAMOATE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 63629-8775-1 NDC GY 1 UN inpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE PAMOATE PER 50 MG ERX-637000000 CDM A9270 CPT 637 RC 66553-008-01 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE PAMOATE PER 50 MG ERX-637000000 CDM A9270 CPT 637 RC 77333-827-25 NDC GY 1 UN inpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 400 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 6936722001 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 400 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7733383525 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 600 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 77333-844-25 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0121119030 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 3932806412 NDC GY 1 UN inpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0436-0936-16 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMIPRAMINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 39328-063-25 NDC GY 1 UN inpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMIPRAMINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0536-7415-51 NDC GY 1 UN inpatient 1.85 1.81 All Payors / Plans All Payors / Plans 1.85 other 1.85 1.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDAPAMIDE 1.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0132020220 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDAPAMIDE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0132-0202-20 NDC GY 1 UN inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDOMETHACIN 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0310-1110-01 NDC GY 1 UN inpatient 1.82 1.78 All Payors / Plans All Payors / Plans 1.82 other 1.82 1.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDOMETHACIN 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0310-1110-30 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDOMETHACIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0310-1105-01 NDC GY 1 UN inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDOMETHACIN 50 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 68084-654-11 NDC GY 1 UN inpatient 206.11 201.99 All Payors / Plans All Payors / Plans 206.11 other 206.11 206.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRBESARTAN 150 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69584-841-10 NDC GY 1 UN inpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRBESARTAN 75 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-487-11 NDC GY 1 UN inpatient 1.89 1.85 All Payors / Plans All Payors / Plans 1.89 other 1.89 1.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISONIAZID 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6927-61 NDC GY 1 UN inpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOSORBIDE DINITRATE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-103-01 NDC GY 1 UN inpatient 2.63 2.58 All Payors / Plans All Payors / Plans 2.63 other 2.63 2.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOSORBIDE DINITRATE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 53489-143-05 NDC GY 1 UN inpatient 3.51 3.44 All Payors / Plans All Payors / Plans 3.51 other 3.51 3.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOSORBIDE DINITRATE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-544-10 NDC GY 1 UN inpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOSORBIDE DINITRATE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-753-01 NDC GY 1 UN inpatient 2.58 2.53 All Payors / Plans All Payors / Plans 2.58 other 2.58 2.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOSORBIDE DINITRATE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62135-436-90 NDC GY 1 UN inpatient 2.63 2.58 All Payors / Plans All Payors / Plans 2.63 other 2.63 2.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOSORBIDE MONONITRATE 30 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0121-0974-10 NDC GY 0.5 UN inpatient 0.54 0.53 All Payors / Plans All Payors / Plans 0.54 other 0.54 0.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOSORBIDE MONONITRATE 30 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0121-0974-94 NDC GY 0.5 UN inpatient 0.47 0.46 All Payors / Plans All Payors / Plans 0.47 other 0.47 0.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOSORBIDE MONONITRATE 60 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 60687-738-42 NDC GY 1 UN inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IVABRADINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68094-043-59 NDC GY 1 UN inpatient 18.51 18.14 All Payors / Plans All Payors / Plans 18.51 other 18.51 18.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IVABRADINE 7.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0121-0747-10 NDC GY 1 UN inpatient 18.51 18.14 All Payors / Plans All Payors / Plans 18.51 other 18.51 18.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 61314-701-01 NDC GY 1 UN inpatient 6.59 6.46 All Payors / Plans All Payors / Plans 6.59 other 6.59 6.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 24208-670-04 NDC GY 0.5 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0121-0853-20 NDC GY 1 UN inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-496-47 NDC GY 1 UN inpatient 1.93 1.89 All Payors / Plans All Payors / Plans 1.93 other 1.93 1.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-419-01 NDC GY 1 UN inpatient 1.85 1.81 All Payors / Plans All Payors / Plans 1.85 other 1.85 1.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-2725-61 NDC GY 1 UN inpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-420-01 NDC GY 1 UN inpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59762-5000-5 NDC GY 1 UN inpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-146-36 NDC GY 1 UN inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACOSAMIDE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69452-344-60 NDC GY 1 UN inpatient 4.83 4.73 All Payors / Plans All Payors / Plans 4.83 other 4.83 4.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACOSAMIDE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59651-299-60 NDC GY 1 UN inpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACOSAMIDE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-567-10 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACTOBACILLUS RHAMNOSUS GG 10 BILLION CELL CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 68084-299-11 NDC GY 1 UN inpatient 3.55 3.48 All Payors / Plans All Payors / Plans 3.55 other 3.55 3.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LAMOTRIGINE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0228-2076-10 NDC GY 1 UN inpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LAMOTRIGINE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-549-11 NDC GY 1 UN inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LAMOTRIGINE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-764-11 NDC GY 1 UN inpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LAMOTRIGINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-764-15 NDC GY 1 UN inpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LANSOPRAZOLE 30 MG TABLET,DISINTEGRAT, DELAY REL" ERX-637000000 CDM A9270 CPT 637 RC 50268-766-11 NDC GY 1 UN inpatient 21.73 21.3 All Payors / Plans All Payors / Plans 21.73 other 21.73 21.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LANSOPRAZOLE 30 MG TABLET,DISINTEGRAT, DELAY REL" ERX-637000000 CDM A9270 CPT 637 RC 0065-0741-14 NDC GY 1 UN inpatient 14.33 14.04 All Payors / Plans All Payors / Plans 14.33 other 14.33 14.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEFLUNOMIDE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0536-1217-94 NDC GY 1 UN inpatient 55.15 54.05 All Payors / Plans All Payors / Plans 55.15 other 55.15 55.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEFLUNOMIDE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7733393410 NDC GY 1 UN inpatient 6.98 6.84 All Payors / Plans All Payors / Plans 6.98 other 6.98 6.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEFLUNOMIDE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7733393425 NDC GY 1 UN inpatient 4.1 4.02 All Payors / Plans All Payors / Plans 4.1 other 4.1 4.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEFLUNOMIDE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60219-1676-1 NDC GY 1 UN inpatient 2.04 2 All Payors / Plans All Payors / Plans 2.04 other 2.04 2.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LETROZOLE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0456-0458-01 NDC GY 1 UN inpatient 2.59 2.54 All Payors / Plans All Payors / Plans 2.59 other 2.59 2.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LETROZOLE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 42192-330-01 NDC GY 1 UN inpatient 1.84 1.8 All Payors / Plans All Payors / Plans 1.84 other 1.84 1.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETIRACETAM 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 64980-514-05 NDC GY 1 UN inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETIRACETAM 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6418-61 NDC GY 1 UN inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETIRACETAM 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-645-11 NDC GY 1 UN inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETIRACETAM 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 17478-290-10 NDC GY 1 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETIRACETAM 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 61314-647-10 NDC GY 1 UN inpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOFLOXACIN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 33342-098-09 NDC GY 1 UN inpatient 1.08 1.06 All Payors / Plans All Payors / Plans 1.08 other 1.08 1.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOFLOXACIN 750 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-344-11 NDC GY 1 UN inpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 100 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6928-61 NDC GY 1 UN inpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 112 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-342-11 NDC GY 1 UN inpatient 2.65 2.6 All Payors / Plans All Payors / Plans 2.65 other 2.65 2.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 112 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69097-122-03 NDC GY 1 UN inpatient 2.01 1.97 All Payors / Plans All Payors / Plans 2.01 other 2.01 2.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 125 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69097-122-15 NDC GY 1 UN inpatient 2.72 2.67 All Payors / Plans All Payors / Plans 2.72 other 2.72 2.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 137 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-755-11 NDC GY 1 UN inpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 137 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-757-11 NDC GY 0.0876 UN inpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 150 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-539-01 NDC GY 1 UN inpatient 2 1.96 All Payors / Plans All Payors / Plans 2 other 2 2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 150 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-539-11 NDC GY 1 UN inpatient 2.74 2.69 All Payors / Plans All Payors / Plans 2.74 other 2.74 2.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 150 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 57664-377-08 NDC GY 1 UN inpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 175 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-795-01 NDC GY 1 UN inpatient 2.63 2.58 All Payors / Plans All Payors / Plans 2.63 other 2.63 2.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 175 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-795-11 NDC GY 1 UN inpatient 2.62 2.57 All Payors / Plans All Payors / Plans 2.62 other 2.62 2.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 200 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-808-11 NDC GY 1 UN inpatient 3.49 3.42 All Payors / Plans All Payors / Plans 3.49 other 3.49 3.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 25 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6869-61 NDC GY 1 UN inpatient 2 1.96 All Payors / Plans All Payors / Plans 2 other 2 2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 25 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-454-11 NDC GY 1 UN inpatient 2 1.96 All Payors / Plans All Payors / Plans 2 other 2 2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 25 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6868-61 NDC GY 1 UN inpatient 1.84 1.8 All Payors / Plans All Payors / Plans 1.84 other 1.84 1.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 50 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-443-11 NDC GY 1 UN inpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 50 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68382-805-01 NDC GY 1 UN inpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 50 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51672-1394-0 NDC GY 1 UN inpatient 1.87 1.83 All Payors / Plans All Payors / Plans 1.87 other 1.87 1.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 75 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0168-0004-15 NDC GY 1 UN inpatient 2.61 2.56 All Payors / Plans All Payors / Plans 2.61 other 2.61 2.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 75 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0168-0004-80 NDC GY 2 UN inpatient 5.21 5.11 All Payors / Plans All Payors / Plans 5.21 other 5.21 5.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 88 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0168-0002-15 NDC GY 1 UN inpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 88 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-750-95 NDC GY 1 UN inpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 88 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0591-0348-01 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-MENTHOL 4-1 % ADHESIVE PATCH,MEDICATED" ERX-637000000 CDM A9270 CPT 637 RC 24208-590-64 NDC GY 1 UN inpatient 10.52 10.31 All Payors / Plans All Payors / Plans 10.52 other 10.52 10.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-MENTHOL 4-1 % ADHESIVE PATCH,MEDICATED" ERX-637000000 CDM A9270 CPT 637 RC 61314-355-02 NDC GY 1 UN inpatient 10.52 10.31 All Payors / Plans All Payors / Plans 10.52 other 10.52 10.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINEZOLID 600 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70069-121-01 NDC GY 1 UN inpatient 11.26 11.03 All Payors / Plans All Payors / Plans 11.26 other 11.26 11.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINEZOLID 600 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 73302-456-01 NDC GY 1 UN inpatient 6.74 6.61 All Payors / Plans All Payors / Plans 6.74 other 6.74 6.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIOTHYRONINE 25 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-100-11 NDC GY 1 UN inpatient 2.04 2 All Payors / Plans All Payors / Plans 2.04 other 2.04 2.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIOTHYRONINE 5 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-093-01 NDC GY 1 UN inpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISDEXAMFETAMINE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0121-0675-85 NDC GY 1 UN inpatient 20.88 20.46 All Payors / Plans All Payors / Plans 20.88 other 20.88 20.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISDEXAMFETAMINE 30 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0591-4012-01 NDC GY 1 UN inpatient 20.88 20.46 All Payors / Plans All Payors / Plans 20.88 other 20.88 20.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISINOPRIL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0121-4675-05 NDC GY 1 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISINOPRIL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-634-11 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISINOPRIL 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 31722-154-90 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISINOPRIL 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62332-047-90 NDC GY 1 UN inpatient 2.59 2.54 All Payors / Plans All Payors / Plans 2.59 other 2.59 2.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISINOPRIL 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0378-5807-93 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISINOPRIL 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 33342-062-07 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISINOPRIL 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0378-5813-77 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISINOPRIL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 23155-858-78 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LITHIUM CARBONATE 150 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 62559-390-20 NDC GY 1 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LITHIUM CARBONATE 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 68180-166-11 NDC GY 1 UN inpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LITHIUM CARBONATE 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-6510-01 NDC GY 1 UN inpatient 1.08 1.06 All Payors / Plans All Payors / Plans 1.08 other 1.08 1.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LITHIUM CARBONATE 450 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 65628-206-05 NDC GY 1 UN inpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOPERAMIDE 2 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 49884-155-76 NDC GY 1 UN inpatient 2.71 2.66 All Payors / Plans All Payors / Plans 2.71 other 2.71 2.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-896-95 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-844-11 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-856-11 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-713-11 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-527-90 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-698-11 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-709-11 NDC GY 1 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOSARTAN 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0591-0345-01 NDC GY 1 UN inpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOSARTAN 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 23155-059-01 NDC GY 1 UN inpatient 1.13 1.11 All Payors / Plans All Payors / Plans 1.13 other 1.13 1.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOSARTAN 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 23155-026-01 NDC GY 0.5 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-292-01 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-293-01 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOXAPINE 5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 68462-260-01 NDC GY 1 UN inpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LURASIDONE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 6025816101 NDC GY 1 UN inpatient 9.04 8.86 All Payors / Plans All Payors / Plans 9.04 other 9.04 9.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LURASIDONE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 4110081163 NDC GY 1 UN inpatient 51.48 50.45 All Payors / Plans All Payors / Plans 51.48 other 51.48 51.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LURASIDONE 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7733395125 NDC GY 1 UN inpatient 2.69 2.64 All Payors / Plans All Payors / Plans 2.69 other 2.69 2.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LURASIDONE 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 27241-063-03 NDC GY 1 UN inpatient 51.48 50.45 All Payors / Plans All Payors / Plans 51.48 other 51.48 51.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LURASIDONE 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-572-30 NDC GY 1 UN inpatient 1.85 1.81 All Payors / Plans All Payors / Plans 1.85 other 1.85 1.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MAGNESIUM CHLORIDE 64 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 64764-730-30 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET ERX-637000000 CDM A9270 CPT 637 RC 64764-720-30 NDC GY 1 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MECLIZINE 12.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0832-1211-89 NDC GY 2 UN inpatient 3.92 3.84 All Payors / Plans All Payors / Plans 3.92 other 3.92 3.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MECLIZINE 12.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51672-4035-1 NDC GY 2 UN inpatient 3.76 3.68 All Payors / Plans All Payors / Plans 3.76 other 3.76 3.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MECLIZINE 12.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0832-1212-89 NDC GY 1 UN inpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MECLIZINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0832-1213-89 NDC GY 1 UN inpatient 4.26 4.17 All Payors / Plans All Payors / Plans 4.26 other 4.26 4.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MECLIZINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0832-1216-89 NDC GY 1 UN inpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MECLIZINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62584-994-11 NDC GY 1 UN inpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEDROXYPROGESTERONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0832-1218-89 NDC GY 1 UN inpatient 1.08 1.06 All Payors / Plans All Payors / Plans 1.08 other 1.08 1.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEDROXYPROGESTERONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7214003711 NDC GY 1 UN inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEDROXYPROGESTERONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0065-0518-01 NDC GY 1 UN inpatient 4.26 4.17 All Payors / Plans All Payors / Plans 4.26 other 4.26 4.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEDROXYPROGESTERONE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 8068115500 NDC GY 2 UN inpatient 1.93 1.89 All Payors / Plans All Payors / Plans 1.93 other 1.93 1.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEGESTROL 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-048-24 NDC GY 1 UN inpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEMANTINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69968-0061-1 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEMANTINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7430000070 NDC GY 1 UN inpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MESALAMINE 1,000 MG SUPPOSITORY" ERX-637000000 CDM A9270 CPT 637 RC 7733398325 NDC GY 1 UN inpatient 6.87 6.73 All Payors / Plans All Payors / Plans 6.87 other 6.87 6.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESALAMINE 400 MG CAPSULE (WITH DEL REL TABLETS) ERX-637000000 CDM A9270 CPT 637 RC 0904-6269-08 NDC GY 2 UN inpatient 20.75 20.34 All Payors / Plans All Payors / Plans 20.75 other 20.75 20.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MESALAMINE 800 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 63739-988-32 NDC GY 2 UN inpatient 30.4 29.79 All Payors / Plans All Payors / Plans 30.4 other 30.4 30.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METFORMIN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-104-09 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METFORMIN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-104-11 NDC GY 1 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METFORMIN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 16714-622-01 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METFORMIN 850 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6082-61 NDC GY 1 UN inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHADONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 16714-621-01 NDC GY 1 UN inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHADONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 83257-005-41 NDC GY 1 UN inpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHADONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60793-701-02 NDC GY 1 UN inpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHADONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60793-702-04 NDC GY 1 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHAZOLAMIDE 1 (ONE) 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55513-223-01 NDC GY 1 UN inpatient 5.02 4.92 All Payors / Plans All Payors / Plans 5.02 other 5.02 5.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHAZOLAMIDE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50242-037-06 NDC GY 1 UN inpatient 9.48 9.29 All Payors / Plans All Payors / Plans 9.48 other 9.48 9.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHIMAZOLE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50242-120-47 NDC GY 1 UN inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHIMAZOLE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55513-132-01 NDC GY 1 UN inpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHIMAZOLE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0069-0305-01 NDC GY 0.0996 UN inpatient 0.1 0.1 All Payors / Plans All Payors / Plans 0.1 other 0.1 0.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLERGONOVINE 0.2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0069-0306-01 NDC GY 1 UN inpatient 24.85 24.35 All Payors / Plans All Payors / Plans 24.85 other 24.85 24.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPHENIDATE HCL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0264-4100-90 NDC GY 1 UN inpatient 4.83 4.73 All Payors / Plans All Payors / Plans 4.83 other 4.83 4.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPHENIDATE HCL 18 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 63323-325-03 NDC GY 1 UN inpatient 9.95 9.75 All Payors / Plans All Payors / Plans 9.95 other 9.95 9.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPHENIDATE HCL 27 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 63323-325-09 NDC GY 1 UN inpatient 8.72 8.55 All Payors / Plans All Payors / Plans 8.72 other 8.72 8.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPHENIDATE HCL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72485-201-01 NDC GY 1 UN inpatient 6.85 6.71 All Payors / Plans All Payors / Plans 6.85 other 6.85 6.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44567-530-01 NDC GY 1 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 39822-0255-1 NDC GY 1 UN inpatient 2 1.96 All Payors / Plans All Payors / Plans 2 other 2 2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOLAZONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 67457-316-25 NDC GY 2 UN inpatient 5.53 5.42 All Payors / Plans All Payors / Plans 5.53 other 5.53 5.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOLAZONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-883-30 NDC GY 2 UN inpatient 6.78 6.64 All Payors / Plans All Payors / Plans 6.78 other 6.78 6.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOLAZONE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-6102-20 NDC GY 1 UN inpatient 9.14 8.96 All Payors / Plans All Payors / Plans 9.14 other 9.14 9.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOLAZONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-631-50 NDC GY 1 UN inpatient 9.49 9.3 All Payors / Plans All Payors / Plans 9.49 other 9.49 9.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL 12.5 MG ERX-637000000 CDM A9270 CPT 637 RC 63323-710-50 NDC GY 1 UN inpatient 0.88 0.86 All Payors / Plans All Payors / Plans 0.88 other 0.88 0.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 100 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 25021-191-10 NDC GY 1 UN inpatient 4.82 4.72 All Payors / Plans All Payors / Plans 4.82 other 4.82 4.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 100 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0143-9279-01 NDC GY 1 UN inpatient 3.39 3.32 All Payors / Plans All Payors / Plans 3.39 other 3.39 3.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 200 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 60505-6132-6 NDC GY 1 UN inpatient 2.62 2.57 All Payors / Plans All Payors / Plans 2.62 other 2.62 2.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 25 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 60505-6132-7 NDC GY 2 UN inpatient 2.22 2.18 All Payors / Plans All Payors / Plans 2.22 other 2.22 2.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 25 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 68817-134-50 NDC GY 0.5 UN inpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 25 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 70114-101-01 NDC GY 0.5 UN inpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 25 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 71288-166-10 NDC GY 0.5 UN inpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 25 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0409-0302-01 NDC GY 1 UN inpatient 2 1.96 All Payors / Plans All Payors / Plans 2 other 2 2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 50 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0069-0249-01 NDC GY 1 UN inpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 50 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 55513-221-01 NDC GY 0.5 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 50 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 55513-222-01 NDC GY 0.5 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL TARTRATE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-310-25 NDC GY 1 UN inpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL TARTRATE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-310-50 NDC GY 1 UN inpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL TARTRATE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-310-90 NDC GY 1 UN inpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL TARTRATE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-310-91 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL TARTRATE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-3613-01 NDC GY 0.5 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL TARTRATE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-360-01 NDC GY 1 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL TARTRATE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-360-03 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL TARTRATE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-360-19 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METRONIDAZOLE 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 58160-821-43 NDC GY 2 UN inpatient 2.17 2.13 All Payors / Plans All Payors / Plans 2.17 other 2.17 2.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METRONIDAZOLE 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-495-07 NDC GY 1 UN inpatient 2 1.96 All Payors / Plans All Payors / Plans 2 other 2 2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METRONIDAZOLE 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-495-27 NDC GY 1 UN inpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEXILETINE 150 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63323-496-03 NDC GY 1 UN inpatient 4.1 4.02 All Payors / Plans All Payors / Plans 4.1 other 4.1 4.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEXILETINE 150 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 61958-2901-2 NDC GY 1 UN inpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEXILETINE 200 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 69374-920-05 NDC GY 1 UN inpatient 2.04 2 All Payors / Plans All Payors / Plans 2.04 other 2.04 2.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDODRINE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 42023-219-01 NDC GY 1 UN inpatient 2.54 2.49 All Payors / Plans All Payors / Plans 2.54 other 2.54 2.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDODRINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 42023-219-10 NDC GY 1 UN inpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDODRINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59676-340-00 NDC GY 1 UN inpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MINOXIDIL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0069-1309-01 NDC GY 1 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MINOXIDIL 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 39822-0190-1 NDC GY 1 UN inpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIRTAZAPINE 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72611-860-01 NDC GY 0.5 UN inpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIRTAZAPINE 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 17478-542-02 NDC GY 1 UN inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIRTAZAPINE 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 67457-855-00 NDC GY 1 UN inpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MISOPROSTOL 100 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 67457-855-02 NDC GY 10 UN inpatient 86.71 84.98 All Payors / Plans All Payors / Plans 86.71 other 86.71 86.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MISOPROSTOL 1000 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 58468-0040-1 NDC GY 1 UN inpatient 2.77 2.71 All Payors / Plans All Payors / Plans 2.77 other 2.77 2.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MISOPROSTOL 200 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 58468-0041-1 NDC GY 5 UN inpatient 33.43 32.76 All Payors / Plans All Payors / Plans 33.43 other 33.43 33.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MISOPROSTOL 200 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-251-05 NDC GY 1 UN inpatient 6.69 6.56 All Payors / Plans All Payors / Plans 6.69 other 6.69 6.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MISOPROSTOL 200 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-251-10 NDC GY 1 UN inpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MISOPROSTOL 25 MCG ERX-637000000 CDM A9270 CPT 637 RC 44206-251-90 NDC GY 1 UN inpatient 1.84 1.8 All Payors / Plans All Payors / Plans 1.84 other 1.84 1.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MODAFINIL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-251-91 NDC GY 2 UN inpatient 22.83 22.37 All Payors / Plans All Payors / Plans 22.83 other 22.83 22.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MONTELUKAST 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50242-041-64 NDC GY 1 UN inpatient 1.26 1.23 All Payors / Plans All Payors / Plans 1.26 other 1.26 1.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MONTELUKAST 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-5922-16 NDC GY 1 UN inpatient 1.82 1.78 All Payors / Plans All Payors / Plans 1.82 other 1.82 1.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MONTELUKAST 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-5921-16 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MONTELUKAST 5 MG TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 43066-150-10 NDC GY 1 UN inpatient 2.66 2.61 All Payors / Plans All Payors / Plans 2.66 other 2.66 2.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 10 MG/0.5 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 43066-360-20 NDC GY 0.5 UN inpatient 4.41 4.32 All Payors / Plans All Payors / Plans 4.41 other 4.41 4.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 15 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 0781-3402-78 NDC GY 1 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 15 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 0781-3402-95 NDC GY 1 UN inpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 30 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 0781-3407-78 NDC GY 1 UN inpatient 1.83 1.79 All Payors / Plans All Payors / Plans 1.83 other 1.83 1.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 30 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 0781-3408-80 NDC GY 1 UN inpatient 3.53 3.46 All Payors / Plans All Payors / Plans 3.53 other 3.53 3.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE IMMEDIATE RELEASE 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44567-101-10 NDC GY 0.5 UN inpatient 1.38 1.35 All Payors / Plans All Payors / Plans 1.38 other 1.38 1.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MULTIVIT-IRON-FA-CALCIUM-MINS 9 MG IRON-400 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55150-114-20 NDC GY 1 UN inpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MULTIVIT-IRON-FA-CALCIUM-MINS 9 MG IRON-400 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72485-422-10 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MULTIVIT-IRON-FA-CALCIUM-MINS 9 MG IRON-400 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6116-01 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MULTIVIT-MINERALS-IRON-FOLIC ACID 7.5 MG IRON-400 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6117-01 NDC GY 1 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NABUMETONE 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6117-10 NDC GY 2 UN inpatient 1.96 1.92 All Payors / Plans All Payors / Plans 1.96 other 1.96 1.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NABUMETONE 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55150-116-20 NDC GY 2 UN inpatient 6.84 6.7 All Payors / Plans All Payors / Plans 6.84 other 6.84 6.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NABUMETONE 750 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55150-117-20 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NADOLOL 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 67457-349-10 NDC GY 1 UN inpatient 6.79 6.65 All Payors / Plans All Payors / Plans 6.79 other 6.79 6.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALOXEGOL 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68982-182-02 NDC GY 0.5 UN inpatient 10.87 10.65 All Payors / Plans All Payors / Plans 10.87 other 10.87 10.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALTREXONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68982-182-01 NDC GY 1 UN inpatient 4.05 3.97 All Payors / Plans All Payors / Plans 4.05 other 4.05 4.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALTREXONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 47426-201-01 NDC GY 1 UN inpatient 3.53 3.46 All Payors / Plans All Payors / Plans 3.53 other 3.53 3.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALTREXONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-1001-25 NDC GY 1 UN inpatient 7.02 6.88 All Payors / Plans All Payors / Plans 7.02 other 7.02 7.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALTREXONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1630-10 NDC GY 1 UN inpatient 6.83 6.69 All Payors / Plans All Payors / Plans 6.83 other 6.83 6.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAPROXEN 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1630-15 NDC GY 0.5 UN inpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAPROXEN 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-1004-01 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAPROXEN 375 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-1004-25 NDC GY 1 UN inpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAPROXEN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 64253-400-30 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAPROXEN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-0144-11 NDC GY 1 UN inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEBIVOLOL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-0144-21 NDC GY 0.5 UN inpatient 8.62 8.45 All Payors / Plans All Payors / Plans 8.62 other 8.62 8.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEBIVOLOL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-398-01 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEBIVOLOL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-398-10 NDC GY 0.5 UN inpatient 6.87 6.73 All Payors / Plans All Payors / Plans 6.87 other 6.87 6.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEOMYCIN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-0829-11 NDC GY 2 UN inpatient 7.03 6.89 All Payors / Plans All Payors / Plans 7.03 other 7.03 7.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIACIN 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0003-2570-16 NDC GY 5 UN inpatient 4.41 4.32 All Payors / Plans All Payors / Plans 4.41 other 4.41 4.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIACIN 500 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0409-0830-01 NDC GY 1 UN inpatient 4.11 4.03 All Payors / Plans All Payors / Plans 4.11 other 4.11 4.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 14 MG/24 HR PATCH 24 HOUR ERX-637000000 CDM A9270 CPT 637 RC 0409-0830-11 NDC GY 1 UN inpatient 4.2 4.12 All Payors / Plans All Payors / Plans 4.2 other 4.2 4.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 14 MG/24 HR PATCH 24 HOUR ERX-637000000 CDM A9270 CPT 637 RC 0143-9729-01 NDC GY 1 UN inpatient 4.23 4.15 All Payors / Plans All Payors / Plans 4.23 other 4.23 4.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 14 MG/24 HR PATCH 24 HOUR ERX-637000000 CDM A9270 CPT 637 RC 68382-860-02 NDC GY 1 UN inpatient 4.89 4.79 All Payors / Plans All Payors / Plans 4.89 other 4.89 4.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 2 MG GUM ERX-637000000 CDM A9270 CPT 637 RC 55513-207-01 NDC GY 1 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 2 MG GUM ERX-637000000 CDM A9270 CPT 637 RC 55513-206-01 NDC GY 1 UN inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 2 MG GUM ERX-637000000 CDM A9270 CPT 637 RC 0069-0342-01 NDC GY 1 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 2 MG GUM ERX-637000000 CDM A9270 CPT 637 RC 0069-0315-01 NDC GY 1 UN inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 21 MG/24 HR PATCH 24 HOUR ERX-637000000 CDM A9270 CPT 637 RC 70121-1755-1 NDC GY 1 UN inpatient 6.93 6.79 All Payors / Plans All Payors / Plans 6.93 other 6.93 6.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 7 MG/24 HR PATCH 24 HOUR ERX-637000000 CDM A9270 CPT 637 RC 70121-1754-1 NDC GY 1 UN inpatient 10.73 10.52 All Payors / Plans All Payors / Plans 10.73 other 10.73 10.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-1412-04 NDC GY 1 UN inpatient 3.32 3.25 All Payors / Plans All Payors / Plans 3.32 other 3.32 3.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE XL 30 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 0641-6008-01 NDC GY 1 UN inpatient 2.71 2.66 All Payors / Plans All Payors / Plans 2.71 other 2.71 2.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE XL 30 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 70860-405-41 NDC GY 1 UN inpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE XL 30 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 72205-101-01 NDC GY 1 UN inpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE XL 30 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 0409-1159-02 NDC GY 1 UN inpatient 4.25 4.17 All Payors / Plans All Payors / Plans 4.25 other 4.25 4.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE XL 60 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 0409-1159-09 NDC GY 0.5 UN inpatient 2.49 2.44 All Payors / Plans All Payors / Plans 2.49 other 2.49 2.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE XL 60 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 55150-167-10 NDC GY 1 UN inpatient 7.07 6.93 All Payors / Plans All Payors / Plans 7.07 other 7.07 7.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE XL 90 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 63323-464-17 NDC GY 1 UN inpatient 4.89 4.79 All Payors / Plans All Payors / Plans 4.89 other 4.89 4.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE XL 90 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 0409-1162-01 NDC GY 1 UN inpatient 4.89 4.79 All Payors / Plans All Payors / Plans 4.89 other 4.89 4.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIMODIPINE 30 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-1162-02 NDC GY 2 UN inpatient 8.26 8.09 All Payors / Plans All Payors / Plans 8.26 other 8.26 8.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROFURANTOIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-1162-18 NDC GY 1 UN inpatient 8.85 8.67 All Payors / Plans All Payors / Plans 8.85 other 8.85 8.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROFURANTOIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-1162-19 NDC GY 1 UN inpatient 4.96 4.86 All Payors / Plans All Payors / Plans 4.96 other 4.96 4.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROFURANTOIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63323-466-01 NDC GY 1 UN inpatient 4.19 4.11 All Payors / Plans All Payors / Plans 4.19 other 4.19 4.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROFURANTOIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-1165-01 NDC GY 1 UN inpatient 4.92 4.82 All Payors / Plans All Payors / Plans 4.92 other 4.92 4.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROFURANTOIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 55150-171-10 NDC GY 2 UN inpatient 3.93 3.85 All Payors / Plans All Payors / Plans 3.93 other 3.93 3.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROGLYCERIN 0.1 MG/HR PATCH 24 HOUR ERX-637000000 CDM A9270 CPT 637 RC 10122-620-10 NDC GY 1 UN inpatient 0.64 0.63 All Payors / Plans All Payors / Plans 0.64 other 0.64 0.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NITROGLYCERIN 0.4 MG TABLET, SUBLINGUAL" ERX-637000000 CDM A9270 CPT 637 RC 10122-620-01 NDC GY 1 UN inpatient 0.29 0.28 All Payors / Plans All Payors / Plans 0.29 other 0.29 0.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NITROGLYCERIN 0.4 MG TABLET, SUBLINGUAL" ERX-637000000 CDM A9270 CPT 637 RC 60505-6231-0 NDC GY 1 UN inpatient 0.5 0.49 All Payors / Plans All Payors / Plans 0.5 other 0.5 0.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NITROGLYCERIN 0.4 MG TABLET, SUBLINGUAL" ERX-637000000 CDM A9270 CPT 637 RC 60505-6231-5 NDC GY 1 UN inpatient 0.29 0.28 All Payors / Plans All Payors / Plans 0.29 other 0.29 0.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROGLYCERIN 0.4 MG/HR PATCH 24 HOUR ERX-637000000 CDM A9270 CPT 637 RC 0143-9140-01 NDC GY 1 UN inpatient 0.87 0.85 All Payors / Plans All Payors / Plans 0.87 other 0.87 0.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROGLYCERIN 0.6 MG/HR PATCH 24 HOUR ERX-637000000 CDM A9270 CPT 637 RC 0143-9140-25 NDC GY 1 UN inpatient 2.75 2.7 All Payors / Plans All Payors / Plans 2.75 other 2.75 2.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORETHINDRONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0143-9923-90 NDC GY 4 UN inpatient 13.87 13.59 All Payors / Plans All Payors / Plans 13.87 other 13.87 13.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORGESTREL-ETHINYL ESTRADIOL 0.3-30 MG-MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0781-3451-70 NDC GY 1 UN inpatient 1.94 1.9 All Payors / Plans All Payors / Plans 1.94 other 1.94 1.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORGESTREL-ETHINYL ESTRADIOL 0.3-30 MG-MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44567-707-25 NDC GY 1 UN inpatient 1.94 1.9 All Payors / Plans All Payors / Plans 1.94 other 1.94 1.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORTRIPTYLINE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 60505-6142-0 NDC GY 4 UN inpatient 4.26 4.17 All Payors / Plans All Payors / Plans 4.26 other 4.26 4.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORTRIPTYLINE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-9566-01 NDC GY 2 UN inpatient 3.73 3.66 All Payors / Plans All Payors / Plans 3.73 other 3.73 3.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORTRIPTYLINE 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-9735-01 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORTRIPTYLINE 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-9735-10 NDC GY 1 UN inpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLANZAPINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 25021-121-20 NDC GY 1 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLANZAPINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44567-241-10 NDC GY 1 UN inpatient 3.33 3.26 All Payors / Plans All Payors / Plans 3.33 other 3.33 3.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLANZAPINE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59630-266-01 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLANZAPINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 25021-109-10 NDC GY 1 UN inpatient 2.07 2.03 All Payors / Plans All Payors / Plans 2.07 other 2.07 2.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLANZAPINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-342-41 NDC GY 1 UN inpatient 2.04 2 All Payors / Plans All Payors / Plans 2.04 other 2.04 2.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLANZAPINE 7.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 25021-127-20 NDC GY 1 UN inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLANZAPINE 7.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 25021-128-50 NDC GY 1 UN inpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OLANZAPINE ODT 10 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 44567-235-25 NDC GY 1 UN inpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OLANZAPINE ZYDIS 5 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 0143-9857-01 NDC GY 2 UN inpatient 3.8 3.72 All Payors / Plans All Payors / Plans 3.8 other 3.8 3.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OLANZAPINE ZYDIS 5 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 0143-9858-01 NDC GY 1 UN inpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OLANZAPINE ZYDIS 5 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 0143-9858-25 NDC GY 1 UN inpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OLANZAPINE ZYDIS 5 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 0264-3153-11 NDC GY 1 UN inpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON 4 (FOUR) 4 MG TABLETS ERX-637000000 CDM A9270 CPT 637 RC 0264-3155-11 NDC GY 4 UN inpatient 3.88 3.8 All Payors / Plans All Payors / Plans 3.88 other 3.88 3.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON 4 (FOUR) 4 MG TABLETS ERX-637000000 CDM A9270 CPT 637 RC 60505-6151-1 NDC GY 4 UN inpatient 4.19 4.11 All Payors / Plans All Payors / Plans 4.19 other 4.19 4.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 8 MG ERX-637000000 CDM A9270 CPT 637 RC 0143-9977-90 NDC GY 0.5 UN inpatient 0.52 0.51 All Payors / Plans All Payors / Plans 0.52 other 0.52 0.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 8 MG ERX-637000000 CDM A9270 CPT 637 RC 0143-9979-22 NDC GY 1 UN inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OSELTAMIVIR 30 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0143-9979-90 NDC GY 1 UN inpatient 4.24 4.16 All Payors / Plans All Payors / Plans 4.24 other 4.24 4.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OSELTAMIVIR 30 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 25021-119-20 NDC GY 1 UN inpatient 2.75 2.7 All Payors / Plans All Payors / Plans 2.75 other 2.75 2.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OSELTAMIVIR 75 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 66733-958-23 NDC GY 1 UN inpatient 2.78 2.72 All Payors / Plans All Payors / Plans 2.78 other 2.78 2.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXAZEPAM 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63323-478-27 NDC GY 1 UN inpatient 2.76 2.7 All Payors / Plans All Payors / Plans 2.76 other 2.76 2.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXAZEPAM 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0641-1398-31 NDC GY 1 UN inpatient 7.01 6.87 All Payors / Plans All Payors / Plans 7.01 other 7.01 7.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXAZEPAM 15 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-3300-01 NDC GY 1 UN inpatient 9.18 9 All Payors / Plans All Payors / Plans 9.18 other 9.18 9.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXCARBAZEPINE 150 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-3300-24 NDC GY 1 UN inpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXCARBAZEPINE 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-4777-23 NDC GY 1 UN inpatient 2.61 2.56 All Payors / Plans All Payors / Plans 2.61 other 2.61 2.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXCARBAZEPINE 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-9549-50 NDC GY 1 UN inpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXCARBAZEPINE 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-9549-60 NDC GY 2 UN inpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYBUTYNIN 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-3410-24 NDC GY 1 UN inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYBUTYNIN 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-3410-50 NDC GY 1 UN inpatient 1.87 1.83 All Payors / Plans All Payors / Plans 1.87 other 1.87 1.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYBUTYNIN 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-3612-50 NDC GY 1 UN inpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-3814-50 NDC GY 1 UN inpatient 2.02 1.98 All Payors / Plans All Payors / Plans 2.02 other 2.02 2.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0781-3289-91 NDC GY 1 UN inpatient 3.39 3.32 All Payors / Plans All Payors / Plans 3.39 other 3.39 3.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0781-3290-91 NDC GY 1 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 71104-922-01 NDC GY 1 UN inpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 71104-911-01 NDC GY 1 UN inpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0548-5900-00 NDC GY 1 UN inpatient 1.85 1.81 All Payors / Plans All Payors / Plans 1.85 other 1.85 1.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OXYCODONE ER 10 MG TABLET,ORAL ONLY,EXT.REL.12 HR" ERX-637000000 CDM A9270 CPT 637 RC 0517-0031-01 NDC GY 1 UN inpatient 10.49 10.28 All Payors / Plans All Payors / Plans 10.49 other 10.49 10.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OXYCODONE ER 10 MG TABLET,ORAL ONLY,EXT.REL.12 HR" ERX-637000000 CDM A9270 CPT 637 RC 0517-0031-25 NDC GY 1 UN inpatient 10.59 10.38 All Payors / Plans All Payors / Plans 10.59 other 10.59 10.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 16714-857-01 NDC GY 1 UN inpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 16714-859-01 NDC GY 1 UN inpatient 1.83 1.79 All Payors / Plans All Payors / Plans 1.83 other 1.83 1.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PALIPERIDONE 1.5 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 0338-0089-03 NDC GY 2 UN inpatient 17.24 16.9 All Payors / Plans All Payors / Plans 17.24 other 17.24 17.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PALIPERIDONE 3 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 0409-7941-03 NDC GY 1 UN inpatient 20.77 20.35 All Payors / Plans All Payors / Plans 20.77 other 20.77 20.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PALIPERIDONE 6 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 63323-870-74 NDC GY 1 UN inpatient 17.26 16.91 All Payors / Plans All Payors / Plans 17.26 other 17.26 17.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PANCRELIPASE (LIP-PROT-AMYL) 12,000-38,000 -60,000 UNIT CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 43598-413-11 NDC GY 1 UN inpatient 10.64 10.43 All Payors / Plans All Payors / Plans 10.64 other 10.64 10.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PANCRELIPASE (LIP-PROT-AMYL) 6,000-19,000 -30,000 UNIT CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 60505-6229-4 NDC GY 1 UN inpatient 8.63 8.46 All Payors / Plans All Payors / Plans 8.63 other 8.63 8.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PANTOPRAZOLE 20 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 70594-034-01 NDC GY 1 UN inpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 55513-032-01 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 55513-025-01 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 55513-028-01 NDC GY 1 UN inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAROXETINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55513-057-01 NDC GY 1 UN inpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAROXETINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55513-111-01 NDC GY 2 UN inpatient 5.25 5.15 All Payors / Plans All Payors / Plans 5.25 other 5.25 5.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAROXETINE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55513-021-01 NDC GY 1 UN inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAROXETINE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55513-023-01 NDC GY 1 UN inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PENICILLIN V POTASSIUM 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55513-730-01 NDC GY 1 UN inpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PENICILLIN V POTASSIUM 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55513-710-01 NDC GY 2 UN inpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PERPHENAZINE PER 4 MG ERX-637000000 CDM A9270 CPT 637 RC 55513-710-21 NDC GY 1 UN inpatient 2.65 2.6 All Payors / Plans All Payors / Plans 2.65 other 2.65 2.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PERPHENAZINE PER 8 MG ERX-637000000 CDM A9270 CPT 637 RC 43598-931-11 NDC GY 1 UN inpatient 4.22 4.14 All Payors / Plans All Payors / Plans 4.22 other 4.22 4.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENAZOPYRIDINE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0054-4184-25 NDC GY 1 UN inpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENAZOPYRIDINE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0054-8175-25 NDC GY 1 UN inpatient 2.01 1.97 All Payors / Plans All Payors / Plans 2.01 other 2.01 2.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENOBARBITAL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6145-01 NDC GY 1 UN inpatient 2.65 2.6 All Payors / Plans All Payors / Plans 2.65 other 2.65 2.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENOBARBITAL 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6145-25 NDC GY 0.5 UN inpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENOBARBITAL 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-165-01 NDC GY 2 UN inpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENOBARBITAL 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 67457-423-00 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYTOIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0338-0089-04 NDC GY 2 UN inpatient 13.59 13.32 All Payors / Plans All Payors / Plans 13.59 other 13.59 13.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYTOIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63323-624-04 NDC GY 2 UN inpatient 3.82 3.74 All Payors / Plans All Payors / Plans 3.82 other 3.82 3.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYTOIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63323-624-06 NDC GY 2 UN inpatient 3.71 3.64 All Payors / Plans All Payors / Plans 3.71 other 3.71 3.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PHENYTOIN 50 MG TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 0409-1273-03 NDC GY 2 UN inpatient 6.92 6.78 All Payors / Plans All Payors / Plans 6.92 other 6.92 6.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHYTONADIONE (VITAMIN K1) 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1273-32 NDC GY 0.5 UN inpatient 29.78 29.18 All Payors / Plans All Payors / Plans 29.78 other 29.78 29.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PILOCARPINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6244-01 NDC GY 1 UN inpatient 8.89 8.71 All Payors / Plans All Payors / Plans 8.89 other 8.89 8.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PINDOLOL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 76045-204-00 NDC GY 1 UN inpatient 4.05 3.97 All Payors / Plans All Payors / Plans 4.05 other 4.05 4.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIOGLITAZONE 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-1980-01 NDC GY 1 UN inpatient 5.02 4.92 All Payors / Plans All Payors / Plans 5.02 other 5.02 5.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POLYETHYLENE GLYCOL 17 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 0641-6173-01 NDC GY 0.235294118 UN inpatient 0.8 0.78 All Payors / Plans All Payors / Plans 0.8 other 0.8 0.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POLYETHYLENE GLYCOL 17 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 0641-6173-10 NDC GY 1 UN inpatient 3.48 3.41 All Payors / Plans All Payors / Plans 3.48 other 3.48 3.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POLYETHYLENE GLYCOL 17 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 72266-127-01 NDC GY 0.5 UN inpatient 1.66 1.63 All Payors / Plans All Payors / Plans 1.66 other 1.66 1.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POLYETHYLENE GLYCOL 236-22.74-6.74 -5.86 GRAM RECON SOLN ERX-637000000 CDM A9270 CPT 637 RC 0904-2056-61 NDC GY 0.0625 UN inpatient 10.31 10.1 All Payors / Plans All Payors / Plans 10.31 other 10.31 10.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM BICARB-CITRIC ACID 10 MEQ TABLET, EFFERVESCENT" ERX-637000000 CDM A9270 CPT 637 RC 63323-664-01 NDC GY 4 UN inpatient 7.94 7.78 All Payors / Plans All Payors / Plans 7.94 other 7.94 7.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM BICARB-CITRIC ACID 20 MEQ TABLET, EFFERVESCENT" ERX-637000000 CDM A9270 CPT 637 RC 72485-101-25 NDC GY 0.5 UN inpatient 1.28 1.25 All Payors / Plans All Payors / Plans 1.28 other 1.28 1.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM BICARB-CITRIC ACID 20 MEQ TABLET, EFFERVESCENT" ERX-637000000 CDM A9270 CPT 637 RC 58160-842-43 NDC GY 1 UN inpatient 2.55 2.5 All Payors / Plans All Payors / Plans 2.55 other 2.55 2.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM CHLORIDE 10 MEQ TABLET,ER PARTICLES/CRYSTALS" ERX-637000000 CDM A9270 CPT 637 RC 58160-842-52 NDC GY 1 UN inpatient 1.08 1.06 All Payors / Plans All Payors / Plans 1.08 other 1.08 1.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM CHLORIDE 10 MEQ TABLET,ER PARTICLES/CRYSTALS" ERX-637000000 CDM A9270 CPT 637 RC 63323-883-05 NDC GY 1 UN inpatient 1.08 1.06 All Payors / Plans All Payors / Plans 1.08 other 1.08 1.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM CHLORIDE 20 MEQ TABLET,ER PARTICLES/CRYSTALS" ERX-637000000 CDM A9270 CPT 637 RC 0069-3032-20 NDC GY 1 UN inpatient 1.83 1.79 All Payors / Plans All Payors / Plans 1.83 other 1.83 1.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM CHLORIDE 20 MEQ TABLET,ER PARTICLES/CRYSTALS" ERX-637000000 CDM A9270 CPT 637 RC 47335-049-40 NDC GY 0.5 UN inpatient 0.56 0.55 All Payors / Plans All Payors / Plans 0.56 other 0.56 0.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM CHLORIDE 20 MEQ TABLET,ER PARTICLES/CRYSTALS" ERX-637000000 CDM A9270 CPT 637 RC 47335-050-40 NDC GY 2 UN inpatient 2.28 2.23 All Payors / Plans All Payors / Plans 2.28 other 2.28 2.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM CITRATE 10 MEQ (1,080 MG) TABLET EXTENDED RELEASE" ERX-637000000 CDM A9270 CPT 637 RC 70710-1531-1 NDC GY 1 UN inpatient 6.99 6.85 All Payors / Plans All Payors / Plans 6.99 other 6.99 6.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM, SODIUM PHOSPHATES 280-160-250 MG POWDER IN PACKET" ERX-637000000 CDM A9270 CPT 637 RC 0517-9702-01 NDC GY 1 UN inpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM, SODIUM PHOSPHATES 280-160-250 MG POWDER IN PACKET" ERX-637000000 CDM A9270 CPT 637 RC 0517-9702-25 NDC GY 1 UN inpatient 4.21 4.13 All Payors / Plans All Payors / Plans 4.21 other 4.21 4.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM, SODIUM PHOSPHATES 280-160-250 MG POWDER IN PACKET" ERX-637000000 CDM A9270 CPT 637 RC 58160-811-43 NDC GY 1 UN inpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAMIPEXOLE 0.125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0075-0621-60 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAMIPEXOLE 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0075-2915-00 NDC GY 1 UN inpatient 3.39 3.32 All Payors / Plans All Payors / Plans 3.39 other 3.39 3.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRASUGREL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0075-8025-10 NDC GY 1 UN inpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0548-5602-00 NDC GY 1 UN inpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAZOSIN 1 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0548-5604-00 NDC GY 1 UN inpatient 4.96 4.86 All Payors / Plans All Payors / Plans 4.96 other 4.96 4.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAZOSIN 1 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-006-01 NDC GY 1 UN inpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAZOSIN 1 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-006-10 NDC GY 1 UN inpatient 4.24 4.16 All Payors / Plans All Payors / Plans 4.24 other 4.24 4.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAZOSIN 2 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-016-01 NDC GY 1 UN inpatient 6.85 6.71 All Payors / Plans All Payors / Plans 6.85 other 6.85 6.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAZOSIN 2 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-026-01 NDC GY 1 UN inpatient 6.85 6.71 All Payors / Plans All Payors / Plans 6.85 other 6.85 6.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAZOSIN 5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-036-01 NDC GY 1 UN inpatient 9.93 9.73 All Payors / Plans All Payors / Plans 9.93 other 9.93 9.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-046-01 NDC GY 2 UN inpatient 5.19 5.09 All Payors / Plans All Payors / Plans 5.19 other 5.19 5.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-056-01 NDC GY 1 UN inpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-056-10 NDC GY 1 UN inpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-066-01 NDC GY 1 UN inpatient 1.93 1.89 All Payors / Plans All Payors / Plans 1.93 other 1.93 1.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 71839-110-10 NDC GY 1 UN inpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 76329-3318-1 NDC GY 1 UN inpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 49502-101-01 NDC GY 1 UN inpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 75 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0115-1694-30 NDC GY 1 UN inpatient 2.05 2.01 All Payors / Plans All Payors / Plans 2.05 other 2.05 2.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 75 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0115-1694-49 NDC GY 2 UN inpatient 3.81 3.73 All Payors / Plans All Payors / Plans 3.81 other 3.81 3.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 75 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 42023-159-25 NDC GY 1 UN inpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRENATAL VITAMIN WITH IRON AND FOLIC ACID 27 MG IRON- 800 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 54288-103-10 NDC GY 1 UN inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRENATAL VITAMIN WITH IRON AND FOLIC ACID 27 MG IRON- 800 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59676-310-00 NDC GY 1 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRENATAL VITAMIN WITH IRON AND FOLIC ACID 27 MG IRON- 800 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0143-9398-01 NDC GY 1 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRIMIDONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0143-9398-10 NDC GY 1 UN inpatient 2.63 2.58 All Payors / Plans All Payors / Plans 2.63 other 2.63 2.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROCHLORPERAZINE MALEATE PER 10 MG ERX-637000000 CDM A9270 CPT 637 RC 60505-6196-0 NDC GY 0.5 UN inpatient 1.71 1.68 All Payors / Plans All Payors / Plans 1.71 other 1.71 1.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROCHLORPERAZINE MALEATE PER 10 MG ERX-637000000 CDM A9270 CPT 637 RC 55150-194-10 NDC GY 1 UN inpatient 2.56 2.51 All Payors / Plans All Payors / Plans 2.56 other 2.56 2.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROCHLORPERAZINE MALEATE PER 5 MG ERX-637000000 CDM A9270 CPT 637 RC 67457-182-10 NDC GY 1 UN inpatient 3.35 3.28 All Payors / Plans All Payors / Plans 3.35 other 3.35 3.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROMETHAZINE 2 (TWO) 25 MG TABLETS ERX-637000000 CDM A9270 CPT 637 RC 63323-739-11 NDC GY 2 UN inpatient 1.93 1.89 All Payors / Plans All Payors / Plans 1.93 other 1.93 1.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROMETHAZINE 25 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 63323-739-12 NDC GY 1 UN inpatient 18.62 18.25 All Payors / Plans All Payors / Plans 18.62 other 18.62 18.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROMETHAZINE 25 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 0338-5197-41 NDC GY 0.5 UN inpatient 5.69 5.58 All Payors / Plans All Payors / Plans 5.69 other 5.69 5.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROMETHAZINE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 0409-9094-22 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPAFENONE 150 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-9094-25 NDC GY 1 UN inpatient 2.59 2.54 All Payors / Plans All Payors / Plans 2.59 other 2.59 2.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPRANOLOL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6027-01 NDC GY 1 UN inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPRANOLOL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6028-01 NDC GY 1 UN inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPRANOLOL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6247-01 NDC GY 1 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPRANOLOL 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-806-11 NDC GY 1 UN inpatient 1.87 1.83 All Payors / Plans All Payors / Plans 1.87 other 1.87 1.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPRANOLOL 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-806-12 NDC GY 1 UN inpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPRANOLOL 80 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-0650-01 NDC GY 1 UN inpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PROPRANOLOL LA 60 MG CAPSULE,EXTENDED RELEASE 24 HR" ERX-637000000 CDM A9270 CPT 637 RC 61314-318-01 NDC GY 1 UN inpatient 7.02 6.88 All Payors / Plans All Payors / Plans 7.02 other 7.02 7.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PROPRANOLOL LA 80 MG CAPSULE,EXTENDED RELEASE 24 HR" ERX-637000000 CDM A9270 CPT 637 RC 61314-326-01 NDC GY 1 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PROPRANOLOL LA 80 MG CAPSULE,EXTENDED RELEASE 24 HR" ERX-637000000 CDM A9270 CPT 637 RC 0338-6045-37 NDC GY 1 UN inpatient 8.63 8.46 All Payors / Plans All Payors / Plans 8.63 other 8.63 8.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PSEUDOEPHEDRINE 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-117-00 NDC GY 1 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PSEUDOEPHEDRINE 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-117-20 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PYRAZINAMIDE 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0069-6001-10 NDC GY 3 UN inpatient 30.79 30.17 All Payors / Plans All Payors / Plans 30.79 other 30.79 30.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PYRIDOSTIGMINE 60 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0143-9022-02 NDC GY 1 UN inpatient 3.31 3.24 All Payors / Plans All Payors / Plans 3.31 other 3.31 3.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PYRIDOSTIGMINE 60 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 43598-262-02 NDC GY 1 UN inpatient 2.74 2.69 All Payors / Plans All Payors / Plans 2.74 other 2.74 2.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PYRIDOXINE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 43598-262-11 NDC GY 1 UN inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PYRIDOXINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70121-1463-2 NDC GY 1 UN inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-6102-18 NDC GY 1 UN inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-6102-19 NDC GY 1 UN inpatient 2.76 2.7 All Payors / Plans All Payors / Plans 2.76 other 2.76 2.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 16729-500-08 NDC GY 1 UN inpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 16729-500-30 NDC GY 1 UN inpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 23155-473-31 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 23155-473-33 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE XR 200 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 25021-311-10 NDC GY 1 UN inpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE XR 300 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 36000-282-25 NDC GY 1 UN inpatient 2.74 2.69 All Payors / Plans All Payors / Plans 2.74 other 2.74 2.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE XR 50 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 36000-283-25 NDC GY 1 UN inpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RALOXIFENE 60 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-280-03 NDC GY 1 UN inpatient 2.77 2.71 All Payors / Plans All Payors / Plans 2.77 other 2.77 2.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RALOXIFENE 60 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-280-04 NDC GY 1 UN inpatient 14.13 13.85 All Payors / Plans All Payors / Plans 14.13 other 14.13 14.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RALTEGRAVIR 400 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72603-133-01 NDC GY 1 UN inpatient 39.79 38.99 All Payors / Plans All Payors / Plans 39.79 other 39.79 39.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RAMIPRIL 1.25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 72603-133-25 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RAMIPRIL 2.5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 72603-251-01 NDC GY 1 UN inpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RAMIPRIL 5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 72603-474-01 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RANOLAZINE 500 MG TABLET EXTENDED RELEASE 12 HR ERX-637000000 CDM A9270 CPT 637 RC 72603-474-25 NDC GY 1 UN inpatient 4.19 4.11 All Payors / Plans All Payors / Plans 4.19 other 4.19 4.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility REPAGLINIDE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-0181-01 NDC GY 1 UN inpatient 8.99 8.81 All Payors / Plans All Payors / Plans 8.99 other 8.99 8.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIFABUTIN 150 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-0183-01 NDC GY 2 UN inpatient 32.92 32.26 All Payors / Plans All Payors / Plans 32.92 other 32.92 32.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIFAMPIN 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0338-0511-41 NDC GY 1 UN inpatient 6.93 6.79 All Payors / Plans All Payors / Plans 6.93 other 6.93 6.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIFAXIMIN 550 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1207-03 NDC GY 1 UN inpatient 59.46 58.27 All Payors / Plans All Payors / Plans 59.46 other 59.46 59.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RISPERIDONE 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1207-13 NDC GY 0.5 UN inpatient 1.08 1.06 All Payors / Plans All Payors / Plans 1.08 other 1.08 1.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "RISPERIDONE 0.5 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 63323-010-02 NDC GY 1 UN inpatient 4.2 4.12 All Payors / Plans All Payors / Plans 4.2 other 4.2 4.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RISPERIDONE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0548-5850-00 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "RISPERIDONE 1 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 63323-593-03 NDC GY 1 UN inpatient 2.66 2.61 All Payors / Plans All Payors / Plans 2.66 other 2.66 2.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "RISPERIDONE 1 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 63323-596-03 NDC GY 1 UN inpatient 4.24 4.16 All Payors / Plans All Payors / Plans 4.24 other 4.24 4.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RISPERIDONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0143-9682-01 NDC GY 1 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RISPERIDONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70720-951-30 NDC GY 1 UN inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RISPERIDONE 3 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70720-950-36 NDC GY 0.5 UN inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RISPERIDONE 3 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 49281-547-58 NDC GY 0.5 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIVAROXABAN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 67457-426-00 NDC GY 1 UN inpatient 22.69 22.24 All Payors / Plans All Payors / Plans 22.69 other 22.69 22.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIVAROXABAN 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-2723-01 NDC GY 1 UN inpatient 22.69 22.24 All Payors / Plans All Payors / Plans 22.69 other 22.69 22.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIVAROXABAN 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-2723-30 NDC GY 1 UN inpatient 22.69 22.24 All Payors / Plans All Payors / Plans 22.69 other 22.69 22.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIVAROXABAN 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-0391-12 NDC GY 1 UN inpatient 22.69 22.24 All Payors / Plans All Payors / Plans 22.69 other 22.69 22.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIVAROXABAN 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 25021-402-01 NDC GY 1 UN inpatient 15.78 15.46 All Payors / Plans All Payors / Plans 15.78 other 15.78 15.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIVAROXABAN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-519-01 NDC GY 1 UN inpatient 22.23 21.79 All Payors / Plans All Payors / Plans 22.23 other 22.23 22.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPINIROLE 0.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-523-01 NDC GY 1 UN inpatient 1.84 1.8 All Payors / Plans All Payors / Plans 1.84 other 1.84 1.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPINIROLE 0.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-953-11 NDC GY 1 UN inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPINIROLE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-953-25 NDC GY 1 UN inpatient 1.89 1.85 All Payors / Plans All Payors / Plans 1.89 other 1.89 1.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPINIROLE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 71288-403-01 NDC GY 1 UN inpatient 1.83 1.79 All Payors / Plans All Payors / Plans 1.83 other 1.83 1.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 71288-422-95 NDC GY 1 UN inpatient 3.45 3.38 All Payors / Plans All Payors / Plans 3.45 other 3.45 3.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 25021-400-01 NDC GY 1 UN inpatient 3.45 3.38 All Payors / Plans All Payors / Plans 3.45 other 3.45 3.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 6380750055 NDC GY 1 UN inpatient 3.45 3.38 All Payors / Plans All Payors / Plans 3.45 other 3.45 3.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 6425322233 NDC GY 1 UN inpatient 2.02 1.98 All Payors / Plans All Payors / Plans 2.02 other 2.02 2.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 6425322235 NDC GY 2 UN inpatient 8.49 8.32 All Payors / Plans All Payors / Plans 8.49 other 8.49 8.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 8290306413 NDC GY 1 UN inpatient 4.25 4.17 All Payors / Plans All Payors / Plans 4.25 other 4.25 4.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 6425333335 NDC GY 1 UN inpatient 4.24 4.16 All Payors / Plans All Payors / Plans 4.24 other 4.24 4.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 58160-820-43 NDC GY 1 UN inpatient 2.54 2.49 All Payors / Plans All Payors / Plans 2.54 other 2.54 2.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 58160-820-52 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63833-387-02 NDC GY 1 UN inpatient 2.68 2.63 All Payors / Plans All Payors / Plans 2.68 other 2.68 2.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63833-397-01 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SACUBITRIL-VALSARTAN 24-26 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63833-386-02 NDC GY 1 UN inpatient 19.42 19.03 All Payors / Plans All Payors / Plans 19.42 other 19.42 19.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SACUBITRIL-VALSARTAN 49-51 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63833-396-01 NDC GY 1 UN inpatient 19.42 19.03 All Payors / Plans All Payors / Plans 19.42 other 19.42 19.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SACUBITRIL-VALSARTAN 97-103 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 18657-117-01 NDC GY 1 UN inpatient 19.42 19.03 All Payors / Plans All Payors / Plans 19.42 other 19.42 19.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCOPOLAMINE BASE 1 MG OVER 3 DAYS PATCH 3 DAY ERX-637000000 CDM A9270 CPT 637 RC 0517-0901-01 NDC GY 1 UN inpatient 14.01 13.73 All Payors / Plans All Payors / Plans 14.01 other 14.01 14.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCOPOLAMINE BASE 1 MG OVER 3 DAYS PATCH 3 DAY ERX-637000000 CDM A9270 CPT 637 RC 0641-6231-01 NDC GY 1 UN inpatient 28.04 27.48 All Payors / Plans All Payors / Plans 28.04 other 28.04 28.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCOPOLAMINE BASE 1 MG OVER 3 DAYS PATCH 3 DAY ERX-637000000 CDM A9270 CPT 637 RC 0641-6231-25 NDC GY 1 UN inpatient 14.03 13.75 All Payors / Plans All Payors / Plans 14.03 other 14.03 14.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SELEGILINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55150-400-01 NDC GY 1 UN inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SELEGILINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-614-01 NDC GY 1 UN inpatient 6.65 6.52 All Payors / Plans All Payors / Plans 6.65 other 6.65 6.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SENNA 8.6 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0009-0011-03 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SENNA 8.6 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0009-0011-04 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0009-0016-12 NDC GY 2 UN inpatient 1.78 1.74 All Payors / Plans All Payors / Plans 1.78 other 1.78 1.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1312-30 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1283-31 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-5601-25 NDC GY 1 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SERTRALINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44567-705-01 NDC GY 1 UN inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SERTRALINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44567-705-10 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SERTRALINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-322-01 NDC GY 1 UN inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SERTRALINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-437-10 NDC GY 1 UN inpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SERTRALINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-437-91 NDC GY 1 UN inpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEVELAMER 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-438-20 NDC GY 1 UN inpatient 2.72 2.67 All Payors / Plans All Payors / Plans 2.72 other 2.72 2.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEVELAMER 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-438-92 NDC GY 1 UN inpatient 9.12 8.94 All Payors / Plans All Payors / Plans 9.12 other 9.12 9.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEVELAMER 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-439-40 NDC GY 1 UN inpatient 2.77 2.71 All Payors / Plans All Payors / Plans 2.77 other 2.77 2.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEVELAMER 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-439-93 NDC GY 1 UN inpatient 9.3 9.11 All Payors / Plans All Payors / Plans 9.3 other 9.3 9.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEVELAMER CARBONATE 0.8 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 49281-423-88 NDC GY 1 UN inpatient 4.18 4.1 All Payors / Plans All Payors / Plans 4.18 other 4.18 4.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SILDENAFIL (PULM.HYPERTENSION) 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 49281-424-88 NDC GY 1 UN inpatient 2.59 2.54 All Payors / Plans All Payors / Plans 2.59 other 2.59 2.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SILVER NITRATE 75-25 % STICK ERX-637000000 CDM A9270 CPT 637 RC 60505-6128-0 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SIMETHICONE 80 MG TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 60505-6128-1 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SIMETHICONE 80 MG TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 0517-2310-05 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIMVASTATIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-2340-01 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIMVASTATIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-2340-10 NDC GY 0.5 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIMVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-0069-10 NDC GY 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIMVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-0072-25 NDC GY 2 UN inpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIMVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-3793-19 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIMVASTATIN 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-3795-19 NDC GY 1 UN inpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SITAGLIPTIN PHOSPHATE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 25021-700-01 NDC GY 1 UN inpatient 26.62 26.09 All Payors / Plans All Payors / Plans 26.62 other 26.62 26.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SITAGLIPTIN PHOSPHATE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-161-00 NDC GY 1 UN inpatient 26.62 26.09 All Payors / Plans All Payors / Plans 26.62 other 26.62 26.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SOD PHOS DI, MONO-K PHOS MONO 250 MG TABLET" ERX-637000000 CDM A9270 CPT 637 RC 68462-756-01 NDC GY 1 UN inpatient 2.72 2.67 All Payors / Plans All Payors / Plans 2.72 other 2.72 2.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 650 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-756-25 NDC GY 1 UN inpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 650 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72266-118-01 NDC GY 1 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 650 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72266-118-25 NDC GY 1 UN inpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 650 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72266-119-01 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SODIUM CHLORIDE 1,000 MG TABLET,SOLUBLE" ERX-637000000 CDM A9270 CPT 637 RC 72266-119-25 NDC GY 1 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SODIUM CHLORIDE 1,000 MG TABLET,SOLUBLE" ERX-637000000 CDM A9270 CPT 637 RC 72266-234-01 NDC GY 2 UN inpatient 2.14 2.1 All Payors / Plans All Payors / Plans 2.14 other 2.14 2.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SODIUM CHLORIDE 1,000 MG TABLET,SOLUBLE" ERX-637000000 CDM A9270 CPT 637 RC 72266-234-25 NDC GY 1 UN inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 72611-722-25 NDC GY 1 UN inpatient 10.88 10.66 All Payors / Plans All Payors / Plans 10.88 other 10.88 10.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 36000-320-01 NDC GY 1 UN inpatient 10.93 10.71 All Payors / Plans All Payors / Plans 10.93 other 10.93 10.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM ZIRCONIUM CYCLOSILICATE 5 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 25021-791-20 NDC GY 1 UN inpatient 10.93 10.71 All Payors / Plans All Payors / Plans 10.93 other 10.93 10.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOTALOL 80 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69543-455-20 NDC GY 0.5 UN inpatient 3.53 3.46 All Payors / Plans All Payors / Plans 3.53 other 3.53 3.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOTALOL 80 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-0117-03 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPIRONOLACTONE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-0117-04 NDC GY 1 UN inpatient 2.56 2.51 All Payors / Plans All Payors / Plans 2.56 other 2.56 2.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPIRONOLACTONE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65219-479-05 NDC GY 0.5 UN inpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPIRONOLACTONE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 15054-1120-4 NDC GY 2 UN inpatient 2.12 2.08 All Payors / Plans All Payors / Plans 2.12 other 2.12 2.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPIRONOLACTONE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 58468-0070-1 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPIRONOLACTONE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-711-00 NDC GY 1 UN inpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCRALFATE 1 GRAM TABLET ERX-637000000 CDM A9270 CPT 637 RC 67457-528-10 NDC GY 1 UN inpatient 1.83 1.79 All Payors / Plans All Payors / Plans 1.83 other 1.83 1.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCRALFATE 1 GRAM TABLET ERX-637000000 CDM A9270 CPT 637 RC 62935-227-10 NDC GY 1 UN inpatient 10.33 10.12 All Payors / Plans All Payors / Plans 10.33 other 10.33 10.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62935-306-40 NDC GY 1 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62935-756-80 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0074-3663-03 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFASALAZINE 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0074-3641-03 NDC GY 1 UN inpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUMATRIPTAN 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1886-02 NDC GY 1 UN inpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUMATRIPTAN 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1886-22 NDC GY 1 UN inpatient 1.85 1.81 All Payors / Plans All Payors / Plans 1.85 other 1.85 1.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAMOXIFEN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-885-10 NDC GY 2 UN inpatient 2.07 2.03 All Payors / Plans All Payors / Plans 2.07 other 2.07 2.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAMSULOSIN 0.4 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63323-890-10 NDC GY 1 UN inpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAMSULOSIN 0.4 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-4279-02 NDC GY 1 UN inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TEMAZEPAM 15 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-4713-02 NDC GY 2 UN inpatient 1.92 1.88 All Payors / Plans All Payors / Plans 1.92 other 1.92 1.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TEMAZEPAM 7.5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-4713-12 NDC GY 1 UN inpatient 8.74 8.57 All Payors / Plans All Payors / Plans 8.74 other 8.74 8.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TERAZOSIN 1 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 55150-161-02 NDC GY 1 UN inpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TERAZOSIN 1 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 55150-162-05 NDC GY 1 UN inpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TERAZOSIN 5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63323-492-04 NDC GY 1 UN inpatient 2.63 2.58 All Payors / Plans All Payors / Plans 2.63 other 2.63 2.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THIAMINE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-492-07 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-492-09 NDC GY 0.5 UN inpatient 0.51 0.5 All Payors / Plans All Payors / Plans 0.51 other 0.51 0.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THIOTHIXENE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63323-492-27 NDC GY 1 UN inpatient 6.92 6.78 All Payors / Plans All Payors / Plans 6.92 other 6.92 6.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THYROID (PORK) 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-492-41 NDC GY 1 UN inpatient 3.49 3.42 All Payors / Plans All Payors / Plans 3.49 other 3.49 3.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THYROID (PORK) 60 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-492-57 NDC GY 1 UN inpatient 3.32 3.25 All Payors / Plans All Payors / Plans 3.32 other 3.32 3.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIZANIDINE 4 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69623-191-37 NDC GY 0.5 UN inpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIZANIDINE 4 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 83090-003-10 NDC GY 1 UN inpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOLTERODINE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55150-242-51 NDC GY 1 UN inpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOPIRAMATE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1985-03 NDC GY 1 UN inpatient 1.93 1.89 All Payors / Plans All Payors / Plans 1.93 other 1.93 1.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOPIRAMATE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 0641-6001-01 NDC GY 1 UN inpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOPIRAMATE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 0641-6044-01 NDC GY 1 UN inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOPIRAMATE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 0641-6044-25 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOPIRAMATE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 0641-6207-01 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TORSEMIDE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-108-01 NDC GY 1 UN inpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TORSEMIDE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-106-01 NDC GY 1 UN inpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TORSEMIDE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-2168-17 NDC GY 2 UN inpatient 2.24 2.2 All Payors / Plans All Payors / Plans 2.24 other 2.24 2.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TORSEMIDE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-064-01 NDC GY 1 UN inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAMADOL 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-064-03 NDC GY 1 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAMADOL 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-064-04 NDC GY 0.5 UN inpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAMADOL 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-642-01 NDC GY 1 UN inpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAMADOL 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-4031-01 NDC GY 1 UN inpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAZODONE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-4031-16 NDC GY 1 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAZODONE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0006-4681-01 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAZODONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0009-0746-30 NDC GY 1 UN inpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAZODONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55150-329-01 NDC GY 1 UN inpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAZODONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 67457-887-00 NDC GY 1 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 58160-976-02 NDC GY 1 UN inpatient 3.35 3.28 All Payors / Plans All Payors / Plans 3.35 other 3.35 3.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRIAMTERENE-HYDROCHLOROTHIAZIDE 75-50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6052-01 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ULIPRISTAL 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 47335-235-83 NDC GY 1 UN inpatient 44.86 43.96 All Payors / Plans All Payors / Plans 44.86 other 44.86 44.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility URSODIOL 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0143-9519-01 NDC GY 1 UN inpatient 10.07 9.87 All Payors / Plans All Payors / Plans 10.07 other 10.07 10.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALACYCLOVIR 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-0740-01 NDC GY 1 UN inpatient 8.95 8.77 All Payors / Plans All Payors / Plans 8.95 other 8.95 8.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALPROIC ACID 250 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0517-0740-20 NDC GY 2 UN inpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALSARTAN 160 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59746-001-06 NDC GY 1 UN inpatient 4.08 4 All Payors / Plans All Payors / Plans 4.08 other 4.08 4.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALSARTAN 320 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68382-916-01 NDC GY 1 UN inpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALSARTAN 320 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70121-1573-1 NDC GY 1 UN inpatient 2.56 2.51 All Payors / Plans All Payors / Plans 2.56 other 2.56 2.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALSARTAN 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70121-1573-5 NDC GY 1 UN inpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALSARTAN 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0009-0018-20 NDC GY 1 UN inpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALSARTAN 80 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0009-0047-22 NDC GY 1 UN inpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 125 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0009-0047-25 NDC GY 1 UN inpatient 9.11 8.93 All Payors / Plans All Payors / Plans 9.11 other 9.11 9.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 125 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0009-0039-28 NDC GY 1 UN inpatient 8.9 8.72 All Payors / Plans All Payors / Plans 8.9 other 8.9 8.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 125 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0009-0039-30 NDC GY 1 UN inpatient 4.07 3.99 All Payors / Plans All Payors / Plans 4.07 other 4.07 4.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VARENICLINE 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-3414-01 NDC GY 1 UN inpatient 3.55 3.48 All Payors / Plans All Payors / Plans 3.55 other 3.55 3.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VENLAFAXINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-3414-11 NDC GY 1 UN inpatient 3.45 3.38 All Payors / Plans All Payors / Plans 3.45 other 3.45 3.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VENLAFAXINE 37.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-3414-18 NDC GY 1 UN inpatient 2 1.96 All Payors / Plans All Payors / Plans 2 other 2 2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VENLAFAXINE 75 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-3414-21 NDC GY 1 UN inpatient 2.71 2.66 All Payors / Plans All Payors / Plans 2.71 other 2.71 2.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "VENLAFAXINE XR 150 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 0703-4502-01 NDC GY 0.75 UN inpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "VENLAFAXINE XR 37.5 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 23155-240-31 NDC GY 1 UN inpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "VENLAFAXINE XR 37.5 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 23155-240-41 NDC GY 1 UN inpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "VENLAFAXINE XR 75 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 0338-1055-48 NDC GY 1 UN inpatient 1.98 1.94 All Payors / Plans All Payors / Plans 1.98 other 1.98 1.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERAPAMIL 120 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-0152-01 NDC GY 1 UN inpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERAPAMIL 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 47335-993-01 NDC GY 1 UN inpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERAPAMIL 80 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0143-9362-01 NDC GY 1 UN inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERAPAMIL SR 120 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 63323-729-01 NDC GY 1 UN inpatient 1.92 1.88 All Payors / Plans All Payors / Plans 1.92 other 1.92 1.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERAPAMIL SR 180 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 0469-3250-10 NDC GY 1 UN inpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERAPAMIL SR 240 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 25021-190-10 NDC GY 1 UN inpatient 1.83 1.79 All Payors / Plans All Payors / Plans 1.83 other 1.83 1.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VIT B COMP NO.3-FOLIC-C-BIOTIN 1-60-300 MG-MG-MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-2305-04 NDC GY 1 UN inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VITAMIN E 180 MG (400 UNIT) CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-2305-05 NDC GY 1 UN inpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VORICONAZOLE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-2305-16 NDC GY 1 UN inpatient 16.37 16.04 All Payors / Plans All Payors / Plans 16.37 other 16.37 16.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VORICONAZOLE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-2305-17 NDC GY 6 UN inpatient 25.14 24.64 All Payors / Plans All Payors / Plans 25.14 other 25.14 25.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VORTIOXETINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70069-816-01 NDC GY 1 UN inpatient 24.04 23.56 All Payors / Plans All Payors / Plans 24.04 other 24.04 24.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VORTIOXETINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44567-611-01 NDC GY 1 UN inpatient 24.04 23.56 All Payors / Plans All Payors / Plans 24.04 other 24.04 24.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WARFARIN 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44567-611-10 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WARFARIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-2308-01 NDC GY 1 UN inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WARFARIN 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-2308-21 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WARFARIN 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55150-288-01 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WARFARIN 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55150-288-10 NDC GY 1 UN inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WARFARIN 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1893-03 NDC GY 1 UN inpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WARFARIN 7.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1890-03 NDC GY 1 UN inpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 76329-1912-1 NDC GY 1 UN inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZIPRASIDONE 20 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-1891-01 NDC GY 1 UN inpatient 9.31 9.12 All Payors / Plans All Payors / Plans 9.31 other 9.31 9.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZIPRASIDONE 20 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-1891-03 NDC GY 1 UN inpatient 7.05 6.91 All Payors / Plans All Payors / Plans 7.05 other 7.05 7.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZIPRASIDONE 40 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-3815-12 NDC GY 1 UN inpatient 6.81 6.67 All Payors / Plans All Payors / Plans 6.81 other 6.81 6.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZIPRASIDONE 40 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0641-6127-01 NDC GY 1 UN inpatient 6.81 6.67 All Payors / Plans All Payors / Plans 6.81 other 6.81 6.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZOLPIDEM 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6127-25 NDC GY 1 UN inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZOLPIDEM 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-451-00 NDC GY 1 UN inpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZOLPIDEM 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0143-9570-01 NDC GY 2 UN inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACOSAMIDE 200 MG/20 ML SOLUTION ERX-636000000 CDM C9254 HCPCS 636 RC 0904-6830-61 NDC JZ 5 ML inpatient 25.58 25.07 All Payors / Plans All Payors / Plans 25.58 other 25.58 25.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACOSAMIDE 200 MG/20 ML SOLUTION ERX-636000000 CDM C9254 HCPCS 636 RC 60687-428-11 NDC JZ 20 ML inpatient 145.47 142.56 All Payors / Plans All Payors / Plans 145.47 other 145.47 145.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANGRELOR 50 MG RECON SOLN ERX-636000000 CDM C9460 HCPCS 636 RC 0206-8862-01 NDC JZ 0.02994 UN inpatient 46.99 46.05 All Payors / Plans All Payors / Plans 46.99 other 46.99 46.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANGRELOR 50 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM C9460 HCPCS 636 RC 0781-3113-90 NDC JZ 1 UN inpatient 1569.18 1537.8 All Payors / Plans All Payors / Plans 1569.18 other 1569.18 1569.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) SOLUTION" ERX-636000000 CDM J0131 HCPCS 636 RC 0264-7510-10 NDC 100 ML inpatient 35.45 34.74 All Payors / Plans All Payors / Plans 35.45 other 35.45 35.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) SOLUTION" ERX-636000000 CDM J0131 HCPCS 636 RC 0264-7510-20 NDC 100 ML inpatient 35.92 35.2 All Payors / Plans All Payors / Plans 35.92 other 35.92 35.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETYLCYSTEINE PER 100 MG ERX-636000000 CDM J0132 HCPCS 636 RC 0904-7243-61 NDC JZ 25 ML inpatient 118.81 116.43 All Payors / Plans All Payors / Plans 118.81 other 118.81 118.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACYCLOVIR PER 5 MG ERX-636000000 CDM J0133 HCPCS 636 RC 60687-807-11 NDC JW 1 ML inpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACYCLOVIR PER 5 MG ERX-636000000 CDM J0133 HCPCS 636 RC 0555-0158-02 NDC JW 4 ML inpatient 5.1 5 All Payors / Plans All Payors / Plans 5.1 other 5.1 5.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) SOLUTION" ERX-636000000 CDM J0136 HCPCS 636 RC 51079-141-01 NDC JW 7 ML inpatient 2.18 2.14 All Payors / Plans All Payors / Plans 2.18 other 2.18 2.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) SOLUTION" ERX-636000000 CDM J0137 HCPCS 636 RC 0409-7929-03 NDC 100 ML inpatient 62.8 61.54 All Payors / Plans All Payors / Plans 62.8 other 62.8 62.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADENOSINE PER 6 MG ERX-636000000 CDM J0153 HCPCS 636 RC 43598-326-75 NDC JZ 6 ML inpatient 0.13 0.13 All Payors / Plans All Payors / Plans 0.13 other 0.13 0.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADENOSINE PER 6 MG ERX-636000000 CDM J0153 HCPCS 636 RC 53746-831-53 NDC JZ 2 ML inpatient 30.93 30.31 All Payors / Plans All Payors / Plans 30.93 other 30.93 30.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADENOSINE PER 6 MG ERX-636000000 CDM J0153 HCPCS 636 RC 0904-6084-61 NDC JZ 0.6 ML inpatient 9.28 9.09 All Payors / Plans All Payors / Plans 9.28 other 9.28 9.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE 1 MG/ML SOLUTION ERX-636000000 CDM J0171 HCPCS 636 RC 25021-132-82 NDC 1 ML inpatient 25.77 25.25 All Payors / Plans All Payors / Plans 25.77 other 25.77 25.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE HCL IN 5% DEXTROSE 4 MG/250 ML (16 MCG/ML) SOLUTION ERX-636000000 CDM J0171 HCPCS 636 RC 0338-0409-03 NDC 2 ML inpatient 0.66 0.65 All Payors / Plans All Payors / Plans 0.66 other 0.66 0.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE HCL IN 5% DEXTROSE 4 MG/250 ML (16 MCG/ML) SOLUTION ERX-636000000 CDM J0171 HCPCS 636 RC 57664-683-31 NDC 254 ML inpatient 185.9 182.18 All Payors / Plans All Payors / Plans 185.9 other 185.9 185.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE 0.1 MG/ML SYRINGE ERX-636000000 CDM J0171 HCPCS 636 RC 69339-152-01 NDC JZ 10 ML inpatient 50.17 49.17 All Payors / Plans All Payors / Plans 50.17 other 50.17 50.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE PER 0.1 MG ERX-636000000 CDM J0171 HCPCS 636 RC 71399-0125-8 NDC JZ 0.1 ML inpatient 6.18 6.06 All Payors / Plans All Payors / Plans 6.18 other 6.18 6.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE PER 0.1 MG ERX-636000000 CDM J0171 HCPCS 636 RC 0121-0978-10 NDC JZ 0.3 ML inpatient 13.39 13.12 All Payors / Plans All Payors / Plans 13.39 other 13.39 13.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE 0.15 MG/0.3 ML AUTO-INJECTOR ERX-636000000 CDM J0171 HCPCS 636 RC 63323-269-50 NDC JZ 1 UN inpatient 347.2 340.26 All Payors / Plans All Payors / Plans 347.2 other 347.2 347.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE 0.3 MG/0.3 ML AUTO-INJECTOR ERX-636000000 CDM J0171 HCPCS 636 RC 63323-269-94 NDC JZ 1 UN inpatient 322.38 315.93 All Payors / Plans All Payors / Plans 322.38 other 322.38 322.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE 0.3 MG/0.3 ML AUTO-INJECTOR ERX-636000000 CDM J0171 HCPCS 636 RC 63323-229-01 NDC JZ 1 UN inpatient 307.17 301.03 All Payors / Plans All Payors / Plans 307.17 other 307.17 307.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AGALSIDASE BETA PER 1 MG ERX-636000000 CDM J0180 HCPCS 636 RC 0078-0825-81 NDC JZ 1 UN inpatient 8139.19 7976.41 All Payors / Plans All Payors / Plans 8139.19 other 8139.19 8139.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AGALSIDASE BETA PER 1 MG ERX-636000000 CDM J0180 HCPCS 636 RC 55150-308-01 NDC JZ 5 UN inpatient 8746.2 8571.28 All Payors / Plans All Payors / Plans 8746.2 other 8746.2 8746.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APREPITANT 130 MG/18 ML (7.2 MG/ML) EMULSION ERX-636000000 CDM J0185 HCPCS 636 RC 0009-0760-04 NDC JZ 18 ML inpatient 629.64 617.05 All Payors / Plans All Payors / Plans 629.64 other 629.64 629.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility REMDESIVIR 100 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM J0248 HCPCS 250 RC 63323-377-01 NDC JZ 1 UN inpatient 1283.94 1258.26 All Payors / Plans All Payors / Plans 1283.94 other 1283.94 1283.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMINOPHYLLINE 500 MG/20 ML SOLUTION ERX-636000000 CDM J0280 HCPCS 636 RC 0904-5959-61 NDC JZ 3 ML inpatient 7.46 7.31 All Payors / Plans All Payors / Plans 7.46 other 7.46 7.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMINOPHYLLINE PER 250 MG ERX-636000000 CDM J0280 HCPCS 636 RC 65862-185-01 NDC JZ 3 ML inpatient 19.56 19.17 All Payors / Plans All Payors / Plans 19.56 other 19.56 19.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMIODARONE IN DEXTROSE,ISO-OSM 150 MG/100 ML (1.5 MG/ML) SOLUTION" ERX-636000000 CDM J0283 HCPCS 636 RC 0168-0277-40 NDC JZ 100 ML inpatient 104.65 102.56 All Payors / Plans All Payors / Plans 104.65 other 104.65 104.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMIODARONE IN DEXTROSE,ISO-OSM 360 MG/200 ML (1.8 MG/ML) SOLUTION" ERX-636000000 CDM J0283 HCPCS 636 RC 63629-2391-1 NDC JZ 200 ML inpatient 102.76 100.7 All Payors / Plans All Payors / Plans 102.76 other 102.76 102.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 60687-486-11 NDC 0.5 UN inpatient 5.2 5.1 All Payors / Plans All Payors / Plans 5.2 other 5.2 5.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 68180-968-01 NDC 1 UN inpatient 25.76 25.24 All Payors / Plans All Payors / Plans 25.76 other 25.76 25.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 23155-547-42 NDC JZ 0.29 UN inpatient 0.24 0.24 All Payors / Plans All Payors / Plans 0.24 other 0.24 0.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 60505-6130-0 NDC JZ 0.29 UN inpatient 0.24 0.24 All Payors / Plans All Payors / Plans 0.24 other 0.24 0.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 60505-6130-5 NDC JZ 0.54 UN inpatient 3.19 3.13 All Payors / Plans All Payors / Plans 3.19 other 3.19 3.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 71288-101-10 NDC JZ 1 UN inpatient 15.45 15.14 All Payors / Plans All Payors / Plans 15.45 other 15.45 15.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 42023-116-25 NDC JZ 0.57 UN inpatient 5.79 5.67 All Payors / Plans All Payors / Plans 5.79 other 5.79 5.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 55111-694-07 NDC JZ 1 UN inpatient 15.48 15.17 All Payors / Plans All Payors / Plans 15.48 other 15.48 15.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 61703-325-18 NDC JZ 1 UN inpatient 10.99 10.77 All Payors / Plans All Payors / Plans 10.99 other 10.99 10.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN-SULBACTAM PER 1.5 G ERX-636000000 CDM J0295 HCPCS 636 RC 67457-430-10 NDC JZ 1 UN inpatient 11.09 10.87 All Payors / Plans All Payors / Plans 11.09 other 11.09 11.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN-SULBACTAM PER 1.5 G ERX-636000000 CDM J0295 HCPCS 636 RC 14789-121-05 NDC JZ 1 UN inpatient 20.4 19.99 All Payors / Plans All Payors / Plans 20.4 other 20.4 20.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN-SULBACTAM PER 1.5 G ERX-636000000 CDM J0295 HCPCS 636 RC 55513-190-01 NDC JZ 1 UN inpatient 20.4 19.99 All Payors / Plans All Payors / Plans 20.4 other 20.4 20.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN-SULBACTAM PER 1.5 G ERX-636000000 CDM J0295 HCPCS 636 RC 70114-130-01 NDC JZ 1 UN inpatient 10.53 10.32 All Payors / Plans All Payors / Plans 10.53 other 10.53 10.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN-SULBACTAM PER 1.5 G ERX-636000000 CDM J0295 HCPCS 636 RC 43598-387-11 NDC JZ 1 UN inpatient 15.88 15.56 All Payors / Plans All Payors / Plans 15.88 other 15.88 15.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN-SULBACTAM PER 1.5 G ERX-636000000 CDM J0295 HCPCS 636 RC 0781-6135-94 NDC JZ 1 UN inpatient 20.87 20.45 All Payors / Plans All Payors / Plans 20.87 other 20.87 20.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCCINYLCHOLINE CHLORIDE 100 MG/5 ML (20 MG/ML) SYRINGE ERX-250000000 CDM J0330 HCPCS 250 RC 60687-525-11 NDC JZ 0.5 ML inpatient 6.32 6.19 All Payors / Plans All Payors / Plans 6.32 other 6.32 6.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCCINYLCHOLINE PER 20 MG ERX-636000000 CDM J0330 HCPCS 636 RC 25021-826-82 NDC 7.5 ML inpatient 69 67.62 All Payors / Plans All Payors / Plans 69 other 69 69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE PER 20 MG ERX-636000000 CDM J0360 HCPCS 636 RC 6936728302 NDC JZ 0.5 ML inpatient 17.78 17.42 All Payors / Plans All Payors / Plans 17.78 other 17.78 17.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE PER 20 MG ERX-636000000 CDM J0360 HCPCS 636 RC 90000-002-51 NDC JZ 0.25 ML inpatient 7.75 7.6 All Payors / Plans All Payors / Plans 7.75 other 7.75 7.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE PER 20 MG ERX-636000000 CDM J0360 HCPCS 636 RC 0574-4024-11 NDC JZ 0.5 ML inpatient 15.49 15.18 All Payors / Plans All Payors / Plans 15.49 other 15.49 15.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE PER 20 MG ERX-636000000 CDM J0360 HCPCS 636 RC 48102-057-11 NDC JZ 0.5 ML inpatient 8.03 7.87 All Payors / Plans All Payors / Plans 8.03 other 8.03 8.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE PER 20 MG ERX-636000000 CDM J0360 HCPCS 636 RC 72485-670-31 NDC JZ 0.2 ML inpatient 3.21 3.15 All Payors / Plans All Payors / Plans 3.21 other 3.21 3.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN PER 500 MG ERX-636000000 CDM J0456 HCPCS 636 RC 76329-3015-5 NDC 0.264 UN inpatient 2.89 2.83 All Payors / Plans All Payors / Plans 2.89 other 2.89 2.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN PER 500 MG ERX-636000000 CDM J0456 HCPCS 636 RC 42494-416-01 NDC JZ 1 UN inpatient 45.23 44.33 All Payors / Plans All Payors / Plans 45.23 other 45.23 45.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN PER 500 MG ERX-636000000 CDM J0456 HCPCS 636 RC 0143-9564-01 NDC JZ 0.5 UN inpatient 22.62 22.17 All Payors / Plans All Payors / Plans 22.62 other 22.62 22.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN PER 500 MG ERX-636000000 CDM J0456 HCPCS 636 RC 70004-810-11 NDC JZ 0.5 UN inpatient 5.37 5.26 All Payors / Plans All Payors / Plans 5.37 other 5.37 5.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN PER 500 MG ERX-636000000 CDM J0456 HCPCS 636 RC 0641-0493-21 NDC JZ 1 UN inpatient 10.73 10.52 All Payors / Plans All Payors / Plans 10.73 other 10.73 10.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZTREONAM 1 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J0457 HCPCS 636 RC 0641-2555-41 NDC JZ 1 UN inpatient 103.42 101.35 All Payors / Plans All Payors / Plans 103.42 other 103.42 103.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZTREONAM 2 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J0457 HCPCS 636 RC 42192-614-05 NDC JZ 1 UN inpatient 187.05 183.31 All Payors / Plans All Payors / Plans 187.05 other 187.05 187.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZTREONAM 2 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J0457 HCPCS 636 RC 76329-1240-1 NDC JZ 1 UN inpatient 151.99 148.95 All Payors / Plans All Payors / Plans 151.99 other 151.99 151.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZTREONAM 2 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J0457 HCPCS 636 RC 43598-405-11 NDC JZ 1 UN inpatient 151.99 148.95 All Payors / Plans All Payors / Plans 151.99 other 151.99 151.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE 1 MG/ML SOLUTION ERX-636000000 CDM J0461 HCPCS 636 RC 49884-307-02 NDC JZ 1 ML inpatient 36.36 35.63 All Payors / Plans All Payors / Plans 36.36 other 36.36 36.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE PER 0.01 MG ERX-636000000 CDM J0461 HCPCS 636 RC 62332-365-06 NDC JZ 5 ML inpatient 22.53 22.08 All Payors / Plans All Payors / Plans 22.53 other 22.53 22.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE PER 0.01 MG ERX-636000000 CDM J0461 HCPCS 636 RC 0904-7227-61 NDC JZ 5 ML inpatient 22.53 22.08 All Payors / Plans All Payors / Plans 22.53 other 22.53 22.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE PER 0.01 MG ERX-636000000 CDM J0461 HCPCS 636 RC 16729-136-00 NDC JZ 1 ML inpatient 25.66 25.15 All Payors / Plans All Payors / Plans 25.66 other 25.66 25.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE PER 0.01 MG ERX-636000000 CDM J0461 HCPCS 636 RC 16729-136-16 NDC JZ 7.5 ML inpatient 192.39 188.54 All Payors / Plans All Payors / Plans 192.39 other 192.39 192.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE PER 0.01 MG ERX-636000000 CDM J0461 HCPCS 636 RC 60687-544-11 NDC JZ 10 ML inpatient 40.42 39.61 All Payors / Plans All Payors / Plans 40.42 other 40.42 40.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE PER 20 MG ERX-636000000 CDM J0500 HCPCS 636 RC 0574007015 NDC JZ 2 ML inpatient 65.16 63.86 All Payors / Plans All Payors / Plans 65.16 other 65.16 65.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE PER 20 MG ERX-636000000 CDM J0500 HCPCS 636 RC 51079-284-01 NDC JZ 2 ML inpatient 81.39 79.76 All Payors / Plans All Payors / Plans 81.39 other 81.39 81.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE PER 20 MG ERX-636000000 CDM J0500 HCPCS 636 RC 51079-284-20 NDC JZ 1 ML inpatient 40.7 39.89 All Payors / Plans All Payors / Plans 40.7 other 40.7 40.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE PER 20 MG ERX-636000000 CDM J0500 HCPCS 636 RC 51079-285-01 NDC JZ 1 ML inpatient 30.46 29.85 All Payors / Plans All Payors / Plans 30.46 other 30.46 30.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZTROPINE MESYLATE PER 1 MG ERX-636000000 CDM J0515 HCPCS 636 RC 0904-7728-61 NDC JZ 1 ML inpatient 66.12 64.8 All Payors / Plans All Payors / Plans 66.12 other 66.12 66.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZTROPINE MESYLATE PER 1 MG ERX-636000000 CDM J0515 HCPCS 636 RC 60687-555-11 NDC JZ 2 ML inpatient 104.39 102.3 All Payors / Plans All Payors / Plans 104.39 other 104.39 104.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PENICILLIN G BENZATHINE PER 1200000 UNITS ERX-636000000 CDM J0561 HCPCS 636 RC 68094-004-59 NDC JG 0.23 ML inpatient 76.89 75.35 All Payors / Plans All Payors / Plans 76.89 other 76.89 76.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PENICILLIN G BENZATHINE PER 2400000 UNITS ERX-636000000 CDM J0561 HCPCS 636 RC 45802-147-53 NDC JG 4 ML inpatient 1209.8 1185.6 All Payors / Plans All Payors / Plans 1209.8 other 1209.8 1209.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM GLUCONATE PER 10 MG ERX-250000000 CDM J0612 HCPCS 250 RC 65219-184-20 NDC 10 ML inpatient 39.85 39.05 All Payors / Plans All Payors / Plans 39.85 other 39.85 39.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM GLUCONATE PER 10 MG ERX-250000000 CDM J0612 HCPCS 250 RC 2055503300 NDC JZ 2.4 ML inpatient 9.58 9.39 All Payors / Plans All Payors / Plans 9.58 other 9.58 9.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM GLUCONATE PER 10 MG ERX-250000000 CDM J0612 HCPCS 250 RC 8068116801 NDC JZ 23 ML inpatient 38.55 37.78 All Payors / Plans All Payors / Plans 38.55 other 38.55 38.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM GLUCONATE PER 10 MG ERX-250000000 CDM J0612 HCPCS 250 RC 42806-266-98 NDC JZ 10 ML inpatient 39.89 39.09 All Payors / Plans All Payors / Plans 39.89 other 39.89 39.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM GLUCONATE IN NACL 1 GRAM/50 ML SOLUTION ERX-250000000 CDM J0613 HCPCS 250 RC 0054-0046-41 NDC 50 ML inpatient 40.4 39.59 All Payors / Plans All Payors / Plans 40.4 other 40.4 40.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM GLUCONATE IN NACL 2 GRAM/100 ML SOLUTION ERX-250000000 CDM J0613 HCPCS 250 RC 16714-527-01 NDC 100 ML inpatient 82.67 81.02 All Payors / Plans All Payors / Plans 82.67 other 82.67 82.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM GLUCONATE IN NACL 2 GRAM/100 ML SOLUTION ERX-250000000 CDM J0613 HCPCS 250 RC 14789-015-05 NDC 100 ML inpatient 82.67 81.02 All Payors / Plans All Payors / Plans 82.67 other 82.67 82.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUCOVORIN CALCIUM PER 50 MG ERX-636000000 CDM J0640 HCPCS 636 RC 63739-052-74 NDC JW 5 ML inpatient 6.51 6.38 All Payors / Plans All Payors / Plans 6.51 other 6.51 6.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUCOVORIN CALCIUM PER 50 MG ERX-636000000 CDM J0640 HCPCS 636 RC 0338-1047-02 NDC JW 0.3 UN inpatient 6.43 6.3 All Payors / Plans All Payors / Plans 6.43 other 6.43 6.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUCOVORIN CALCIUM PER 50 MG ERX-636000000 CDM J0640 HCPCS 636 RC 0338-0049-10 NDC JZ 0.92 UN inpatient 151.67 148.64 All Payors / Plans All Payors / Plans 151.67 other 151.67 151.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUCOVORIN CALCIUM PER 50 MG ERX-636000000 CDM J0640 HCPCS 636 RC 0338-0049-11 NDC JZ 0.3 UN inpatient 1.51 1.48 All Payors / Plans All Payors / Plans 1.51 other 1.51 1.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 20 MCG/ML SOLUTION ERX-636000000 CDM J0651 HCPCS 636 RC 68462-101-30 NDC JZ 1.9 ML inpatient 75.29 73.78 All Payors / Plans All Payors / Plans 75.29 other 75.29 75.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 40 MCG/ML SOLUTION ERX-636000000 CDM J0651 HCPCS 636 RC 50268-330-11 NDC JZ 3.75 ML inpatient 267.24 261.9 All Payors / Plans All Payors / Plans 267.24 other 267.24 267.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPIVACAINE 0.125% 0.125 % (1,250 MCG/ML) SOLUTION" ERX-250000000 CDM J0665 HCPCS 250 RC 63323-424-05 NDC 100 ML inpatient 50.56 49.55 All Payors / Plans All Payors / Plans 50.56 other 50.56 50.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPIVACAINE 0.125% 0.125 % (1,250 MCG/ML) SOLUTION" ERX-250000000 CDM J0665 HCPCS 250 RC 63323-184-10 NDC 100 ML inpatient 30.6 29.99 All Payors / Plans All Payors / Plans 30.6 other 30.6 30.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) SOLUTION ERX-250000000 CDM J0665 HCPCS 250 RC 5483800650 NDC JZ 1.4 ML inpatient 15.67 15.36 All Payors / Plans All Payors / Plans 15.67 other 15.67 15.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE HCL 0.25 % (2.5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 0338-0017-04 NDC 2 ML inpatient 61.45 60.22 All Payors / Plans All Payors / Plans 61.45 other 61.45 61.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE HCL 0.5 % (5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 0338-0017-11 NDC 10 ML inpatient 21.01 20.59 All Payors / Plans All Payors / Plans 21.01 other 21.01 21.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE 0.25 % (2.5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 62332-056-31 NDC JZ 30 ML inpatient 10.86 10.64 All Payors / Plans All Payors / Plans 10.86 other 10.86 10.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE 0.25 % (2.5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 0378-0873-16 NDC JZ 30 ML inpatient 10.73 10.52 All Payors / Plans All Payors / Plans 10.73 other 10.73 10.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE 0.25 % (2.5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 0591-3510-54 NDC JZ 4 ML inpatient 15.31 15 All Payors / Plans All Payors / Plans 15.31 other 15.31 15.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE 0.25 % (2.5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 50268-184-11 NDC JZ 7 ML inpatient 10.4 10.19 All Payors / Plans All Payors / Plans 10.4 other 10.4 10.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE PF 0.5 % (5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 50268-184-12 NDC JZ 10 ML inpatient 11.1 10.88 All Payors / Plans All Payors / Plans 11.1 other 11.1 11.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE PF 0.5 % (5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 55111-671-06 NDC JZ 10 ML inpatient 11.04 10.82 All Payors / Plans All Payors / Plans 11.04 other 11.04 11.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE PF 0.5 % (5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 68084-752-25 NDC JZ 5 ML inpatient 11.1 10.88 All Payors / Plans All Payors / Plans 11.1 other 11.1 11.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE PF 0.5 % (5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 68084-752-95 NDC JZ 25 ML inpatient 9.2 9.02 All Payors / Plans All Payors / Plans 9.2 other 9.2 9.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE PF 0.5 % (5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 0904-6294-61 NDC JZ 25 ML inpatient 9.16 8.98 All Payors / Plans All Payors / Plans 9.16 other 9.16 9.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE PF 0.75 % (7.5 MG/ML) SOLUTION 10 ML VIAL ERX-636000000 CDM J0665 HCPCS 636 RC 0536-1272-22 NDC JZ 5 ML inpatient 11.11 10.89 All Payors / Plans All Payors / Plans 11.11 other 11.11 11.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE PF 0.75 % (7.5 MG/ML) SOLUTION 10 ML VIAL ERX-636000000 CDM J0665 HCPCS 636 RC 51672-2002-2 NDC JZ 5 ML inpatient 15.93 15.61 All Payors / Plans All Payors / Plans 15.93 other 15.93 15.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN 3 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J0688 HCPCS 636 RC 60505-6156-4 NDC JZ 1 UN inpatient 26.07 25.55 All Payors / Plans All Payors / Plans 26.07 other 26.07 26.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0689 HCPCS 636 RC 0338-0017-48 NDC 50 ML inpatient 30.95 30.33 All Payors / Plans All Payors / Plans 30.95 other 30.95 30.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0689 HCPCS 636 RC 0409-7922-09 NDC 50 ML inpatient 24.91 24.41 All Payors / Plans All Payors / Plans 24.91 other 24.91 24.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0690 HCPCS 636 RC 0338-0017-38 NDC 100 ML inpatient 15.96 15.64 All Payors / Plans All Payors / Plans 15.96 other 15.96 15.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0690 HCPCS 636 RC 0338-0017-41 NDC 50 ML inpatient 62.23 60.99 All Payors / Plans All Payors / Plans 62.23 other 62.23 62.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0690 HCPCS 636 RC 0121-0903-15 NDC 1 UN inpatient 63.67 62.4 All Payors / Plans All Payors / Plans 63.67 other 63.67 63.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN 2 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J0690 HCPCS 636 RC 55150-119-30 NDC JZ 1 UN inpatient 25.61 25.1 All Payors / Plans All Payors / Plans 25.61 other 25.61 25.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN 2 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J0690 HCPCS 636 RC 55150-120-30 NDC JZ 1 UN inpatient 25.61 25.1 All Payors / Plans All Payors / Plans 25.61 other 25.61 25.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN 3 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J0690 HCPCS 636 RC 60505-6156-0 NDC JZ 1 UN inpatient 26.07 25.55 All Payors / Plans All Payors / Plans 26.07 other 26.07 26.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0690 HCPCS 636 RC 60505-6157-0 NDC JZ 1 UN inpatient 10.81 10.59 All Payors / Plans All Payors / Plans 10.81 other 10.81 10.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0690 HCPCS 636 RC 60505-6157-4 NDC JZ 1 UN inpatient 10.53 10.32 All Payors / Plans All Payors / Plans 10.53 other 10.53 10.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0690 HCPCS 636 RC 60505-6159-0 NDC JZ 0.5 UN inpatient 5.33 5.22 All Payors / Plans All Payors / Plans 5.33 other 5.33 5.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0690 HCPCS 636 RC 60505-6159-4 NDC JZ 1 UN inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFEPIME PER 500 MG ERX-636000000 CDM J0692 HCPCS 636 RC 64679-056-02 NDC JZ 0.5 UN inpatient 10.25 10.05 All Payors / Plans All Payors / Plans 10.25 other 10.25 10.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFEPIME PER 500 MG ERX-636000000 CDM J0692 HCPCS 636 RC 68001-507-53 NDC JZ 1 UN inpatient 31.11 30.49 All Payors / Plans All Payors / Plans 31.11 other 31.11 31.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFEPIME PER 500 MG ERX-636000000 CDM J0692 HCPCS 636 RC 72485-403-01 NDC JZ 1 UN inpatient 31.11 30.49 All Payors / Plans All Payors / Plans 31.11 other 31.11 31.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFEPIME PER 500 MG ERX-636000000 CDM J0692 HCPCS 636 RC 0005-2000-01 NDC JZ 0.5 UN inpatient 12.68 12.43 All Payors / Plans All Payors / Plans 12.68 other 12.68 12.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFEPIME PER 500 MG ERX-636000000 CDM J0692 HCPCS 636 RC 0338-0683-04 NDC JZ 1 UN inpatient 39.87 39.07 All Payors / Plans All Payors / Plans 39.87 other 39.87 39.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFOXITIN PER 1 G ERX-636000000 CDM J0694 HCPCS 636 RC 14789-107-05 NDC JZ 1 UN inpatient 20.45 20.04 All Payors / Plans All Payors / Plans 20.45 other 20.45 20.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFOXITIN PER 1 G ERX-636000000 CDM J0694 HCPCS 636 RC 0409-6653-18 NDC JZ 1 UN inpatient 30.75 30.14 All Payors / Plans All Payors / Plans 30.75 other 30.75 30.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTRIAXONE PER 250 MG ERX-636000000 CDM J0696 HCPCS 636 RC 0990-7922-55 NDC 10 ML inpatient 25.75 25.24 All Payors / Plans All Payors / Plans 25.75 other 25.75 25.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTRIAXONE PER 250 MG ERX-636000000 CDM J0696 HCPCS 636 RC 70677-1231-1 NDC JZ 50 ML inpatient 83.2 81.54 All Payors / Plans All Payors / Plans 83.2 other 83.2 83.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTRIAXONE PER 250 MG ERX-636000000 CDM J0696 HCPCS 636 RC 16714-496-01 NDC JZ 5.1 ML inpatient 11.37 11.14 All Payors / Plans All Payors / Plans 11.37 other 11.37 11.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTRIAXONE PER 250 MG ERX-636000000 CDM J0696 HCPCS 636 RC 0121-4950-15 NDC 0.2 UN inpatient 12.43 12.18 All Payors / Plans All Payors / Plans 12.43 other 12.43 12.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTRIAXONE PER 250 MG ERX-636000000 CDM J0696 HCPCS 636 RC 0054-8724-25 NDC JZ 0.5 UN inpatient 5.08 4.98 All Payors / Plans All Payors / Plans 5.08 other 5.08 5.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTRIAXONE PER 250 MG ERX-636000000 CDM J0696 HCPCS 636 RC 0904-6923-61 NDC JZ 1 UN inpatient 5.84 5.72 All Payors / Plans All Payors / Plans 5.84 other 5.84 5.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTRIAXONE PER 250 MG ERX-636000000 CDM J0696 HCPCS 636 RC 10135-775-01 NDC JZ 1 UN inpatient 5.84 5.72 All Payors / Plans All Payors / Plans 5.84 other 5.84 5.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTRIAXONE PER 250 MG ERX-636000000 CDM J0696 HCPCS 636 RC 60687-122-11 NDC JZ 1 UN inpatient 0.55 0.54 All Payors / Plans All Payors / Plans 0.55 other 0.55 0.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFUROXIME PER 750 MG ERX-636000000 CDM J0697 HCPCS 636 RC 60687-134-11 NDC JZ 1 UN inpatient 26.18 25.66 All Payors / Plans All Payors / Plans 26.18 other 26.18 26.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFUROXIME PER 750 MG ERX-636000000 CDM J0697 HCPCS 636 RC 60687-145-01 NDC JZ 1 UN inpatient 15.63 15.32 All Payors / Plans All Payors / Plans 15.63 other 15.63 15.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFUROXIME PER 750 MG ERX-636000000 CDM J0697 HCPCS 636 RC 60687-145-11 NDC JZ 1 UN inpatient 15.63 15.32 All Payors / Plans All Payors / Plans 15.63 other 15.63 15.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFUROXIME PER 750 MG ERX-636000000 CDM J0697 HCPCS 636 RC 64380-782-06 NDC JZ 1 UN inpatient 20.6 20.19 All Payors / Plans All Payors / Plans 20.6 other 20.6 20.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFIDEROCOL PER 10 MG ERX-636000000 CDM J0699 HCPCS 636 RC 0990-7905-09 NDC JZ 1 UN inpatient 589.37 577.58 All Payors / Plans All Payors / Plans 589.37 other 589.37 589.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BETAMETHASONE ACET & SOD PHOS PER 4 MG ERX-636000000 CDM J0702 HCPCS 636 RC 0338-0017-02 NDC 2 ML inpatient 58.02 56.86 All Payors / Plans All Payors / Plans 58.02 other 58.02 58.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTAZIDIME PER 500 MG ERX-636000000 CDM J0713 HCPCS 636 RC 63323-965-02 NDC JZ 0.1125 UN inpatient 2.87 2.81 All Payors / Plans All Payors / Plans 2.87 other 2.87 2.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTAZIDIME PER 500 MG ERX-636000000 CDM J0713 HCPCS 636 RC 63323-965-03 NDC JZ 1 UN inpatient 44.86 43.96 All Payors / Plans All Payors / Plans 44.86 other 44.86 44.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTAZIDIME PER 500 MG ERX-636000000 CDM J0713 HCPCS 636 RC 0054-0018-20 NDC JZ 0.135 UN inpatient 2.15 2.11 All Payors / Plans All Payors / Plans 2.15 other 2.15 2.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN PER 300 MG ERX-636000000 CDM J0736 HCPCS 636 RC 5026885511 NDC JZ 50 ML inpatient 16.11 15.79 All Payors / Plans All Payors / Plans 16.11 other 16.11 16.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN PER 300 MG ERX-636000000 CDM J0736 HCPCS 636 RC 5026885515 NDC JZ 1.85 ML inpatient 16.11 15.79 All Payors / Plans All Payors / Plans 16.11 other 16.11 16.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN PER 300 MG ERX-636000000 CDM J0736 HCPCS 636 RC 7733393825 NDC JZ 50 ML inpatient 25.43 24.92 All Payors / Plans All Payors / Plans 25.43 other 25.43 25.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN PER 300 MG ERX-636000000 CDM J0736 HCPCS 636 RC 5026885211 NDC JZ 50 ML inpatient 30.46 29.85 All Payors / Plans All Payors / Plans 30.46 other 30.46 30.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN PER 300 MG ERX-636000000 CDM J0736 HCPCS 636 RC 52817-332-10 NDC JZ 50 ML inpatient 61.73 60.5 All Payors / Plans All Payors / Plans 61.73 other 61.73 61.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN PER 300 MG ERX-636000000 CDM J0736 HCPCS 636 RC 60687-558-01 NDC JZ 50 ML inpatient 64.17 62.89 All Payors / Plans All Payors / Plans 64.17 other 64.17 64.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN IN 0.9% NS 900 MG/50 ML PIGGYBACK ERX-250000000 CDM J0737 HCPCS 250 RC 0409-4276-16 NDC 50 ML inpatient 26.25 25.73 All Payors / Plans All Payors / Plans 26.25 other 26.25 26.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN 600 MG/50 ML PIGGYBACK ERX-636000000 CDM J0737 HCPCS 636 RC 0046-0872-21 NDC JZ 50 ML inpatient 25.3 24.79 All Payors / Plans All Payors / Plans 25.3 other 25.3 25.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN 600 MG/50 ML PIGGYBACK ERX-636000000 CDM J0737 HCPCS 636 RC 2055500600 NDC JZ 50 ML inpatient 25.3 24.79 All Payors / Plans All Payors / Plans 25.3 other 25.3 25.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMIPENEM-CILASTATIN PER 250 MG ERX-636000000 CDM J0743 HCPCS 636 RC 0338-0049-02 NDC JZ 1 UN inpatient 50.46 49.45 All Payors / Plans All Payors / Plans 50.46 other 50.46 50.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMIPENEM-CILASTATIN PER 250 MG ERX-636000000 CDM J0743 HCPCS 636 RC 0338-0049-03 NDC JZ 1 UN inpatient 50.46 49.45 All Payors / Plans All Payors / Plans 50.46 other 50.46 50.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMIPENEM-CILASTATIN PER 250 MG ERX-636000000 CDM J0743 HCPCS 636 RC 0338-0049-04 NDC JZ 1 UN inpatient 50.49 49.48 All Payors / Plans All Payors / Plans 50.49 other 50.49 50.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN PER 200 MG ERX-636000000 CDM J0744 HCPCS 636 RC 65219-456-05 NDC 100 ML inpatient 15.27 14.96 All Payors / Plans All Payors / Plans 15.27 other 15.27 15.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN PER 200 MG ERX-636000000 CDM J0744 HCPCS 636 RC 65219-458-05 NDC 200 ML inpatient 42.87 42.01 All Payors / Plans All Payors / Plans 42.87 other 42.87 42.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN PER 200 MG ERX-636000000 CDM J0744 HCPCS 636 RC 65219-460-05 NDC 100 ML inpatient 15.47 15.16 All Payors / Plans All Payors / Plans 15.47 other 15.47 15.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN PER 200 MG ERX-636000000 CDM J0744 HCPCS 636 RC 50484-010-30 NDC JZ 200 ML inpatient 23.39 22.92 All Payors / Plans All Payors / Plans 23.39 other 23.39 23.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN PER 200 MG ERX-636000000 CDM J0744 HCPCS 636 RC 0574030316 NDC JZ 200 ML inpatient 23.39 22.92 All Payors / Plans All Payors / Plans 23.39 other 23.39 23.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN PER 200 MG ERX-636000000 CDM J0744 HCPCS 636 RC 0574030416 NDC JZ 100 ML inpatient 15.27 14.96 All Payors / Plans All Payors / Plans 15.27 other 15.27 15.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROCHLORPERAZINE EDISYLATE PER 10 MG ERX-636000000 CDM J0780 HCPCS 636 RC 70121-1168-1 NDC 0.5 ML inpatient 5.08 4.98 All Payors / Plans All Payors / Plans 5.08 other 5.08 5.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROCHLORPERAZINE EDISYLATE PER 10 MG ERX-636000000 CDM J0780 HCPCS 636 RC 0338-0122-04 NDC 1 ML inpatient 10.15 9.95 All Payors / Plans All Payors / Plans 10.15 other 10.15 10.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROCHLORPERAZINE EDISYLATE PER 10 MG ERX-636000000 CDM J0780 HCPCS 636 RC 0338-0124-04 NDC 1 ML inpatient 7.78 7.62 All Payors / Plans All Payors / Plans 7.78 other 7.78 7.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROCHLORPERAZINE EDISYLATE PER 10 MG ERX-636000000 CDM J0780 HCPCS 636 RC 25021-158-99 NDC 1 ML inpatient 8.09 7.93 All Payors / Plans All Payors / Plans 8.09 other 8.09 8.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COSYNTROPIN PER 0.25 MG ERX-636000000 CDM J0834 HCPCS 636 RC 0069-0209-01 NDC JZ 1 UN inpatient 82.63 80.98 All Payors / Plans All Payors / Plans 82.63 other 82.63 82.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DAPTOMYCIN PER 1 MG ERX-636000000 CDM J0878 HCPCS 636 RC 0409-4699-54 NDC JZ 1 UN inpatient 65.56 64.25 All Payors / Plans All Payors / Plans 65.56 other 65.56 65.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DAPTOMYCIN PER 1 MG ERX-636000000 CDM J0878 HCPCS 636 RC 0409-6010-25 NDC JZ 1.284 UN inpatient 175.23 171.73 All Payors / Plans All Payors / Plans 175.23 other 175.23 175.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DAPTOMYCIN PER 1 MG ERX-636000000 CDM J0878 HCPCS 636 RC 16714-690-01 NDC JZ 1 UN inpatient 61.85 60.61 All Payors / Plans All Payors / Plans 61.85 other 61.85 61.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DARBEPOETIN ALFA-ALBUMIN PER 1 MCG ERX-636000000 CDM J0881 HCPCS 636 RC 70710-1110-1 NDC JZ 1 ML inpatient 2674.03 2620.55 All Payors / Plans All Payors / Plans 2674.03 other 2674.03 2674.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DARBEPOETIN ALFA-POLYSORBATE 100 MCG/0.5 ML SYRINGE ERX-636000000 CDM J0881 HCPCS 636 RC 0597-0360-82 NDC JZ 0.5 ML inpatient 783.24 767.58 All Payors / Plans All Payors / Plans 783.24 other 783.24 783.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DARBEPOETIN ALFA-POLYSORBATE 200 MCG/0.4 ML SYRINGE ERX-636000000 CDM J0881 HCPCS 636 RC 0310-6205-30 NDC JZ 0.4 ML inpatient 1480.29 1450.68 All Payors / Plans All Payors / Plans 1480.29 other 1480.29 1480.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DARBEPOETIN ALFA-POLYSORBATE 25 MCG/0.42 ML SYRINGE ERX-636000000 CDM J0881 HCPCS 636 RC 66993-456-30 NDC JZ 0.42 ML inpatient 256.65 251.52 All Payors / Plans All Payors / Plans 256.65 other 256.65 256.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DARBEPOETIN ALFA-POLYSORBATE 300 MCG/0.6 ML SYRINGE ERX-636000000 CDM J0881 HCPCS 636 RC 43598-705-30 NDC JZ 0.6 ML inpatient 1878.2 1840.64 All Payors / Plans All Payors / Plans 1878.2 other 1878.2 1878.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DARBEPOETIN ALFA-POLYSORBATE 40 MCG/0.4 ML SYRINGE ERX-636000000 CDM J0881 HCPCS 636 RC 69918-101-01 NDC JZ 0.4 ML inpatient 417.74 409.39 All Payors / Plans All Payors / Plans 417.74 other 417.74 417.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DARBEPOETIN ALFA-POLYSORBATE 60 MCG/0.3 ML SYRINGE ERX-636000000 CDM J0881 HCPCS 636 RC 0054-0400-22 NDC JZ 0.3 ML inpatient 624.07 611.59 All Payors / Plans All Payors / Plans 624.07 other 624.07 624.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPOETIN ALFA PER 1000 UNITS ERX-635000000 CDM J0885 HCPCS 636 RC 65862-076-01 NDC JZ 1 ML inpatient 1244.41 1219.52 All Payors / Plans All Payors / Plans 1244.41 other 1244.41 1244.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPOETIN ALFA PER 1000 UNITS ERX-636000000 CDM J0885 HCPCS 636 RC 0904-5307-80 NDC JZ 1 ML inpatient 347.86 340.9 All Payors / Plans All Payors / Plans 347.86 other 347.86 347.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DECITABINE PER 1 MG ERX-636000000 CDM J0894 HCPCS 636 RC 0338-1049-02 NDC JW 0.3 UN inpatient 51.56 50.53 All Payors / Plans All Payors / Plans 51.56 other 51.56 51.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SOLUTION ERX-636000000 CDM J0897 HCPCS 636 RC 63323-165-03 NDC JZ 1.7 ML inpatient 3871.05 3793.63 All Payors / Plans All Payors / Plans 3871.05 other 3871.05 3871.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DENOSUMAB 60 MG/ML SYRINGE ERX-636000000 CDM J0897 HCPCS 636 RC 24208-720-02 NDC JZ 1 ML inpatient 2417 2368.66 All Payors / Plans All Payors / Plans 2417 other 2417 2417 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DENOSUMAB 60 MG/ML SYRINGE ERX-636000000 CDM J0897 HCPCS 636 RC 0054-3176-44 NDC JZ 1 ML inpatient 2417 2368.66 All Payors / Plans All Payors / Plans 2417 other 2417 2417 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE PER 40 MG ERX-636000000 CDM J1010 HCPCS 636 RC 0713-0351-09 NDC 25 ML inpatient 498.1 488.14 All Payors / Plans All Payors / Plans 498.1 other 498.1 498.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE PER 40 MG ERX-636000000 CDM J1010 HCPCS 636 RC 0904-6667-61 NDC JZ 2 ML inpatient 42.24 41.4 All Payors / Plans All Payors / Plans 42.24 other 42.24 42.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE PER 40 MG ERX-636000000 CDM J1010 HCPCS 636 RC 50268-350-11 NDC JZ 1 ML inpatient 21.13 20.71 All Payors / Plans All Payors / Plans 21.13 other 21.13 21.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEDROXYPROGESTERONE 150 MG/ML SUSPENSION ERX-636000000 CDM J1050 HCPCS 636 RC 0904-6665-61 NDC JZ 1 ML inpatient 155.36 152.25 All Payors / Plans All Payors / Plans 155.36 other 155.36 155.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEDROXYPROGESTERONE 150 MG/ML SUSPENSION ERX-636000000 CDM J1050 HCPCS 636 RC 63739-902-10 NDC JZ 1 ML inpatient 103.4 101.33 All Payors / Plans All Payors / Plans 103.4 other 103.4 103.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEDROXYPROGESTERONE 150 MG/ML SUSPENSION ERX-636000000 CDM J1050 HCPCS 636 RC 59762-5050-1 NDC JZ 1 ML inpatient 44.7 43.81 All Payors / Plans All Payors / Plans 44.7 other 44.7 44.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 1 MG ERX-636000000 CDM J1100 HCPCS 636 RC 0338-1075-02 NDC 3 ML inpatient 5.98 5.86 All Payors / Plans All Payors / Plans 5.98 other 5.98 5.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 1 MG ERX-636000000 CDM J1100 HCPCS 636 RC 67457-533-16 NDC 0.5 ML inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 1 MG ERX-636000000 CDM J1100 HCPCS 636 RC 0054-8176-25 NDC JZ 0.25 ML inpatient 1.47 1.44 All Payors / Plans All Payors / Plans 1.47 other 1.47 1.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 1 MG ERX-636000000 CDM J1100 HCPCS 636 RC 0115-9919-01 NDC JZ 1 ML inpatient 5.88 5.76 All Payors / Plans All Payors / Plans 5.88 other 5.88 5.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 1 MG ERX-636000000 CDM J1100 HCPCS 636 RC 0078-0430-05 NDC JZ 1 ML inpatient 0.85 0.83 All Payors / Plans All Payors / Plans 0.85 other 0.85 0.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 1 MG ERX-636000000 CDM J1100 HCPCS 636 RC 0527-8106-37 NDC JZ 1.5 ML inpatient 1.45 1.42 All Payors / Plans All Payors / Plans 1.45 other 1.45 1.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAZOLAMIDE PER 500 MG ERX-636000000 CDM J1120 HCPCS 636 RC 0078-0818-81 NDC JZ 1 UN inpatient 133.64 130.97 All Payors / Plans All Payors / Plans 133.64 other 133.64 133.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIGOXIN 250 MCG/ML (0.25 MG/ML) SOLUTION ERX-636000000 CDM J1160 HCPCS 636 RC 71288-402-11 NDC 1 ML inpatient 8.02 7.86 All Payors / Plans All Payors / Plans 8.02 other 8.02 8.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYTOIN PER 50 MG ERX-636000000 CDM J1165 HCPCS 636 RC 68084-284-11 NDC JZ 1 ML inpatient 5.14 5.04 All Payors / Plans All Payors / Plans 5.14 other 5.14 5.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYTOIN PER 50 MG ERX-636000000 CDM J1165 HCPCS 636 RC 63739-483-10 NDC JZ 4 ML inpatient 8.62 8.45 All Payors / Plans All Payors / Plans 8.62 other 8.62 8.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYTOIN PER 50 MG ERX-636000000 CDM J1165 HCPCS 636 RC 62135-502-47 NDC JZ 4 ML inpatient 12.22 11.98 All Payors / Plans All Payors / Plans 12.22 other 12.22 12.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE 2 MG/ML SYRINGE ERX-636000000 CDM J1170 HCPCS 636 RC 24208-910-19 NDC JZ 0.1 ML inpatient 1.59 1.56 All Payors / Plans All Payors / Plans 1.59 other 1.59 1.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE 0.5 MG/0.5 ML SYRINGE ERX-636000000 CDM J1171 HCPCS 636 RC 0409-1467-61 NDC 0.5 ML inpatient 15.88 15.56 All Payors / Plans All Payors / Plans 15.88 other 15.88 15.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE 0.5 MG/0.5 ML SYRINGE ERX-636000000 CDM J1171 HCPCS 636 RC 0641-6132-01 NDC 0.1 ML inpatient 3.16 3.1 All Payors / Plans All Payors / Plans 3.16 other 3.16 3.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE PER 4 MG ERX-636000000 CDM J1171 HCPCS 636 RC 75834-242-30 NDC JZ 0.2 ML inpatient 3.09 3.03 All Payors / Plans All Payors / Plans 3.09 other 3.09 3.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE PER 50 MG ERX-636000000 CDM J1200 HCPCS 636 RC 71288-420-96 NDC 1 ML inpatient 0.79 0.77 All Payors / Plans All Payors / Plans 0.79 other 0.79 0.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE PER 50 MG ERX-636000000 CDM J1200 HCPCS 636 RC 71288-402-10 NDC 0.25 ML inpatient 0.2 0.2 All Payors / Plans All Payors / Plans 0.2 other 0.2 0.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE PER 50 MG ERX-636000000 CDM J1200 HCPCS 636 RC 51079-285-20 NDC JZ 0.5 ML inpatient 0.4 0.39 All Payors / Plans All Payors / Plans 0.4 other 0.4 0.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE PER 50 MG ERX-636000000 CDM J1200 HCPCS 636 RC 68094-750-59 NDC JZ 0.25 ML inpatient 2.71 2.66 All Payors / Plans All Payors / Plans 2.71 other 2.71 2.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOBUTAMINE PER 250 MG ERX-636000000 CDM J1250 HCPCS 636 RC 0409-1283-05 NDC 250 ML inpatient 44.74 43.85 All Payors / Plans All Payors / Plans 44.74 other 44.74 44.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOPAMINE PER 40 MG ERX-636000000 CDM J1265 HCPCS 636 RC 0143-9720-01 NDC 250 ML inpatient 61.06 59.84 All Payors / Plans All Payors / Plans 61.06 other 61.06 61.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOPAMINE PER 40 MG ERX-636000000 CDM J1265 HCPCS 636 RC 0143-9721-24 NDC 2.541947917 ML inpatient 0.63 0.62 All Payors / Plans All Payors / Plans 0.63 other 0.63 0.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERTAPENEM PER 500 MG ERX-636000000 CDM J1335 HCPCS 636 RC 63323-229-05 NDC JZ 0.5 UN inpatient 51.94 50.9 All Payors / Plans All Payors / Plans 51.94 other 51.94 51.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERTAPENEM PER 500 MG ERX-636000000 CDM J1335 HCPCS 636 RC 63323-229-30 NDC JZ 0.5 UN inpatient 51.94 50.9 All Payors / Plans All Payors / Plans 51.94 other 51.94 51.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERTAPENEM PER 500 MG ERX-636000000 CDM J1335 HCPCS 636 RC 71288-201-85 NDC JZ 0.5 UN inpatient 68.24 66.88 All Payors / Plans All Payors / Plans 68.24 other 68.24 68.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FERRIC CARBOXYMALTOSE 50 MG IRON/ML SOLUTION ERX-636000000 CDM J1439 HCPCS 636 RC 68084-415-11 NDC JZ 15 ML inpatient 1605.21 1573.11 All Payors / Plans All Payors / Plans 1605.21 other 1605.21 1605.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TBO-FILGRASTIM PER 1 MCG ERX-636000000 CDM J1447 HCPCS 636 RC 65628-080-03 NDC JZ 0.41 ML inpatient 338.01 331.25 All Payors / Plans All Payors / Plans 338.01 other 338.01 338.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TBO-FILGRASTIM PER 1 MCG ERX-636000000 CDM J1447 HCPCS 636 RC 64764-544-30 NDC JZ 0.5 ML inpatient 412.16 403.92 All Payors / Plans All Payors / Plans 412.16 other 412.16 412.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TBO-FILGRASTIM PER 1 MCG ERX-636000000 CDM J1447 HCPCS 636 RC 68382-772-30 NDC JZ 0.8 ML inpatient 629.94 617.34 All Payors / Plans All Payors / Plans 629.94 other 629.94 629.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TBO-FILGRASTIM PER 1 MCG ERX-636000000 CDM J1447 HCPCS 636 RC 59762-0333-2 NDC JZ 0.8 ML inpatient 629.94 617.34 All Payors / Plans All Payors / Plans 629.94 other 629.94 629.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUCONAZOLE PER 200 MG ERX-636000000 CDM J1450 HCPCS 636 RC 0338-1708-40 NDC 50 ML inpatient 12.93 12.67 All Payors / Plans All Payors / Plans 12.93 other 12.93 12.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUCONAZOLE PER 200 MG ERX-636000000 CDM J1450 HCPCS 636 RC 68084-782-11 NDC JZ 200 ML inpatient 30.41 29.8 All Payors / Plans All Payors / Plans 30.41 other 30.41 30.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMUNE GLOBULIN (HUMAN) 10 % SOLUTION ERX-636000000 CDM J1459 HCPCS 636 RC 0378-3352-16 NDC JZ 100 ML inpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMUNE GLOBULIN (HUMAN) 10 % SOLUTION ERX-636000000 CDM J1459 HCPCS 636 RC 42806-087-01 NDC JZ 100 ML inpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMUNE GLOBULIN (HUMAN) 10 % SOLUTION ERX-636000000 CDM J1459 HCPCS 636 RC 0555-0886-02 NDC JZ 200 ML inpatient 1460 1430.8 All Payors / Plans All Payors / Plans 1460 other 1460 1460 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMUNE GLOBULIN (HUMAN) 10 % SOLUTION ERX-636000000 CDM J1459 HCPCS 636 RC 68084-280-11 NDC JZ 200 ML inpatient 1460 1430.8 All Payors / Plans All Payors / Plans 1460 other 1460 1460 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMUNE GLOBULIN (HUMAN) 10 % SOLUTION ERX-636000000 CDM J1459 HCPCS 636 RC 0904-7103-04 NDC JZ 400 ML inpatient 2920 2861.6 All Payors / Plans All Payors / Plans 2920 other 2920 2920 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMUNE GLOBULIN (HUMAN) 10 % SOLUTION ERX-636000000 CDM J1459 HCPCS 636 RC 50268-298-11 NDC JZ 400 ML inpatient 2920 2861.6 All Payors / Plans All Payors / Plans 2920 other 2920 2920 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN 120 MG/100 ML PIGGYBACK ERX-636000000 CDM J1580 HCPCS 636 RC 44567-420-24 NDC 100 ML inpatient 15.31 15 All Payors / Plans All Payors / Plans 15.31 other 15.31 15.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN PER 80 MG ERX-636000000 CDM J1580 HCPCS 636 RC 63323-106-05 NDC 50 ML inpatient 10.88 10.66 All Payors / Plans All Payors / Plans 10.88 other 10.88 10.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN PER 80 MG ERX-636000000 CDM J1580 HCPCS 636 RC 60687-513-11 NDC JZ 3.2 ML inpatient 0.71 0.7 All Payors / Plans All Payors / Plans 0.71 other 0.71 0.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN PER 80 MG ERX-636000000 CDM J1580 HCPCS 636 RC 60687-375-11 NDC JZ 2 ML inpatient 20.31 19.9 All Payors / Plans All Payors / Plans 20.31 other 20.31 20.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN PER 80 MG ERX-636000000 CDM J1580 HCPCS 636 RC 60687-375-21 NDC JZ 2 ML inpatient 20.31 19.9 All Payors / Plans All Payors / Plans 20.31 other 20.31 20.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN PER 80 MG ERX-636000000 CDM J1580 HCPCS 636 RC 0904-7043-04 NDC JZ 2 ML inpatient 10.21 10.01 All Payors / Plans All Payors / Plans 10.21 other 10.21 10.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLYCOPYRROLATE 0.2 MG/ML SOLUTION ERX-636000000 CDM J1596 HCPCS 636 RC 63323-106-15 NDC 1 ML inpatient 39.85 39.05 All Payors / Plans All Payors / Plans 39.85 other 39.85 39.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLYCOPYRROLATE 0.2 MG/ML SOLUTION ERX-636000000 CDM J1596 HCPCS 636 RC 0409-6729-41 NDC 1 ML inpatient 61.66 60.43 All Payors / Plans All Payors / Plans 61.66 other 61.66 61.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLYCOPYRROLATE 0.2 MG/ML SOLUTION ERX-636000000 CDM J1596 HCPCS 636 RC 44567-421-24 NDC 1 ML inpatient 0.84 0.82 All Payors / Plans All Payors / Plans 0.84 other 0.84 0.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLYCOPYRROLATE 0.2 MG/ML SOLUTION ERX-636000000 CDM J1596 HCPCS 636 RC 60687-723-11 NDC JZ 2 ML inpatient 1.67 1.64 All Payors / Plans All Payors / Plans 1.67 other 1.67 1.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLUCAGON 1 MG RECON SOLN ERX-636000000 CDM J1610 HCPCS 636 RC 76329-3321-0 NDC JZ 1 UN inpatient 179.32 175.73 All Payors / Plans All Payors / Plans 179.32 other 179.32 179.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLUCAGON 1 MG/ML RECON SOLN ERX-636000000 CDM J1611 HCPCS 636 RC 44206-300-01 NDC JZ 1 UN inpatient 146.81 143.87 All Payors / Plans All Payors / Plans 146.81 other 146.81 146.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLUCAGON 1 MG/ML RECON SOLN ERX-636000000 CDM J1611 HCPCS 636 RC 44206-300-90 NDC JZ 0.3 UN inpatient 44.05 43.17 All Payors / Plans All Payors / Plans 44.05 other 44.05 44.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HALOPERIDOL LACTATE PER 5 MG ERX-636000000 CDM J1630 HCPCS 636 RC 60687-723-21 NDC JZ 0.4 ML inpatient 0.87 0.85 All Payors / Plans All Payors / Plans 0.87 other 0.87 0.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HEPARIN, PORCINE (PF) 10 UNIT/ML SYRINGE" ERX-636000000 CDM J1642 HCPCS 636 RC 51672-4245-1 NDC JZ 4 ML inpatient 0.44 0.43 All Payors / Plans All Payors / Plans 0.44 other 0.44 0.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HEPARIN, PORCINE (PF) 10 UNIT/ML SYRINGE" ERX-636000000 CDM J1642 HCPCS 636 RC 16714-442-01 NDC JZ 1 ML inpatient 0.26 0.25 All Payors / Plans All Payors / Plans 0.26 other 0.26 0.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HEPARIN, PORCINE (PF) 10 UNIT/ML SYRINGE" ERX-636000000 CDM J1642 HCPCS 636 RC 51672-4038-1 NDC JZ 1 ML inpatient 0.13 0.13 All Payors / Plans All Payors / Plans 0.13 other 0.13 0.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HEPARIN, PORCINE (PF) 10 UNIT/ML SYRINGE 3 ML SYRINGE" ERX-636000000 CDM J1642 HCPCS 636 RC 16729-293-15 NDC JZ 6 ML inpatient 1.16 1.14 All Payors / Plans All Payors / Plans 1.16 other 1.16 1.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HEPARIN, PORCINE (PF) 100 UNIT/ML SYRINGE" ERX-636000000 CDM J1642 HCPCS 636 RC 42291-454-90 NDC JZ 1 ML inpatient 0.16 0.16 All Payors / Plans All Payors / Plans 0.16 other 0.16 0.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HEPARIN (PORCINE) IN 0.9% NACL 5,000 UNIT/500 ML (10 UNIT/ML) PARENTERAL SOLUTION" ERX-250000000 CDM J1644 HCPCS 250 RC 0008-0923-51 NDC 1 ML inpatient 23.14 22.68 All Payors / Plans All Payors / Plans 23.14 other 23.14 23.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 0009-0758-01 NDC 9.576111111 ML inpatient 2.48 2.43 All Payors / Plans All Payors / Plans 2.48 other 2.48 2.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 63323-265-30 NDC 1 ML inpatient 23.1 22.64 All Payors / Plans All Payors / Plans 23.1 other 23.1 23.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM j1644 HCPCS 636 RC 0009-0280-03 NDC 800 ML inpatient 33.53 32.86 All Payors / Plans All Payors / Plans 33.53 other 33.53 33.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 0641-6059-10 NDC 6 ML inpatient 15.64 15.33 All Payors / Plans All Payors / Plans 15.64 other 15.64 15.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 0143-9718-01 NDC 32 ML inpatient 21.88 21.44 All Payors / Plans All Payors / Plans 21.88 other 21.88 21.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 51079-379-01 NDC 1 ML inpatient 2.12 2.08 All Payors / Plans All Payors / Plans 2.12 other 2.12 2.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 51079-721-01 NDC 10 ML inpatient 15.5 15.19 All Payors / Plans All Payors / Plans 15.5 other 15.5 15.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PROCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 68084-918-95 NDC 1 ML inpatient 2.12 2.08 All Payors / Plans All Payors / Plans 2.12 other 2.12 2.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 0904-7044-61 NDC JZ 0.4 ML inpatient 0.37 0.36 All Payors / Plans All Payors / Plans 0.37 other 0.37 0.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 0904-7045-61 NDC JZ 1 ML inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 27241-099-03 NDC JZ 3 ML inpatient 46.73 45.8 All Payors / Plans All Payors / Plans 46.73 other 46.73 46.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 60687-745-11 NDC JZ 0.6 ML inpatient 0.53 0.52 All Payors / Plans All Payors / Plans 0.53 other 0.53 0.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 68084-692-11 NDC JZ 1 ML inpatient 33.04 32.38 All Payors / Plans All Payors / Plans 33.04 other 33.04 33.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 42806-549-09 NDC JZ 250 ML inpatient 36.58 35.85 All Payors / Plans All Payors / Plans 36.58 other 36.58 36.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 0597-0152-30 NDC JZ 1 ML inpatient 10.27 10.06 All Payors / Plans All Payors / Plans 10.27 other 10.27 10.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 0597-0152-37 NDC JZ 1.5 ML inpatient 15.56 15.25 All Payors / Plans All Payors / Plans 15.56 other 15.56 15.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 0597-0153-37 NDC JZ 1 ML inpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 65862-354-30 NDC JZ 1 ML inpatient 6.03 5.91 All Payors / Plans All Payors / Plans 6.03 other 6.03 6.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PROCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 16714-444-01 NDC JZ 1 ML inpatient 0.82 0.8 All Payors / Plans All Payors / Plans 0.82 other 0.82 0.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 10135-747-01 NDC JZ 0.6 ML inpatient 25.44 24.93 All Payors / Plans All Payors / Plans 25.44 other 25.44 25.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 60687-540-11 NDC JZ 1 ML inpatient 61.27 60.04 All Payors / Plans All Payors / Plans 61.27 other 61.27 61.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 0904-5922-61 NDC JZ 1 ML inpatient 61.27 60.04 All Payors / Plans All Payors / Plans 61.27 other 61.27 61.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 0093-0318-01 NDC JZ 0.3 ML inpatient 23.52 23.05 All Payors / Plans All Payors / Plans 23.52 other 23.52 23.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 0093-0319-01 NDC JZ 0.6 ML inpatient 47.03 46.09 All Payors / Plans All Payors / Plans 47.03 other 47.03 47.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 60687-195-11 NDC JZ 0.3 ML inpatient 15.28 14.97 All Payors / Plans All Payors / Plans 15.28 other 15.28 15.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 68682-993-98 NDC JZ 0.3 ML inpatient 15.28 14.97 All Payors / Plans All Payors / Plans 15.28 other 15.28 15.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 50742-249-30 NDC JZ 0.4 ML inpatient 15.76 15.44 All Payors / Plans All Payors / Plans 15.76 other 15.76 15.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 60687-206-11 NDC JZ 0.6 ML inpatient 21.18 20.76 All Payors / Plans All Payors / Plans 21.18 other 21.18 21.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 0904-7219-61 NDC JZ 0.8 ML inpatient 30.6 29.99 All Payors / Plans All Payors / Plans 30.6 other 30.6 30.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 60687-217-11 NDC JZ 0.8 ML inpatient 29.03 28.45 All Payors / Plans All Payors / Plans 29.03 other 29.03 29.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 68682-997-98 NDC JZ 0.8 ML inpatient 40.44 39.63 All Payors / Plans All Payors / Plans 40.44 other 40.44 40.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 51079-924-01 NDC JZ 0.8 ML inpatient 40.44 39.63 All Payors / Plans All Payors / Plans 40.44 other 40.44 40.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 0121-0865-05 NDC JZ 1 ML inpatient 50.55 49.54 All Payors / Plans All Payors / Plans 50.55 other 50.55 50.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 57896-780-16 NDC JZ 0.4 ML inpatient 15.33 15.02 All Payors / Plans All Payors / Plans 15.33 other 15.33 15.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML RECON SOLN ERX-636000000 CDM J1720 HCPCS 636 RC 0338-0049-48 NDC JZ 0.25 UN inpatient 21.12 20.7 All Payors / Plans All Payors / Plans 21.12 other 21.12 21.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML RECON SOLN ERX-636000000 CDM J1720 HCPCS 636 RC 0264-1800-32 NDC JZ 0.5 UN inpatient 42.41 41.56 All Payors / Plans All Payors / Plans 42.41 other 42.41 42.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE SOD SUCC (PF) 500 MG/4 ML RECON SOLN ERX-636000000 CDM J1720 HCPCS 636 RC 0264-7800-10 NDC JZ 0.4 UN inpatient 79.32 77.73 All Payors / Plans All Payors / Plans 79.32 other 79.32 79.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRON SUCROSE 200 MG IRON/10 ML SOLUTION ERX-636000000 CDM J1756 HCPCS 636 RC 63739-645-10 NDC JZ 5 ML inpatient 97.42 95.47 All Payors / Plans All Payors / Plans 97.42 other 97.42 97.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRON SUCROSE PER 1 MG ERX-636000000 CDM J1756 HCPCS 636 RC 72865-214-05 NDC JZ 2.5 ML inpatient 68.99 67.61 All Payors / Plans All Payors / Plans 68.99 other 68.99 68.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRON SUCROSE PER 1 MG ERX-636000000 CDM J1756 HCPCS 636 RC 70954-316-10 NDC JZ 5 ML inpatient 137.98 135.22 All Payors / Plans All Payors / Plans 137.98 other 137.98 137.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DROPERIDOL PER 5 MG ERX-636000000 CDM J1790 HCPCS 636 RC 0527-1282-01 NDC JZ 0.25 ML inpatient 4.98 4.88 All Payors / Plans All Payors / Plans 4.98 other 4.98 4.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DROPERIDOL PER 5 MG ERX-636000000 CDM J1790 HCPCS 636 RC 60687-380-11 NDC JZ 0.5 ML inpatient 9.96 9.76 All Payors / Plans All Payors / Plans 9.96 other 9.96 9.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ESMOLOL 100 MG/10 ML (10 MG/ML) SOLUTION ERX-636000000 CDM J1805 HCPCS 636 RC 0904-7237-61 NDC JZ 2 ML inpatient 15.21 14.91 All Payors / Plans All Payors / Plans 15.21 other 15.21 15.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ESMOLOL 100 MG/10 ML (10 MG/ML) SOLUTION ERX-636000000 CDM J1805 HCPCS 636 RC 65628-050-04 NDC JZ 5 ML inpatient 20.59 20.18 All Payors / Plans All Payors / Plans 20.59 other 20.59 20.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METRONIDAZOLE 500 MG/100 ML PIGGYBACK ERX-636000000 CDM J1836 HCPCS 636 RC 68084-327-11 NDC JZ 100 ML inpatient 6.03 5.91 All Payors / Plans All Payors / Plans 6.03 other 6.03 6.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METRONIDAZOLE 500 MG/100 ML PIGGYBACK ERX-636000000 CDM J1836 HCPCS 636 RC 50268-362-11 NDC JZ 100 ML inpatient 10.77 10.55 All Payors / Plans All Payors / Plans 10.77 other 10.77 10.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METRONIDAZOLE 500 MG/100 ML PIGGYBACK ERX-636000000 CDM J1836 HCPCS 636 RC 60687-701-11 NDC JZ 100 ML inpatient 15.26 14.95 All Payors / Plans All Payors / Plans 15.26 other 15.26 15.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 68180-150-01 NDC JZ 1 ML inpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 51079-608-01 NDC JZ 0.5 ML inpatient 0.47 0.46 All Payors / Plans All Payors / Plans 0.47 other 0.47 0.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 60687-629-11 NDC JZ 1 ML inpatient 15.98 15.66 All Payors / Plans All Payors / Plans 15.98 other 15.98 15.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 0378-3065-77 NDC JZ 0.19 ML inpatient 1.14 1.12 All Payors / Plans All Payors / Plans 1.14 other 1.14 1.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 51079-599-01 NDC JZ 0.57 ML inpatient 0.48 0.47 All Payors / Plans All Payors / Plans 0.48 other 0.48 0.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 0378-9119-16 NDC JZ 1 ML inpatient 0.87 0.85 All Payors / Plans All Payors / Plans 0.87 other 0.87 0.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 47781-424-11 NDC JZ 0.5 ML inpatient 2.94 2.88 All Payors / Plans All Payors / Plans 2.94 other 2.94 2.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 47781-427-47 NDC JZ 0.5 ML inpatient 0.41 0.4 All Payors / Plans All Payors / Plans 0.41 other 0.41 0.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 10481-0112-8 NDC JZ 0.5 ML inpatient 0.3 0.29 All Payors / Plans All Payors / Plans 0.3 other 0.3 0.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 0574050811 NDC JZ 0.375 ML inpatient 0.23 0.23 All Payors / Plans All Payors / Plans 0.23 other 0.23 0.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 0087074002 NDC JZ 0.5 ML inpatient 1.47 1.44 All Payors / Plans All Payors / Plans 1.47 other 1.47 1.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 5483800180 NDC JZ 0.5 ML inpatient 1.47 1.44 All Payors / Plans All Payors / Plans 1.47 other 1.47 1.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 0904759060 NDC JZ 0.24 ML inpatient 0.22 0.22 All Payors / Plans All Payors / Plans 0.22 other 0.22 0.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 0904759161 NDC JZ 0.54 ML inpatient 0.48 0.47 All Payors / Plans All Payors / Plans 0.48 other 0.48 0.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 83078-702-02 NDC JZ 1 ML inpatient 6.12 6 All Payors / Plans All Payors / Plans 6.12 other 6.12 6.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 5 MG/ML SOLUTION ERX-636000000 CDM J1920 HCPCS 636 RC 23155-549-31 NDC 2 ML inpatient 10.68 10.47 All Payors / Plans All Payors / Plans 10.68 other 10.68 10.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 5 MG/ML SOLUTION ERX-636000000 CDM J1920 HCPCS 636 RC 52015-080-01 NDC JZ 2 ML inpatient 10.23 10.03 All Payors / Plans All Payors / Plans 10.23 other 10.23 10.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LANREOTIDE 120 MG/0.5 ML SYRINGE ERX-636000000 CDM J1930 HCPCS 636 RC 68084-728-11 NDC JZ 0.5 ML inpatient 10246.46 10041.53 All Payors / Plans All Payors / Plans 10246.46 other 10246.46 10246.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LARONIDASE 2.9 MG/5 ML SOLUTION 5 ML VIAL ERX-636000000 CDM J1931 HCPCS 636 RC 68084-735-11 NDC JZ 55 ML inpatient 19305.22 18919.12 All Payors / Plans All Payors / Plans 19305.22 other 19305.22 19305.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUMETANIDE PER 0.5 MG ERX-636000000 CDM J1939 HCPCS 636 RC 0338-0017-03 NDC 8 ML inpatient 16.21 15.89 All Payors / Plans All Payors / Plans 16.21 other 16.21 16.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUMETANIDE PER 0.5 MG ERX-636000000 CDM J1939 HCPCS 636 RC 62332-055-31 NDC JZ 8 ML inpatient 11.94 11.7 All Payors / Plans All Payors / Plans 11.94 other 11.94 11.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUMETANIDE PER 0.5 MG ERX-636000000 CDM J1939 HCPCS 636 RC 0378-0872-16 NDC JZ 4 ML inpatient 15.96 15.64 All Payors / Plans All Payors / Plans 15.96 other 15.96 15.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUMETANIDE PER 0.5 MG ERX-636000000 CDM J1939 HCPCS 636 RC 0228-2129-10 NDC JZ 4 ML inpatient 10.79 10.57 All Payors / Plans All Payors / Plans 10.79 other 10.79 10.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUMETANIDE PER 0.5 MG ERX-636000000 CDM J1939 HCPCS 636 RC 29300-137-01 NDC JZ 8 ML inpatient 35.86 35.14 All Payors / Plans All Payors / Plans 35.86 other 35.86 35.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 0121-0893-15 NDC JW 5 ML inpatient 15.19 14.89 All Payors / Plans All Payors / Plans 15.19 other 15.19 15.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 57896-401-03 NDC JZ 2 ML inpatient 5.47 5.36 All Payors / Plans All Payors / Plans 5.47 other 5.47 5.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 60687-129-11 NDC JZ 4 ML inpatient 32.56 31.91 All Payors / Plans All Payors / Plans 32.56 other 32.56 32.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 0069-5800-43 NDC JZ 4 ML inpatient 30.45 29.84 All Payors / Plans All Payors / Plans 30.45 other 30.45 30.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 0069-5800-61 NDC JZ 2 ML inpatient 15.23 14.93 All Payors / Plans All Payors / Plans 15.23 other 15.23 15.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 42291-412-60 NDC JZ 1 ML inpatient 0.46 0.45 All Payors / Plans All Payors / Plans 0.46 other 0.46 0.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 49702-228-13 NDC JZ 10 ML inpatient 10.43 10.22 All Payors / Plans All Payors / Plans 10.43 other 10.43 10.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 60687-292-11 NDC JZ 10 ML inpatient 10.58 10.37 All Payors / Plans All Payors / Plans 10.58 other 10.58 10.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 24208-485-10 NDC JZ 2 ML inpatient 0.61 0.6 All Payors / Plans All Payors / Plans 0.61 other 0.61 0.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 70377-081-11 NDC JZ 4 ML inpatient 0.8 0.78 All Payors / Plans All Payors / Plans 0.8 other 0.8 0.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 24208-486-10 NDC JZ 1 ML inpatient 0.21 0.21 All Payors / Plans All Payors / Plans 0.21 other 0.21 0.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 65862-946-01 NDC JZ 2 ML inpatient 0.42 0.41 All Payors / Plans All Payors / Plans 0.42 other 0.42 0.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 0904-5523-61 NDC JZ 2 ML inpatient 0.87 0.85 All Payors / Plans All Payors / Plans 0.87 other 0.87 0.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 16729-414-01 NDC JZ 2 ML inpatient 0.87 0.85 All Payors / Plans All Payors / Plans 0.87 other 0.87 0.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 60505-0096-0 NDC JZ 1 ML inpatient 0.25 0.25 All Payors / Plans All Payors / Plans 0.25 other 0.25 0.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 51079-437-01 NDC JZ 2 ML inpatient 2.08 2.04 All Payors / Plans All Payors / Plans 2.08 other 2.08 2.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 69238-1171-9 NDC JZ 25 ML inpatient 25.9 25.38 All Payors / Plans All Payors / Plans 25.9 other 25.9 25.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUPROLIDE ACETATE (3 MONTH) PER 3.75 MG ERX-636000000 CDM J1950 HCPCS 636 RC 0990-7983-61 NDC JZ 1 UN inpatient 5676.15 5562.63 All Payors / Plans All Payors / Plans 5676.15 other 5676.15 5676.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUPROLIDE PER 3.75 MG ERX-636000000 CDM J1950 HCPCS 636 RC 63323-623-53 NDC JZ 1 UN inpatient 2348.34 2301.37 All Payors / Plans All Payors / Plans 2348.34 other 2348.34 2348.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETRIRACETAM PER 10 MG ERX-636000000 CDM J1953 HCPCS 636 RC 16714-696-01 NDC JZ 5 ML inpatient 10.38 10.17 All Payors / Plans All Payors / Plans 10.38 other 10.38 10.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETRIRACETAM PER 10 MG ERX-636000000 CDM J1953 HCPCS 636 RC 16714-694-01 NDC JZ 2.5 ML inpatient 5.19 5.09 All Payors / Plans All Payors / Plans 5.19 other 5.19 5.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOFLOXACIN PER 250 MG ERX-636000000 CDM J1956 HCPCS 636 RC 63323-012-10 NDC 150 ML inpatient 15.19 14.89 All Payors / Plans All Payors / Plans 15.19 other 15.19 15.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOFLOXACIN PER 250 MG ERX-636000000 CDM J1956 HCPCS 636 RC 70004-085-44 NDC 100 ML inpatient 11 10.78 All Payors / Plans All Payors / Plans 11 other 11 11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOFLOXACIN PER 250 MG ERX-636000000 CDM J1956 HCPCS 636 RC 42852-705-50 NDC 150 ML inpatient 15.67 15.36 All Payors / Plans All Payors / Plans 15.67 other 15.67 15.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOFLOXACIN PER 250 MG ERX-636000000 CDM J1956 HCPCS 636 RC 61703-342-50 NDC 150 ML inpatient 15.67 15.36 All Payors / Plans All Payors / Plans 15.67 other 15.67 15.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOFLOXACIN PER 250 MG ERX-636000000 CDM J1956 HCPCS 636 RC 70860-200-50 NDC 100 ML inpatient 15.23 14.93 All Payors / Plans All Payors / Plans 15.23 other 15.23 15.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOFLOXACIN PER 250 MG ERX-636000000 CDM J1956 HCPCS 636 RC 0338-1025-41 NDC 150 ML inpatient 15.53 15.22 All Payors / Plans All Payors / Plans 15.53 other 15.53 15.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2001 HCPCS 636 RC 50111-648-01 NDC JZ 0.08 ML inpatient 0.25 0.25 All Payors / Plans All Payors / Plans 0.25 other 0.25 0.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2001 HCPCS 636 RC 62332-023-31 NDC JZ 5 ML inpatient 10.4 10.19 All Payors / Plans All Payors / Plans 10.4 other 10.4 10.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PER 10 MG ERX-636000000 CDM J2002 HCPCS 636 RC 0641-6142-25 NDC 500 ML inpatient 40.45 39.64 All Payors / Plans All Payors / Plans 40.45 other 40.45 40.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PER 10 MG ERX-636000000 CDM J2002 HCPCS 636 RC 0641-6188-01 NDC 500 ML inpatient 36.21 35.49 All Payors / Plans All Payors / Plans 36.21 other 36.21 36.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 20 MG/ML (2 %) SOLUTION ERX-250000000 CDM J2003 HCPCS 250 RC 68382-528-60 NDC JZ 2 ML inpatient 4.16 4.08 All Payors / Plans All Payors / Plans 4.16 other 4.16 4.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 20 MG/ML (2 %) SOLUTION ERX-250000000 CDM J2003 HCPCS 250 RC 50268-176-11 NDC JZ 1 ML inpatient 5.42 5.31 All Payors / Plans All Payors / Plans 5.42 other 5.42 5.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 20 MG/ML (2 %) SOLUTION ERX-250000000 CDM J2003 HCPCS 250 RC 31722-103-30 NDC JZ 6 ML inpatient 21.51 21.08 All Payors / Plans All Payors / Plans 21.51 other 21.51 21.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 68084-288-11 NDC JZ 30 ML inpatient 15.82 15.5 All Payors / Plans All Payors / Plans 15.82 other 15.82 15.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 51672-1386-3 NDC JZ 2 ML inpatient 2.39 2.34 All Payors / Plans All Payors / Plans 2.39 other 2.39 2.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 17238-900-11 NDC JZ 5 ML inpatient 5.97 5.85 All Payors / Plans All Payors / Plans 5.97 other 5.97 5.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 17238-900-99 NDC JZ 0.8 ML inpatient 2.35 2.3 All Payors / Plans All Payors / Plans 2.35 other 2.35 2.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 0904-5784-61 NDC JZ 10 ML inpatient 20.28 19.87 All Payors / Plans All Payors / Plans 20.28 other 20.28 20.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 50111-647-01 NDC JZ 0.8 ML inpatient 2.41 2.36 All Payors / Plans All Payors / Plans 2.41 other 2.41 2.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 0904-5785-61 NDC JZ 5 ML inpatient 2.58 2.53 All Payors / Plans All Payors / Plans 2.58 other 2.58 2.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 0904-7346-61 NDC JZ 2 ML inpatient 4.16 4.08 All Payors / Plans All Payors / Plans 4.16 other 4.16 4.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 16714-721-02 NDC JZ 0.8 ML inpatient 2.41 2.36 All Payors / Plans All Payors / Plans 2.41 other 2.41 2.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 0121-0721-04 NDC JZ 20 ML inpatient 83.41 81.74 All Payors / Plans All Payors / Plans 83.41 other 83.41 83.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 0904-7159-61 NDC JZ 7 ML inpatient 7.27 7.12 All Payors / Plans All Payors / Plans 7.27 other 7.27 7.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINEZOLID PER 200 MG ERX-636000000 CDM J2020 HCPCS 636 RC 72485-504-25 NDC 300 ML inpatient 40.18 39.38 All Payors / Plans All Payors / Plans 40.18 other 40.18 40.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINEZOLID PER 200 MG ERX-636000000 CDM J2020 HCPCS 636 RC 0338-9636-01 NDC 300 ML inpatient 84.91 83.21 All Payors / Plans All Payors / Plans 84.91 other 84.91 84.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINEZOLID PER 200 MG ERX-636000000 CDM J2020 HCPCS 636 RC 50268-368-11 NDC JZ 300 ML inpatient 40.26 39.45 All Payors / Plans All Payors / Plans 40.26 other 40.26 40.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM 2 MG/ML SYRINGE 1 ML CARTRIDGE ERX-636000000 CDM J2060 HCPCS 636 RC 66993-079-96 NDC JZ 0.25 ML inpatient 5.1 5 All Payors / Plans All Payors / Plans 5.1 other 5.1 5.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM PER 2 MG ERX-636000000 CDM J2060 HCPCS 636 RC 0173-0718-20 NDC JZ 0.25 ML inpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM PER 2 MG ERX-636000000 CDM J2060 HCPCS 636 RC 66993-078-96 NDC JZ 0.25 ML inpatient 1.51 1.48 All Payors / Plans All Payors / Plans 1.51 other 1.51 1.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM PER 2 MG ERX-636000000 CDM J2060 HCPCS 636 RC 0054-3270-99 NDC JZ 1 ML inpatient 6.16 6.04 All Payors / Plans All Payors / Plans 6.16 other 6.16 6.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM PER 2 MG ERX-636000000 CDM J2060 HCPCS 636 RC 60505-0829-1 NDC JZ 1 ML inpatient 6.18 6.06 All Payors / Plans All Payors / Plans 6.18 other 6.18 6.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANNITOL PER 50 ML ERX-636000000 CDM J2150 HCPCS 636 RC 68094-756-59 NDC JZ 50 ML inpatient 11.13 10.91 All Payors / Plans All Payors / Plans 11.13 other 11.13 11.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANNITOL PER 50 ML ERX-636000000 CDM J2150 HCPCS 636 RC 0054-8301-25 NDC JZ 50 ML inpatient 11.13 10.91 All Payors / Plans All Payors / Plans 11.13 other 11.13 11.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEPERIDINE (PF) 25 MG/ML SOLUTION ERX-636000000 CDM J2175 HCPCS 636 RC 0904-6666-61 NDC JZ 0.5 ML inpatient 7.63 7.48 All Payors / Plans All Payors / Plans 7.63 other 7.63 7.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLERGONOVINE MALEATE PER 0.2 MG ERX-636000000 CDM J2210 HCPCS 636 RC 60687-591-11 NDC JZ 1 ML inpatient 87 85.26 All Payors / Plans All Payors / Plans 87 other 87 87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLERGONOVINE MALEATE PER 0.2 MG ERX-636000000 CDM J2210 HCPCS 636 RC 63739-903-10 NDC JZ 1 ML inpatient 101.27 99.24 All Payors / Plans All Payors / Plans 101.27 other 101.27 101.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICAFUNGIN 100 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J2248 HCPCS 636 RC 0641-6174-01 NDC JW 0.5 UN inpatient 68.84 67.46 All Payors / Plans All Payors / Plans 68.84 other 68.84 68.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICAFUNGIN 100 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J2248 HCPCS 636 RC 0264-7850-00 NDC JZ 1 UN inpatient 138.05 135.29 All Payors / Plans All Payors / Plans 138.05 other 138.05 138.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICAFUNGIN 100 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J2248 HCPCS 636 RC 0143-9746-01 NDC JZ 1 UN inpatient 134.9 132.2 All Payors / Plans All Payors / Plans 134.9 other 134.9 134.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICAFUNGIN PER 1 MG ERX-636000000 CDM J2248 HCPCS 636 RC 0143-9746-10 NDC JZ 1 UN inpatient 244.02 239.14 All Payors / Plans All Payors / Plans 244.02 other 244.02 244.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICAFUNGIN PER 1 MG ERX-636000000 CDM J2248 HCPCS 636 RC 63323-665-00 NDC JZ 1 UN inpatient 81.52 79.89 All Payors / Plans All Payors / Plans 81.52 other 81.52 81.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM PER 1 MG ERX-636000000 CDM J2250 HCPCS 636 RC 23155-294-31 NDC 2 ML inpatient 0.26 0.25 All Payors / Plans All Payors / Plans 0.26 other 0.26 0.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM (PF) 1 MG/ML SOLUTION ERX-636000000 CDM J2250 HCPCS 636 RC 16714-896-01 NDC JZ 2 ML inpatient 2.34 2.29 All Payors / Plans All Payors / Plans 2.34 other 2.34 2.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM (PF) 1 MG/ML SOLUTION ERX-636000000 CDM J2250 HCPCS 636 RC 60687-480-11 NDC JZ 0.5 ML inpatient 0.59 0.58 All Payors / Plans All Payors / Plans 0.59 other 0.59 0.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM (PF) 1 MG/ML SOLUTION ERX-636000000 CDM J2250 HCPCS 636 RC 0904-6637-61 NDC JZ 0.5 ML inpatient 0.19 0.19 All Payors / Plans All Payors / Plans 0.19 other 0.19 0.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM (PF) 1 MG/ML SOLUTION ERX-636000000 CDM J2250 HCPCS 636 RC 50289-3250-1 NDC JZ 0.25 ML inpatient 0.1 0.1 All Payors / Plans All Payors / Plans 0.1 other 0.1 0.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM (PF) 1 MG/ML SOLUTION ERX-636000000 CDM J2250 HCPCS 636 RC 0904-6709-61 NDC JZ 1 ML inpatient 5.12 5.02 All Payors / Plans All Payors / Plans 5.12 other 5.12 5.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM PER 1 MG ERX-636000000 CDM J2250 HCPCS 636 RC 0904-6718-39 NDC JZ 1 ML inpatient 5.85 5.73 All Payors / Plans All Payors / Plans 5.85 other 5.85 5.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM PER 1 MG ERX-636000000 CDM J2250 HCPCS 636 RC 68084-572-01 NDC JZ 0.4 ML inpatient 2.34 2.29 All Payors / Plans All Payors / Plans 2.34 other 2.34 2.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM IN 0.9 % NACL 1 MG/ML SOLUTION ERX-636000000 CDM J2251 HCPCS 636 RC 0121-1488-10 NDC JZ 100 ML inpatient 133.88 131.2 All Payors / Plans All Payors / Plans 133.88 other 133.88 133.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM IN 0.9 % NACL 1 MG/ML SOLUTION ERX-636000000 CDM J2251 HCPCS 636 RC 0121-1744-05 NDC JZ 100 ML inpatient 64.26 62.97 All Payors / Plans All Payors / Plans 64.26 other 64.26 64.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MILRINONE 40 MG/200 ML (200 MCG/ML) PIGGYBACK ERX-636000000 CDM J2260 HCPCS 636 RC 70860-778-41 NDC 200 ML inpatient 64.56 63.27 All Payors / Plans All Payors / Plans 64.56 other 64.56 64.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MILRINONE 40 MG/200 ML (200 MCG/ML) PIGGYBACK ERX-636000000 CDM J2260 HCPCS 636 RC 68084-572-11 NDC JZ 200 ML inpatient 63.77 62.49 All Payors / Plans All Payors / Plans 63.77 other 63.77 63.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MILRINONE 40 MG/200 ML (200 MCG/ML) PIGGYBACK ERX-636000000 CDM J2260 HCPCS 636 RC 70436-039-01 NDC JZ 200 ML inpatient 63.77 62.49 All Payors / Plans All Payors / Plans 63.77 other 63.77 63.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 10 MG/ML SYRINGE ERX-636000000 CDM J2270 HCPCS 636 RC 60505-3928-1 NDC JZ 0.4 ML inpatient 4.15 4.07 All Payors / Plans All Payors / Plans 4.15 other 4.15 4.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 2 MG/ML SYRINGE ERX-636000000 CDM J2270 HCPCS 636 RC 4390097647 NDC JZ 0.25 ML inpatient 2.77 2.71 All Payors / Plans All Payors / Plans 2.77 other 2.77 2.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 30 MG/30 ML (1 MG/ML) PATIENT CONTROL.ANALGESIA SOLN ERX-636000000 CDM J2270 HCPCS 636 RC 51079-734-01 NDC JZ 30 ML inpatient 49.85 48.85 All Payors / Plans All Payors / Plans 49.85 other 49.85 49.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 4 MG/ML SYRINGE ERX-636000000 CDM J2270 HCPCS 636 RC 51079-735-01 NDC JZ 0.5 ML inpatient 5.45 5.34 All Payors / Plans All Payors / Plans 5.45 other 5.45 5.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 4 MG/ML SYRINGE ERX-636000000 CDM J2270 HCPCS 636 RC 51079-736-01 NDC JZ 0.13 ML inpatient 1.42 1.39 All Payors / Plans All Payors / Plans 1.42 other 1.42 1.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE PER 10 MG ERX-636000000 CDM J2270 HCPCS 636 RC 51079-074-01 NDC JZ 0.4 ML inpatient 6.11 5.99 All Payors / Plans All Payors / Plans 6.11 other 6.11 6.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE PER 10 MG ERX-636000000 CDM J2270 HCPCS 636 RC 62135-579-12 NDC JZ 0.2 ML inpatient 3.06 3 All Payors / Plans All Payors / Plans 3.06 other 3.06 3.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE PER 10 MG ERX-636000000 CDM J2272 HCPCS 636 RC 68084-447-11 NDC JZ 0.6 ML inpatient 6.58 6.45 All Payors / Plans All Payors / Plans 6.58 other 6.58 6.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE PER 10 MG ERX-636000000 CDM J2274 HCPCS 636 RC 23155-832-01 NDC JZ 0.1 ML inpatient 0.37 0.36 All Payors / Plans All Payors / Plans 0.37 other 0.37 0.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALBUPHINE PER 10 MG ERX-636000000 CDM J2300 HCPCS 636 RC 50268-718-11 NDC 0.5 ML inpatient 15.46 15.15 All Payors / Plans All Payors / Plans 15.46 other 15.46 15.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROGLYCERIN 50 MG/250 ML (200 MCG/ML) SOLUTION ERX-636000000 CDM J2305 HCPCS 636 RC 29300-128-01 NDC JZ 250 ML inpatient 50.13 49.13 All Payors / Plans All Payors / Plans 50.13 other 50.13 50.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROGLYCERIN IN 5 % DEXTROSE 25 MG/250 ML (100 MCG/ML) SOLUTION ERX-636000000 CDM J2305 HCPCS 636 RC 60687-593-01 NDC JZ 1 ML inpatient 49.65 48.66 All Payors / Plans All Payors / Plans 49.65 other 49.65 49.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALOXONE PER 1 MG ERX-636000000 CDM J2310 HCPCS 636 RC 0338-0691-04 NDC 0.1 ML inpatient 1.62 1.59 All Payors / Plans All Payors / Plans 1.62 other 1.62 1.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALOXONE 1 MG/ML 1 MG/ML SYRINGE ERX-636000000 CDM J2310 HCPCS 636 RC 31722-520-01 NDC JZ 1 ML inpatient 32.2 31.56 All Payors / Plans All Payors / Plans 32.2 other 32.2 32.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALOXONE 1 MG/ML 1 MG/ML SYRINGE ERX-636000000 CDM J2310 HCPCS 636 RC 51079-075-01 NDC JZ 0.4 ML inpatient 12.88 12.62 All Payors / Plans All Payors / Plans 12.88 other 12.88 12.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALOXONE 1 MG/ML 1 MG/ML SYRINGE ERX-636000000 CDM J2310 HCPCS 636 RC 63739-327-10 NDC JZ 0.4 ML inpatient 10.02 9.82 All Payors / Plans All Payors / Plans 10.02 other 10.02 10.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALOXONE PER 1 MG ERX-636000000 CDM J2310 HCPCS 636 RC 0904-6442-61 NDC JZ 0.1 ML inpatient 2.1 2.06 All Payors / Plans All Payors / Plans 2.1 other 2.1 2.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALOXONE PER 1 MG ERX-636000000 CDM J2310 HCPCS 636 RC 23155-834-01 NDC JZ 0.1 ML inpatient 2.1 2.06 All Payors / Plans All Payors / Plans 2.1 other 2.1 2.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OCTREOTIDE,MICROSPHERES 20 MG SUSPENSION,EXTENDED REL RECON" ERX-636000000 CDM J2353 HCPCS 636 RC 49281-215-88 NDC JZ 1 UN inpatient 4929.66 4831.07 All Payors / Plans All Payors / Plans 4929.66 other 4929.66 4929.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OCTREOTIDE,MICROSPHERES 30 MG SUSPENSION,EXTENDED REL RECON" ERX-636000000 CDM J2353 HCPCS 636 RC 49281-400-10 NDC JZ 1 UN inpatient 7041.32 6900.49 All Payors / Plans All Payors / Plans 7041.32 other 7041.32 7041.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCTREOTIDE PER 25 MCG ERX-636000000 CDM J2354 HCPCS 636 RC 60687-593-11 NDC JZ 1 ML inpatient 15.28 14.97 All Payors / Plans All Payors / Plans 15.28 other 15.28 15.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCTREOTIDE PER 25 MCG ERX-636000000 CDM J2354 HCPCS 636 RC 0406-0125-01 NDC JZ 1 ML inpatient 61.21 59.99 All Payors / Plans All Payors / Plans 61.21 other 61.21 61.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCTREOTIDE PER 25 MCG ERX-636000000 CDM J2354 HCPCS 636 RC 0406-0125-23 NDC JZ 1 ML inpatient 15.27 14.96 All Payors / Plans All Payors / Plans 15.27 other 15.27 15.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCTREOTIDE PER 25 MCG ERX-636000000 CDM J2354 HCPCS 636 RC 0406-0123-23 NDC JZ 1 ML inpatient 65.57 64.26 All Payors / Plans All Payors / Plans 65.57 other 65.57 65.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCTREOTIDE PER 25 MCG ERX-636000000 CDM J2354 HCPCS 636 RC 0904-6824-61 NDC JZ 0.5 ML inpatient 7.76 7.6 All Payors / Plans All Payors / Plans 7.76 other 7.76 7.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCTREOTIDE PER 25 MCG ERX-636000000 CDM J2354 HCPCS 636 RC 0121-2316-15 NDC JZ 1 ML inpatient 50.03 49.03 All Payors / Plans All Payors / Plans 50.03 other 50.03 50.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCTREOTIDE PER 25 MCG ERX-636000000 CDM J2354 HCPCS 636 RC 0168-0015-31 NDC JZ 1 ML inpatient 50.03 49.03 All Payors / Plans All Payors / Plans 50.03 other 50.03 50.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLANZAPINE 10 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J2359 HCPCS 636 RC 14789-102-02 NDC JZ 0.5 UN inpatient 83.39 81.72 All Payors / Plans All Payors / Plans 83.39 other 83.39 83.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPHRINE IN 0.9% NACL 40 MG/250 ML (160 MCG/ML) SOLUTION ERX-250000000 CDM J2371 HCPCS 250 RC 0186-0777-39 NDC 4.875 ML inpatient 81.87 80.23 All Payors / Plans All Payors / Plans 81.87 other 81.87 81.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPHRINE IN 0.9% NACL 40 MG/250 ML (160 MCG/ML) SOLUTION ERX-250000000 CDM J2371 HCPCS 250 RC 0517-9302-01 NDC 1.48125 ML inpatient 151.1 148.08 All Payors / Plans All Payors / Plans 151.1 other 151.1 151.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPHRINE 0.5 MG/5 ML (100 MCG/ML) SYRINGE ERX-636000000 CDM J2371 HCPCS 636 RC 0469-0607-73 NDC 2 ML inpatient 0.1 0.1 All Payors / Plans All Payors / Plans 0.1 other 0.1 0.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPHRINE PER 1 ML ERX-636000000 CDM J2371 HCPCS 636 RC 0904-6624-61 NDC 15 ML inpatient 76.16 74.64 All Payors / Plans All Payors / Plans 76.16 other 76.16 76.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPHRINE PER 1 ML ERX-636000000 CDM J2371 HCPCS 636 RC 68084-449-11 NDC 1 ML inpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPHRINE 0.5 MG/5 ML (100 MCG/ML) SYRINGE ERX-636000000 CDM J2371 HCPCS 636 RC 49884-724-01 NDC JZ 0.04 ML inpatient 0.25 0.25 All Payors / Plans All Payors / Plans 0.25 other 0.25 0.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLOROPROCAINE 20 MG/ML (2 %) SOLUTION ERX-636000000 CDM J2401 HCPCS 636 RC 0990-7923-36 NDC 2.5 ML inpatient 6.79 6.65 All Payors / Plans All Payors / Plans 6.79 other 6.79 6.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLOROPROCAINE PER 30 ML ERX-636000000 CDM J2401 HCPCS 636 RC 0904-7120-04 NDC JZ 3 ML inpatient 12.7 12.45 All Payors / Plans All Payors / Plans 12.7 other 12.7 12.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICARDIPINE 25 MG/10 ML SOLUTION ERX-636000000 CDM J2404 HCPCS 636 RC 60687-833-11 NDC JZ 0.04 ML inpatient 65.57 64.26 All Payors / Plans All Payors / Plans 65.57 other 65.57 65.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICARDIPINE 25 MG/10 ML SOLUTION 10 ML VIAL ERX-636000000 CDM J2404 HCPCS 636 RC 63739-328-10 NDC JZ 20 ML inpatient 99.7 97.71 All Payors / Plans All Payors / Plans 99.7 other 99.7 99.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 1 MG ERX-636000000 CDM J2405 HCPCS 636 RC 0338-0553-18 NDC 4 ML inpatient 4.16 4.08 All Payors / Plans All Payors / Plans 4.16 other 4.16 4.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 1 MG ERX-636000000 CDM J2405 HCPCS 636 RC 59762-0074-1 NDC JZ 2 ML inpatient 0.5 0.49 All Payors / Plans All Payors / Plans 0.5 other 0.5 0.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 1 MG ERX-636000000 CDM J2405 HCPCS 636 RC 60687-582-01 NDC JZ 2 ML inpatient 0.5 0.49 All Payors / Plans All Payors / Plans 0.5 other 0.5 0.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 1 MG ERX-636000000 CDM J2405 HCPCS 636 RC 60687-582-11 NDC JZ 0.61 ML inpatient 0.19 0.19 All Payors / Plans All Payors / Plans 0.19 other 0.19 0.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 1 MG ERX-636000000 CDM J2405 HCPCS 636 RC 62559-138-11 NDC JZ 1 ML inpatient 0.31 0.3 All Payors / Plans All Payors / Plans 0.31 other 0.31 0.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAMIDRONATE DISODIUM PER 30 MG ERX-636000000 CDM J2430 HCPCS 636 RC 0713-0503-06 NDC JZ 10 ML inpatient 142.46 139.61 All Payors / Plans All Payors / Plans 142.46 other 142.46 142.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAMIDRONATE DISODIUM PER 30 MG ERX-636000000 CDM J2430 HCPCS 636 RC 59762-0073-1 NDC JZ 10 ML inpatient 44.81 43.91 All Payors / Plans All Payors / Plans 44.81 other 44.81 44.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAPAVERINE PER 60 MG ERX-636000000 CDM J2440 HCPCS 636 RC 0406-3243-01 NDC JZ 2 ML inpatient 65.57 64.26 All Payors / Plans All Payors / Plans 65.57 other 65.57 65.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PALONOSETRON PER 25 MCG ERX-636000000 CDM J2469 HCPCS 636 RC 0168-0146-30 NDC JZ 5 ML inpatient 31.02 30.4 All Payors / Plans All Payors / Plans 31.02 other 31.02 31.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEGFILGRASTIM PER 6 MG ERX-636000000 CDM J2506 HCPCS 636 RC 42858-301-01 NDC JZ 0.6 ML inpatient 5180.41 5076.8 All Payors / Plans All Payors / Plans 5180.41 other 5180.41 5180.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PENICILLIN G POTASSIUM PER 600000 UNITS ERX-636000000 CDM J2540 HCPCS 636 RC 0781-3411-95 NDC 50 ML inpatient 64.95 63.65 All Payors / Plans All Payors / Plans 64.95 other 64.95 64.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PENICILLIN G POTASSIUM PER 600000 UNITS ERX-636000000 CDM J2540 HCPCS 636 RC 0409-3515-11 NDC JZ 0.024 UN inpatient 1.53 1.5 All Payors / Plans All Payors / Plans 1.53 other 1.53 1.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 68084-450-01 NDC 50 ML inpatient 51.34 50.31 All Payors / Plans All Payors / Plans 51.34 other 51.34 51.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 50268-398-11 NDC JZ 100 ML inpatient 62.1 60.86 All Payors / Plans All Payors / Plans 62.1 other 62.1 62.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 0338-3580-48 NDC JZ 1 UN inpatient 30.5 29.89 All Payors / Plans All Payors / Plans 30.5 other 30.5 30.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 63323-221-01 NDC JZ 1 UN inpatient 10.71 10.5 All Payors / Plans All Payors / Plans 10.71 other 10.71 10.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 63323-221-10 NDC JZ 0.074666667 UN inpatient 0.83 0.81 All Payors / Plans All Payors / Plans 0.83 other 0.83 0.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 63323-284-01 NDC JZ 1 UN inpatient 10.72 10.51 All Payors / Plans All Payors / Plans 10.72 other 10.72 10.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 63323-284-20 NDC JZ 1 UN inpatient 10.72 10.51 All Payors / Plans All Payors / Plans 10.72 other 10.72 10.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 67457-339-00 NDC JZ 0.074666667 UN inpatient 0.83 0.81 All Payors / Plans All Payors / Plans 0.83 other 0.83 0.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 67457-823-12 NDC JZ 1 UN inpatient 11.3 11.07 All Payors / Plans All Payors / Plans 11.3 other 11.3 11.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 67457-823-99 NDC JZ 1 UN inpatient 16.09 15.77 All Payors / Plans All Payors / Plans 16.09 other 16.09 16.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 42023-164-01 NDC JZ 1 UN inpatient 16.09 15.77 All Payors / Plans All Payors / Plans 16.09 other 16.09 16.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 61703-309-16 NDC JZ 1 UN inpatient 20.66 20.25 All Payors / Plans All Payors / Plans 20.66 other 20.66 20.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 61703-309-06 NDC JZ 1 UN inpatient 21.01 20.59 All Payors / Plans All Payors / Plans 21.01 other 21.01 21.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 39822-1077-1 NDC JZ 0.074666667 UN inpatient 1.53 1.5 All Payors / Plans All Payors / Plans 1.53 other 1.53 1.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROMETHAZINE PER 50 MG ERX-636000000 CDM J2550 HCPCS 636 RC 68094-503-59 NDC JZ 1 ML inpatient 10.68 10.47 All Payors / Plans All Payors / Plans 10.68 other 10.68 10.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROMETHAZINE PER 50 MG ERX-636000000 CDM J2550 HCPCS 636 RC 68094-600-61 NDC JZ 0.5 ML inpatient 5.33 5.22 All Payors / Plans All Payors / Plans 5.33 other 5.33 5.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENOBARBITAL PER 120 MG ERX-636000000 CDM J2560 HCPCS 636 RC 60687-579-11 NDC JZ 1 ML inpatient 141.69 138.86 All Payors / Plans All Payors / Plans 141.69 other 141.69 141.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENOBARBITAL PER 120 MG ERX-636000000 CDM J2560 HCPCS 636 RC 68084-269-11 NDC JZ 5.79 ML inpatient 786.1 770.38 All Payors / Plans All Payors / Plans 786.1 other 786.1 786.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYTOCIN IN 0.9 NACL 30 UNIT/500 ML SOLUTION ERX-636000000 CDM J2590 HCPCS 636 RC 0338-9159-30 NDC 500 ML inpatient 63.77 62.49 All Payors / Plans All Payors / Plans 63.77 other 63.77 63.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYTOCIN IN 0.9 NACL 30 UNIT/500 ML SOLUTION ERX-636000000 CDM J2590 HCPCS 636 RC 0338-0013-06 NDC 500 ML inpatient 62.9 61.64 All Payors / Plans All Payors / Plans 62.9 other 62.9 62.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYTOCIN IN LACTATED RINGERS 30 UNIT/500 ML SOLUTION ERX-636000000 CDM J2590 HCPCS 636 RC 0264-2101-10 NDC 500 ML inpatient 49.71 48.72 All Payors / Plans All Payors / Plans 49.71 other 49.71 49.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYTOCIN PER 10 UNITS ERX-636000000 CDM J2590 HCPCS 636 RC 0472-0337-30 NDC JZ 1 ML inpatient 10.58 10.37 All Payors / Plans All Payors / Plans 10.58 other 10.58 10.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DESMOPRESSIN PER 1 MCG ERX-636000000 CDM J2597 HCPCS 636 RC 0054-4183-25 NDC JZ 0.25 ML inpatient 32.94 32.28 All Payors / Plans All Payors / Plans 32.94 other 32.94 32.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VASOPRESSIN 0.4 UNIT/ML SOLUTION ERX-250000000 CDM J2598 HCPCS 250 RC 61314-656-25 NDC JZ 5 ML inpatient 16.44 16.11 All Payors / Plans All Payors / Plans 16.44 other 16.44 16.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VASOPRESSIN 0.4 UNIT/ML SOLUTION ERX-250000000 CDM J2598 HCPCS 250 RC 0143-9927-01 NDC JZ 100 ML inpatient 328.63 322.06 All Payors / Plans All Payors / Plans 328.63 other 328.63 328.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VASOPRESSIN 20 UNIT/ML SOLUTION ERX-636000000 CDM J2598 HCPCS 636 RC 51672-2116-2 NDC 0.15 ML inpatient 82.49 80.84 All Payors / Plans All Payors / Plans 82.49 other 82.49 82.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VASOPRESSIN 20 UNIT/ML SOLUTION ERX-636000000 CDM J2598 HCPCS 636 RC 60687-450-01 NDC JZ 0.15 ML inpatient 87.07 85.33 All Payors / Plans All Payors / Plans 87.07 other 87.07 87.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 60687-446-01 NDC JZ 1.5 ML inpatient 0.84 0.82 All Payors / Plans All Payors / Plans 0.84 other 0.84 0.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 60687-446-11 NDC JZ 1 ML inpatient 0.56 0.55 All Payors / Plans All Payors / Plans 0.56 other 0.56 0.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 0904-5854-61 NDC JZ 7 ML inpatient 3.15 3.09 All Payors / Plans All Payors / Plans 3.15 other 3.15 3.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 0904-5855-61 NDC JZ 2 ML inpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 60687-468-11 NDC JZ 8 ML inpatient 4.41 4.32 All Payors / Plans All Payors / Plans 4.41 other 4.41 4.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 65162-466-10 NDC JZ 2.5 ML inpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 64380-169-01 NDC JZ 55.343 ML inpatient 22.49 22.04 All Payors / Plans All Payors / Plans 22.49 other 22.49 22.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 69315-135-01 NDC JZ 3 ML inpatient 2.29 2.24 All Payors / Plans All Payors / Plans 2.29 other 2.29 2.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 0228-2597-11 NDC JZ 1 ML inpatient 0.72 0.71 All Payors / Plans All Payors / Plans 0.72 other 0.72 0.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 62559-511-01 NDC JZ 15 ML inpatient 9.34 9.15 All Payors / Plans All Payors / Plans 9.34 other 9.34 9.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 50268-430-11 NDC JZ 7 ML inpatient 3.86 3.78 All Payors / Plans All Payors / Plans 3.86 other 3.86 3.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEOSTIGMINE METHYLSULFATE 3 MG/3 ML (1 MG/ML) SYRINGE ERX-636000000 CDM J2710 HCPCS 636 RC 50111-328-01 NDC JZ 2 ML inpatient 41.6 40.77 All Payors / Plans All Payors / Plans 41.6 other 41.6 41.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEOSTIGMINE PER 0.5 MG ERX-636000000 CDM J2710 HCPCS 636 RC 51079-076-01 NDC JZ 2 ML inpatient 24.58 24.09 All Payors / Plans All Payors / Plans 24.58 other 24.58 24.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROTAMINE SULFATE PER 10 MG ERX-636000000 CDM J2720 HCPCS 636 RC 68462-406-01 NDC JZ 1 ML inpatient 12.17 11.93 All Payors / Plans All Payors / Plans 12.17 other 12.17 12.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROTAMINE SULFATE PER 10 MG ERX-636000000 CDM J2720 HCPCS 636 RC 68462-302-01 NDC JZ 1.5 ML inpatient 18.25 17.89 All Payors / Plans All Payors / Plans 18.25 other 18.25 18.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROTAMINE SULFATE PER 10 MG ERX-636000000 CDM J2720 HCPCS 636 RC 70710-1852-7 NDC JZ 20 ML inpatient 109.5 107.31 All Payors / Plans All Payors / Plans 109.5 other 109.5 109.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENTOLAMINE MESYLATE PER 5 MG ERX-636000000 CDM J2760 HCPCS 636 RC 0338-3552-48 NDC JZ 1 UN inpatient 658.42 645.25 All Payors / Plans All Payors / Plans 658.42 other 658.42 658.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE PER 10 MG ERX-636000000 CDM J2765 HCPCS 636 RC 60687-224-11 NDC JZ 2 ML inpatient 5.88 5.76 All Payors / Plans All Payors / Plans 5.88 other 5.88 5.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE PER 10 MG ERX-636000000 CDM J2765 HCPCS 636 RC 0713-0683-15 NDC JZ 1 ML inpatient 2.94 2.88 All Payors / Plans All Payors / Plans 2.94 other 2.94 2.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE PER 10 MG ERX-636000000 CDM J2765 HCPCS 636 RC 45802-056-35 NDC JZ 1 ML inpatient 2.94 2.88 All Payors / Plans All Payors / Plans 2.94 other 2.94 2.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE PER 10 MG ERX-636000000 CDM J2765 HCPCS 636 RC 52565-085-15 NDC JZ 1 ML inpatient 2.94 2.88 All Payors / Plans All Payors / Plans 2.94 other 2.94 2.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE PER 10 MG ERX-636000000 CDM J2765 HCPCS 636 RC 24208-580-60 NDC JZ 1 ML inpatient 10.3 10.09 All Payors / Plans All Payors / Plans 10.3 other 10.3 10.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE PER 10 MG ERX-636000000 CDM J2765 HCPCS 636 RC 50268-359-11 NDC JZ 1 ML inpatient 0.5 0.49 All Payors / Plans All Payors / Plans 0.5 other 0.5 0.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE PER 10 MG ERX-636000000 CDM J2765 HCPCS 636 RC 68084-326-11 NDC JZ 1 ML inpatient 0.5 0.49 All Payors / Plans All Payors / Plans 0.5 other 0.5 0.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RASBURICASE PER 0.5 MG ERX-636000000 CDM J2783 HCPCS 636 RC 70100-424-01 NDC JZ 2 UN inpatient 2833.5 2776.83 All Payors / Plans All Payors / Plans 2833.5 other 2833.5 2833.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility REGADENOSON 0.4 MG/5 ML SYRINGE ERX-636000000 CDM J2785 HCPCS 636 RC 0088-2219-05 NDC JZ 5 ML inpatient 36.35 35.62 All Payors / Plans All Payors / Plans 36.35 other 36.35 36.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility REGADENOSON 0.4 MG/5 ML SYRINGE ERX-636000000 CDM J2785 HCPCS 636 RC 0088-2220-33 NDC JZ 5 ML inpatient 61.8 60.56 All Payors / Plans All Payors / Plans 61.8 other 61.8 61.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML SYRINGE" ERX-636000000 CDM J2791 HCPCS 636 RC 0955-1729-01 NDC JZ 2 ML inpatient 242.13 237.29 All Payors / Plans All Payors / Plans 242.13 other 242.13 242.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML SYRINGE" ERX-636000000 CDM J2791 HCPCS 636 RC 0002-7510-01 NDC JZ 2 ML inpatient 203.92 199.84 All Payors / Plans All Payors / Plans 203.92 other 203.92 203.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPIVACAINE PER 1 MG ERX-636000000 CDM J2795 HCPCS 636 RC 0002-7737-01 NDC JZ 20 ML inpatient 20.62 20.21 All Payors / Plans All Payors / Plans 20.62 other 20.62 20.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPIVACAINE PER 1 MG ERX-636000000 CDM J2795 HCPCS 636 RC 0024-5926-05 NDC JZ 100 ML inpatient 82.26 80.61 All Payors / Plans All Payors / Plans 82.26 other 82.26 82.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPIVACAINE PER 1 MG ERX-636000000 CDM J2795 HCPCS 636 RC 0002-8222-01 NDC JZ 15 ML inpatient 10.61 10.4 All Payors / Plans All Payors / Plans 10.61 other 10.61 10.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPIVACAINE PER 1 MG ERX-636000000 CDM J2795 HCPCS 636 RC 0002-8222-59 NDC JZ 10 ML inpatient 20.29 19.88 All Payors / Plans All Payors / Plans 20.29 other 20.29 20.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPIVACAINE PER 1 MG ERX-636000000 CDM J2795 HCPCS 636 RC 0002-8799-01 NDC JZ 40 ML inpatient 63.52 62.25 All Payors / Plans All Payors / Plans 63.52 other 63.52 63.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROMIPLOSTIM PER 10 MCG ERX-636000000 CDM J2796 HCPCS 636 RC 43598-750-11 NDC JG 0.08 UN inpatient 159.64 156.45 All Payors / Plans All Payors / Plans 159.64 other 159.64 159.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROMIPLOSTIM PER 10 MCG ERX-636000000 CDM J2796 HCPCS 636 RC 63323-376-00 NDC JW 0.04 UN inpatient 132.25 129.61 All Payors / Plans All Payors / Plans 132.25 other 132.25 132.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROMIPLOSTIM PER 10 MCG ERX-636000000 CDM J2796 HCPCS 636 RC 63323-377-00 NDC JW 0.1 UN inpatient 592.78 580.92 All Payors / Plans All Payors / Plans 592.78 other 592.78 592.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SINCALIDE PER 5 MCG ERX-636000000 CDM J2805 HCPCS 636 RC 43598-848-11 NDC JZ 0.24 UN inpatient 78.98 77.4 All Payors / Plans All Payors / Plans 78.98 other 78.98 78.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NA FERRIC GLUC CPLX PER 12.5 MG ERX-636000000 CDM J2916 HCPCS 636 RC 0904-6441-61 NDC JZ 5 ML inpatient 82.17 80.53 All Payors / Plans All Payors / Plans 82.17 other 82.17 82.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE PER 125 MG ERX-636000000 CDM J2919 HCPCS 636 RC 70954-518-10 NDC 1 UN inpatient 85.57 83.86 All Payors / Plans All Payors / Plans 85.57 other 85.57 85.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE PER 125 MG ERX-636000000 CDM J2919 HCPCS 636 RC 63135-312-13 NDC 0.5 UN inpatient 31.72 31.09 All Payors / Plans All Payors / Plans 31.72 other 31.72 31.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "METHYLPREDNISOLONE SOD SUC(PF) 1,000 MG/8 ML RECON SOLN 1 EACH VIAL" ERX-636000000 CDM J2919 HCPCS 636 RC 65219-472-05 NDC JZ 0.5 UN inpatient 92.47 90.62 All Payors / Plans All Payors / Plans 92.47 other 92.47 92.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML RECON SOLN ERX-636000000 CDM J2919 HCPCS 636 RC 65219-474-05 NDC JZ 0.65 UN inpatient 25.78 25.26 All Payors / Plans All Payors / Plans 25.78 other 25.78 25.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML RECON SOLN ERX-636000000 CDM J2919 HCPCS 636 RC 0264-7800-09 NDC JZ 0.32 UN inpatient 12.69 12.44 All Payors / Plans All Payors / Plans 12.69 other 12.69 12.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML RECON SOLN ERX-636000000 CDM J2919 HCPCS 636 RC 0264-7800-20 NDC JZ 1 UN inpatient 25.82 25.3 All Payors / Plans All Payors / Plans 25.82 other 25.82 25.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML RECON SOLN 1 EACH VIAL ERX-636000000 CDM J2919 HCPCS 636 RC 0338-9543-02 NDC JZ 0.201 UN inpatient 5.19 5.09 All Payors / Plans All Payors / Plans 5.19 other 5.19 5.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALTEPLASE 2 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J2997 HCPCS 636 RC 23155-547-31 NDC JZ 1 UN inpatient 427.43 418.88 All Payors / Plans All Payors / Plans 427.43 other 427.43 427.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL PER 0.1 MG ERX-636000000 CDM J3010 HCPCS 636 RC 0904-6363-45 NDC JZ 2 ML inpatient 10.56 10.35 All Payors / Plans All Payors / Plans 10.56 other 10.56 10.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL PER 0.1 MG ERX-636000000 CDM J3010 HCPCS 636 RC 51079-766-01 NDC JZ 0.5 ML inpatient 1.54 1.51 All Payors / Plans All Payors / Plans 1.54 other 1.54 1.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL PER 0.1 MG ERX-636000000 CDM J3010 HCPCS 636 RC 0904-6860-61 NDC JZ 0.2 ML inpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL PER 0.1 MG ERX-636000000 CDM J3010 HCPCS 636 RC 29300-139-01 NDC JZ 1 ML inpatient 2.19 2.15 All Payors / Plans All Payors / Plans 2.19 other 2.19 2.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL PER 0.1 MG ERX-636000000 CDM J3010 HCPCS 636 RC 68084-776-11 NDC JZ 0.25 ML inpatient 2.58 2.53 All Payors / Plans All Payors / Plans 2.58 other 2.58 2.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL PER 0.1 MG ERX-636000000 CDM J3010 HCPCS 636 RC 0904-7182-61 NDC JZ 0.5 ML inpatient 5.29 5.18 All Payors / Plans All Payors / Plans 5.29 other 5.29 5.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL PER 0.1 MG ERX-636000000 CDM J3010 HCPCS 636 RC 50268-260-13 NDC JZ 0.5 ML inpatient 2.65 2.6 All Payors / Plans All Payors / Plans 2.65 other 2.65 2.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TENECTEPLASE PER 50 MG ERX-636000000 CDM J3101 HCPCS 636 RC 43598-750-58 NDC JG 0.34 UN inpatient 2814.26 2757.97 All Payors / Plans All Payors / Plans 2814.26 other 2814.26 2814.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TENECTEPLASE PER 50 MG ERX-636000000 CDM J3101 HCPCS 636 RC 76329-3369-1 NDC JG 0.3 UN inpatient 2483.17 2433.51 All Payors / Plans All Payors / Plans 2483.17 other 2483.17 2483.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TERBUTALINE PER 1 MG ERX-636000000 CDM J3105 HCPCS 636 RC 60505-1003-1 NDC JZ 0.25 ML inpatient 2.58 2.53 All Payors / Plans All Payors / Plans 2.58 other 2.58 2.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TERBUTALINE PER 1 MG ERX-636000000 CDM J3105 HCPCS 636 RC 61314-126-05 NDC JZ 0.25 ML inpatient 2.58 2.53 All Payors / Plans All Payors / Plans 2.58 other 2.58 2.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TERBUTALINE PER 1 MG ERX-636000000 CDM J3105 HCPCS 636 RC 0378-1134-01 NDC JZ 0.25 ML inpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORPROMAZINE PER 50 MG ERX-636000000 CDM J3230 HCPCS 636 RC 42292-054-01 NDC JZ 1 ML inpatient 52.77 51.71 All Payors / Plans All Payors / Plans 52.77 other 52.77 52.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIROFIBAN-0.9% SODIUM CHLORIDE 12.5 MG/250 ML (50 MCG/ML) SOLUTION ERX-636000000 CDM J3246 HCPCS 636 RC 71247-126-01 NDC JZ 250 ML inpatient 323.11 316.65 All Payors / Plans All Payors / Plans 323.11 other 323.11 323.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOBRAMYCIN PER 80 MG ERX-636000000 CDM J3260 HCPCS 636 RC 45802-732-30 NDC 2 ML inpatient 20.38 19.97 All Payors / Plans All Payors / Plans 20.38 other 20.38 20.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOBRAMYCIN PER 80 MG ERX-636000000 CDM J3260 HCPCS 636 RC 0121-1314-00 NDC 0.5 ML inpatient 5.1 5 All Payors / Plans All Payors / Plans 5.1 other 5.1 5.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOBRAMYCIN PER 80 MG ERX-636000000 CDM J3260 HCPCS 636 RC 59417-101-10 NDC 2 UN inpatient 311.4 305.17 All Payors / Plans All Payors / Plans 311.4 other 311.4 311.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRIAMCINOLONE PER 10 MG ERX-636000000 CDM J3301 HCPCS 636 RC 0121-1314-11 NDC 0.1 ML inpatient 3.07 3.01 All Payors / Plans All Payors / Plans 3.07 other 3.07 3.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRIAMCINOLONE PER 10 MG ERX-636000000 CDM J3301 HCPCS 636 RC 68094-231-59 NDC 0.05 ML inpatient 0.51 0.5 All Payors / Plans All Payors / Plans 0.51 other 0.51 0.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIAZEPAM 5 MG/ML SYRINGE ERX-636000000 CDM J3360 HCPCS 636 RC 0121-1276-10 NDC JZ 0.2 ML inpatient 4.17 4.09 All Payors / Plans All Payors / Plans 4.17 other 4.17 4.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIAZEPAM 5 MG/ML SYRINGE ERX-636000000 CDM J3360 HCPCS 636 RC 69339-149-05 NDC JZ 0.2 ML inpatient 4.17 4.09 All Payors / Plans All Payors / Plans 4.17 other 4.17 4.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIAZEPAM 5 MG/ML SYRINGE ERX-636000000 CDM J3360 HCPCS 636 RC 70030-510-79 NDC JZ 0.1 ML inpatient 1.57 1.54 All Payors / Plans All Payors / Plans 1.57 other 1.57 1.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIAZEPAM 5 MG/ML SYRINGE ERX-636000000 CDM J3360 HCPCS 636 RC 0574006915 NDC JZ 1 ML inpatient 15.61 15.3 All Payors / Plans All Payors / Plans 15.61 other 15.61 15.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 1.25 GRAM/250 ML PIGGYBACK ERX-636000000 CDM J3370 HCPCS 636 RC 68094-231-61 NDC 250 ML inpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 1.5 GRAM/300 ML PIGGYBACK ERX-636000000 CDM J3370 HCPCS 636 RC 51672-2116-0 NDC 300 ML inpatient 139 136.22 All Payors / Plans All Payors / Plans 139 other 139 139 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 0904-7110-61 NDC JZ 6.6 ML inpatient 4.47 4.38 All Payors / Plans All Payors / Plans 4.47 other 4.47 4.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 23155-724-01 NDC JZ 33 ML inpatient 51.54 50.51 All Payors / Plans All Payors / Plans 51.54 other 51.54 51.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 10 GRAM RECON SOLN ERX-636000000 CDM J3370 HCPCS 636 RC 59417-103-10 NDC 0.0125 UN inpatient 0.83 0.81 All Payors / Plans All Payors / Plans 0.83 other 0.83 0.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 10 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J3370 HCPCS 636 RC 0904-6798-61 NDC 0.125 UN inpatient 15.54 15.23 All Payors / Plans All Payors / Plans 15.54 other 15.54 15.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 10 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J3370 HCPCS 636 RC 43547-353-10 NDC 0.15 UN inpatient 45.5 44.59 All Payors / Plans All Payors / Plans 45.5 other 45.5 45.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 0591-0405-01 NDC 0.5 UN inpatient 5.36 5.25 All Payors / Plans All Payors / Plans 5.36 other 5.36 5.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 60687-656-11 NDC 1 UN inpatient 15.67 15.36 All Payors / Plans All Payors / Plans 15.67 other 15.67 15.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 0904-6799-61 NDC 1 UN inpatient 26.24 25.72 All Payors / Plans All Payors / Plans 26.24 other 26.24 26.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 43547-354-10 NDC 1 UN inpatient 26.24 25.72 All Payors / Plans All Payors / Plans 26.24 other 26.24 26.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 1.5 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J3370 HCPCS 636 RC 72266-160-01 NDC JZ 1 UN inpatient 62.41 61.16 All Payors / Plans All Payors / Plans 62.41 other 62.41 62.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 1.5 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J3370 HCPCS 636 RC 72266-160-10 NDC JZ 1 UN inpatient 62.41 61.16 All Payors / Plans All Payors / Plans 62.41 other 62.41 62.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 67457-390-54 NDC JZ 0.066 UN inpatient 0.72 0.71 All Payors / Plans All Payors / Plans 0.72 other 0.72 0.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 70860-210-51 NDC JZ 1 UN inpatient 10.9 10.68 All Payors / Plans All Payors / Plans 10.9 other 10.9 10.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 76125-150-02 NDC JZ 0.033 UN inpatient 0.37 0.36 All Payors / Plans All Payors / Plans 0.37 other 0.37 0.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 76125-150-10 NDC JZ 0.5 UN inpatient 5.51 5.4 All Payors / Plans All Payors / Plans 5.51 other 5.51 5.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 50632-010-01 NDC JZ 1 UN inpatient 10.9 10.68 All Payors / Plans All Payors / Plans 10.9 other 10.9 10.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3371 HCPCS 636 RC 0024-5154-11 NDC JZ 1 UN inpatient 84.03 82.35 All Payors / Plans All Payors / Plans 84.03 other 84.03 84.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3371 HCPCS 636 RC 0069-0238-01 NDC JZ 1 UN inpatient 84.03 82.35 All Payors / Plans All Payors / Plans 84.03 other 84.03 84.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE PER 25 MG ERX-636000000 CDM J3410 HCPCS 636 RC 0904-6426-61 NDC JZ 0.5 ML inpatient 42.67 41.82 All Payors / Plans All Payors / Plans 42.67 other 42.67 42.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THIAMINE PER 100 MG ERX-636000000 CDM J3411 HCPCS 636 RC 25021-830-82 NDC 1 ML inpatient 10.48 10.27 All Payors / Plans All Payors / Plans 10.48 other 10.48 10.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THIAMINE PER 100 MG ERX-636000000 CDM J3411 HCPCS 636 RC 45802-732-00 NDC 1 ML inpatient 10.48 10.27 All Payors / Plans All Payors / Plans 10.48 other 10.48 10.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYANOCOBALAMIN PER 1000 MCG ERX-636000000 CDM J3420 HCPCS 636 RC 0641-0376-25 NDC 1 ML inpatient 20.29 19.88 All Payors / Plans All Payors / Plans 20.29 other 20.29 20.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYANOCOBALAMIN PER 1000 MCG ERX-636000000 CDM J3420 HCPCS 636 RC 60687-558-11 NDC JZ 0.1 ML inpatient 1.55 1.52 All Payors / Plans All Payors / Plans 1.55 other 1.55 1.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYANOCOBALAMIN PER 1000 MCG ERX-636000000 CDM J3420 HCPCS 636 RC 69097-846-07 NDC JZ 1 ML inpatient 15.45 15.14 All Payors / Plans All Payors / Plans 15.45 other 15.45 15.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML SYRINGE ERX-636000000 CDM J3430 HCPCS 636 RC 0185-0674-01 NDC JZ 0.5 ML inpatient 103.3 101.23 All Payors / Plans All Payors / Plans 103.3 other 103.3 103.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHYTONADIONE (VITAMIN K1) 10 MG/ML SOLUTION 1 ML AMPUL ERX-636000000 CDM J3430 HCPCS 636 RC 0904-7065-61 NDC JZ 0.25 ML inpatient 20.89 20.47 All Payors / Plans All Payors / Plans 20.89 other 20.89 20.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VORICONAZOLE PER 10 MG ERX-636000000 CDM J3465 HCPCS 636 RC 63459-910-11 NDC JZ 1 UN inpatient 101.32 99.29 All Payors / Plans All Payors / Plans 101.32 other 101.32 101.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VORICONAZOLE PER 10 MG ERX-636000000 CDM J3465 HCPCS 636 RC 63459-910-12 NDC JZ 1 UN inpatient 64.87 63.57 All Payors / Plans All Payors / Plans 64.87 other 64.87 64.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HYALURONIDASE, HUMAN RECOMB. 150 UNIT/ML SOLUTION 1 ML VIAL" ERX-636000000 CDM J3473 HCPCS 636 RC 69452-151-20 NDC JZ 1 ML inpatient 143.88 141 All Payors / Plans All Payors / Plans 143.88 other 143.88 143.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 1 GRAM/100 ML PIGGYBACK ERX-636000000 CDM J3475 HCPCS 636 RC 0338-0709-48 NDC 100 ML inpatient 15.96 15.64 All Payors / Plans All Payors / Plans 15.96 other 15.96 15.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 1 GRAM/100 ML PIGGYBACK ERX-636000000 CDM J3475 HCPCS 636 RC 0338-0705-41 NDC 100 ML inpatient 16.04 15.72 All Payors / Plans All Payors / Plans 16.04 other 16.04 16.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) PIGGYBACK ERX-636000000 CDM J3475 HCPCS 636 RC 0338-0695-04 NDC 50 ML inpatient 15.73 15.42 All Payors / Plans All Payors / Plans 15.73 other 15.73 15.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) PIGGYBACK ERX-636000000 CDM J3475 HCPCS 636 RC 0338-0703-41 NDC 50 ML inpatient 21.16 20.74 All Payors / Plans All Payors / Plans 21.16 other 21.16 21.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) PIGGYBACK ERX-636000000 CDM J3475 HCPCS 636 RC 0338-0704-34 NDC 50 ML inpatient 20.47 20.06 All Payors / Plans All Payors / Plans 20.47 other 20.47 20.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) PARENTERAL SOLUTION ERX-636000000 CDM J3475 HCPCS 636 RC 0338-0705-48 NDC 100 ML inpatient 4.16 4.08 All Payors / Plans All Payors / Plans 4.16 other 4.16 4.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE PER 500 MG MAGNESIUM ERX-636000000 CDM J3475 HCPCS 636 RC 0990-7075-26 NDC 100 ML inpatient 25.98 25.46 All Payors / Plans All Payors / Plans 25.98 other 25.98 25.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE PER 500 MG MAGNESIUM ERX-636000000 CDM J3475 HCPCS 636 RC 0713-0351-02 NDC 100 ML inpatient 20.72 20.31 All Payors / Plans All Payors / Plans 20.72 other 20.72 20.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 1 GRAM/100 ML PIGGYBACK ERX-636000000 CDM J3475 HCPCS 636 RC 60505-0165-1 NDC JZ 100 ML inpatient 15.24 14.94 All Payors / Plans All Payors / Plans 15.24 other 15.24 15.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE PER 500 MG MAGNESIUM ERX-636000000 CDM J3475 HCPCS 636 RC 0904-7224-61 NDC JZ 100 ML inpatient 15.37 15.06 All Payors / Plans All Payors / Plans 15.37 other 15.37 15.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE PER 500 MG OF MAGNESIUM ERX-636000000 CDM J3475 HCPCS 636 RC 60687-681-01 NDC JZ 0.09 ML inpatient 0.12 0.12 All Payors / Plans All Payors / Plans 0.12 other 0.12 0.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE PER 500 MG OF MAGNESIUM ERX-636000000 CDM J3475 HCPCS 636 RC 60687-681-11 NDC JZ 2 ML inpatient 10.2 10 All Payors / Plans All Payors / Plans 10.2 other 10.2 10.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE PER 500 MG OF MAGNESIUM ERX-636000000 CDM J3475 HCPCS 636 RC 0054-8297-25 NDC JZ 2 ML inpatient 10.2 10 All Payors / Plans All Payors / Plans 10.2 other 10.2 10.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE PER 500 MG OF MAGNESIUM ERX-636000000 CDM J3475 HCPCS 636 RC 64980-562-01 NDC JZ 1.971 ML inpatient 2.06 2.02 All Payors / Plans All Payors / Plans 2.06 other 2.06 2.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE PER 500 MG OF MAGNESIUM ERX-636000000 CDM J3475 HCPCS 636 RC 0054-8299-25 NDC JZ 0.14 ML inpatient 0.18 0.18 All Payors / Plans All Payors / Plans 0.18 other 0.18 0.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE 10 MEQ/100 ML PIGGYBACK ERX-636000000 CDM J3480 HCPCS 636 RC 68084-450-11 NDC 100 ML inpatient 22.55 22.1 All Payors / Plans All Payors / Plans 22.55 other 22.55 22.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE 10 MEQ/50 ML PIGGYBACK ERX-636000000 CDM J3480 HCPCS 636 RC 0641-6228-01 NDC 50 ML inpatient 11.11 10.89 All Payors / Plans All Payors / Plans 11.11 other 11.11 11.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE IN 0.9%NACL 40 MEQ/L PARENTERAL SOLUTION ERX-636000000 CDM J3480 HCPCS 636 RC 0641-6228-25 NDC 1000 ML inpatient 15.96 15.64 All Payors / Plans All Payors / Plans 15.96 other 15.96 15.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE PER 2 MEQ ERX-636000000 CDM J3480 HCPCS 636 RC 39822-0412-1 NDC 50 ML inpatient 11.13 10.91 All Payors / Plans All Payors / Plans 11.13 other 11.13 11.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE PER 2 MEQ ERX-636000000 CDM J3480 HCPCS 636 RC 63323-306-01 NDC 1000 ML inpatient 15.5 15.19 All Payors / Plans All Payors / Plans 15.5 other 15.5 15.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE PER 2 MEQ ERX-636000000 CDM J3480 HCPCS 636 RC 63323-306-02 NDC 100 ML inpatient 15.28 14.97 All Payors / Plans All Payors / Plans 15.28 other 15.28 15.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE PER 2 MEQ ERX-636000000 CDM J3480 HCPCS 636 RC 0003-0293-20 NDC 100 ML inpatient 26.15 25.63 All Payors / Plans All Payors / Plans 26.15 other 26.15 26.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 0.9 % WITH KCL 20 MEQ/L INFUSION 20 MEQ/L PARENTERAL SOLUTION ERX-636000000 CDM J3480 HCPCS 636 RC 0143-9164-01 NDC 1000 ML inpatient 15.19 14.89 All Payors / Plans All Payors / Plans 15.19 other 15.19 15.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE IN 5 % DEX 20 MEQ/L PARENTERAL SOLUTION ERX-636000000 CDM J3480 HCPCS 636 RC 0185-0676-01 NDC JZ 1000 ML inpatient 23.26 22.79 All Payors / Plans All Payors / Plans 23.26 other 23.26 23.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE IN 5 % DEX 20 MEQ/L PARENTERAL SOLUTION ERX-636000000 CDM J3480 HCPCS 636 RC 50268-399-11 NDC JZ 1000 ML inpatient 43.84 42.96 All Payors / Plans All Payors / Plans 43.84 other 43.84 43.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE PER 2 MEQ ERX-636000000 CDM J3480 HCPCS 636 RC 77790-022-15 NDC JZ 50 ML inpatient 103.19 101.13 All Payors / Plans All Payors / Plans 103.19 other 103.19 103.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE PER 2 MEQ OF POTASSIUM ERX-636000000 CDM J3480 HCPCS 636 RC 0121-1828-00 NDC JZ 0.06 ML inpatient 0.07 0.07 All Payors / Plans All Payors / Plans 0.07 other 0.07 0.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE PER 2 MEQ OF POTASSIUM ERX-636000000 CDM J3480 HCPCS 636 RC 0121-1828-10 NDC JZ 10 ML inpatient 5.21 5.11 All Payors / Plans All Payors / Plans 5.21 other 5.21 5.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE PER 2 MEQ OF POTASSIUM ERX-636000000 CDM J3480 HCPCS 636 RC 68094-494-59 NDC JZ 5 ML inpatient 2.99 2.93 All Payors / Plans All Payors / Plans 2.99 other 2.99 2.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZIPRASIDONE MESYLATE PER 10 MG ERX-636000000 CDM J3486 HCPCS 636 RC 63459-912-11 NDC JZ 1 UN inpatient 45.3 44.39 All Payors / Plans All Payors / Plans 45.3 other 45.3 45.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZIPRASIDONE MESYLATE PER 10 MG ERX-636000000 CDM J3486 HCPCS 636 RC 63459-912-12 NDC JZ 1 UN inpatient 65.65 64.34 All Payors / Plans All Payors / Plans 65.65 other 65.65 65.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZIPRASIDONE MESYLATE PER 10 MG ERX-636000000 CDM J3486 HCPCS 636 RC 0703-4248-01 NDC JZ 1 UN inpatient 65.65 64.34 All Payors / Plans All Payors / Plans 65.65 other 65.65 65.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZOLEDRONIC ACID PER 1 MG ERX-636000000 CDM J3489 HCPCS 636 RC 0904-6773-61 NDC 100 ML inpatient 104.45 102.36 All Payors / Plans All Payors / Plans 104.45 other 104.45 104.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZOLEDRONIC ACID PER 1 MG ERX-636000000 CDM J3489 HCPCS 636 RC 68094-330-59 NDC 100 ML inpatient 152.75 149.7 All Payors / Plans All Payors / Plans 152.75 other 152.75 152.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZOLEDRONIC ACID PER 1 MG ERX-636000000 CDM J3489 HCPCS 636 RC 13668-047-01 NDC JZ 4.1 ML inpatient 113.97 111.69 All Payors / Plans All Payors / Plans 113.97 other 113.97 113.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZOLEDRONIC ACID-MANNITOL-WATER 4 MG/100 ML PIGGYBACK ERX-636000000 CDM J3489 HCPCS 636 RC 68084-319-11 NDC JZ 100 ML inpatient 45.33 44.42 All Payors / Plans All Payors / Plans 45.33 other 45.33 45.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FAMOTIDINE 20 MG/2 ML SOLUTION 2 ML VIAL ERX-636000000 CDM J3490 HCPCS 636 RC 71205-909-90 NDC JZ 2 ML inpatient 0.8 0.78 All Payors / Plans All Payors / Plans 0.8 other 0.8 0.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FAMOTIDINE PER 20 MG ERX-636000000 CDM J3490 HCPCS 636 RC 0832-7122-11 NDC JZ 50 ML inpatient 10.74 10.53 All Payors / Plans All Payors / Plans 10.74 other 10.74 10.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7030 HCPCS 636 RC 0002-8215-17 NDC JZ 10 ML inpatient 0.18 0.18 All Payors / Plans All Payors / Plans 0.18 other 0.18 0.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7030 HCPCS 636 RC 50268-447-11 NDC JZ 700 ML inpatient 16.04 15.72 All Payors / Plans All Payors / Plans 16.04 other 16.04 16.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7030 HCPCS 636 RC 0904-6450-61 NDC JZ 500 ML inpatient 11.46 11.23 All Payors / Plans All Payors / Plans 11.46 other 11.46 11.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250ML ERX-636000000 CDM J7030 HCPCS 636 RC 55513-800-60 NDC JZ 986.5 ML inpatient 22.71 22.26 All Payors / Plans All Payors / Plans 22.71 other 22.71 22.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7040 HCPCS 636 RC 0169-3004-01 NDC JZ 300 ML inpatient 19.06 18.68 All Payors / Plans All Payors / Plans 19.06 other 19.06 19.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7040 HCPCS 636 RC 0002-8215-01 NDC JZ 150 ML inpatient 5.31 5.2 All Payors / Plans All Payors / Plans 5.31 other 5.31 5.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7040 HCPCS 636 RC 59651-539-01 NDC JZ 250 ML inpatient 11.33 11.1 All Payors / Plans All Payors / Plans 11.33 other 11.33 11.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility D5 % AND 0.9 % SODIUM CHLORIDE PARENTERAL SOLUTION ERX-636000000 CDM J7042 HCPCS 636 RC 24208-735-01 NDC JZ 500 ML inpatient 17.88 17.52 All Payors / Plans All Payors / Plans 17.88 other 17.88 17.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility D5 % AND 0.9 % SODIUM CHLORIDE PARENTERAL SOLUTION ERX-636000000 CDM J7042 HCPCS 636 RC 0023-9163-30 NDC JZ 500 ML inpatient 33.1 32.44 All Payors / Plans All Payors / Plans 33.1 other 33.1 33.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility D5 % AND 0.9 % SODIUM CHLORIDE PARENTERAL SOLUTION ERX-636000000 CDM J7042 HCPCS 636 RC 68180-214-30 NDC JZ 1000 ML inpatient 18.39 18.02 All Payors / Plans All Payors / Plans 18.39 other 18.39 18.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% AND 0.9% SODIUM CHLORIDE PARENTERAL SOLUTION ERX-636000000 CDM J7042 HCPCS 636 RC 0555-0972-02 NDC JZ 250 ML inpatient 4.5 4.41 All Payors / Plans All Payors / Plans 4.5 other 4.5 4.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250ML ERX-636000000 CDM J7050 HCPCS 636 RC 70594-048-01 NDC 100 ML inpatient 23.1 22.64 All Payors / Plans All Payors / Plans 23.1 other 23.1 23.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250ML ERX-636000000 CDM J7050 HCPCS 636 RC 0143-9162-01 NDC 10 ML inpatient 2.34 2.29 All Payors / Plans All Payors / Plans 2.34 other 2.34 2.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 0.9 % ERX-636000000 CDM J7050 HCPCS 636 RC 0002-8799-59 NDC JZ 30 ML inpatient 13.82 13.54 All Payors / Plans All Payors / Plans 13.82 other 13.82 13.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 0.9 % ERX-636000000 CDM J7050 HCPCS 636 RC 0002-8233-01 NDC JZ 100 ML inpatient 17.73 17.38 All Payors / Plans All Payors / Plans 17.73 other 17.73 17.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 0002-8233-05 NDC JZ 100 ML inpatient 23.03 22.57 All Payors / Plans All Payors / Plans 23.03 other 23.03 23.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 0169-3004-15 NDC JZ 40 ML inpatient 2.83 2.77 All Payors / Plans All Payors / Plans 2.83 other 2.83 2.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 0169-1833-11 NDC JZ 1 ML inpatient 0.72 0.71 All Payors / Plans All Payors / Plans 0.72 other 0.72 0.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 0338-0126-12 NDC JZ 10 ML inpatient 3.54 3.47 All Payors / Plans All Payors / Plans 3.54 other 3.54 3.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 31722-730-30 NDC JZ 10 ML inpatient 1.77 1.73 All Payors / Plans All Payors / Plans 1.77 other 1.77 1.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 50268-440-11 NDC JZ 1.809 ML inpatient 0.64 0.63 All Payors / Plans All Payors / Plans 0.64 other 0.64 0.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 0555-0071-02 NDC JZ 1.125 ML inpatient 0.4 0.39 All Payors / Plans All Payors / Plans 0.4 other 0.4 0.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 68084-082-11 NDC JZ 125 ML inpatient 31.45 30.82 All Payors / Plans All Payors / Plans 31.45 other 31.45 31.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 0781-1695-01 NDC JZ 2.25 ML inpatient 0.81 0.79 All Payors / Plans All Payors / Plans 0.81 other 0.81 0.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 63739-367-10 NDC JZ 5.94 ML inpatient 1.08 1.06 All Payors / Plans All Payors / Plans 1.08 other 1.08 1.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 68084-083-11 NDC JZ 250 ML inpatient 22.54 22.09 All Payors / Plans All Payors / Plans 22.54 other 22.54 22.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 0904-6449-61 NDC JZ 5.94 ML inpatient 0.54 0.53 All Payors / Plans All Payors / Plans 0.54 other 0.54 0.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250ML ERX-636000000 CDM J7050 HCPCS 636 RC 55513-810-60 NDC JZ 202 ML inpatient 18.73 18.36 All Payors / Plans All Payors / Plans 18.73 other 18.73 18.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250ML ERX-636000000 CDM J7050 HCPCS 636 RC 0168-0099-15 NDC JZ 225 ML inpatient 20.28 19.87 All Payors / Plans All Payors / Plans 20.28 other 20.28 20.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5 % PIGGYBACK 100 ML BAG ERX-636000000 CDM J7060 HCPCS 636 RC 67457-781-08 NDC 1.92 ML inpatient 0.45 0.44 All Payors / Plans All Payors / Plans 0.45 other 0.45 0.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5 % PIGGYBACK 100 ML BAG ERX-636000000 CDM J7060 HCPCS 636 RC 0338-1009-02 NDC 100 ML inpatient 23.31 22.84 All Payors / Plans All Payors / Plans 23.31 other 23.31 23.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5 % PIGGYBACK 100 ML BAG ERX-636000000 CDM J7060 HCPCS 636 RC 0409-7810-22 NDC 100 ML inpatient 22.7 22.25 All Payors / Plans All Payors / Plans 22.7 other 22.7 22.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5 % PIGGYBACK 250 ML BAG ERX-636000000 CDM J7060 HCPCS 636 RC 50242-100-39 NDC 250 ML inpatient 31.73 31.1 All Payors / Plans All Payors / Plans 31.73 other 31.73 31.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 42023-315-10 NDC 475 ML inpatient 30.49 29.88 All Payors / Plans All Payors / Plans 30.49 other 30.49 30.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 61553-712-61 NDC 225 ML inpatient 28.63 28.06 All Payors / Plans All Payors / Plans 28.63 other 28.63 28.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 71019-085-02 NDC 1.92 ML inpatient 0.14 0.14 All Payors / Plans All Payors / Plans 0.14 other 0.14 0.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 16729-114-08 NDC 446 ML inpatient 15.85 15.53 All Payors / Plans All Payors / Plans 15.85 other 15.85 15.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 16729-114-11 NDC 43 ML inpatient 15.21 14.91 All Payors / Plans All Payors / Plans 15.21 other 15.21 15.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 25021-184-82 NDC 1.92 ML inpatient 0.34 0.33 All Payors / Plans All Payors / Plans 0.34 other 0.34 0.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 0338-0507-48 NDC 36 ML inpatient 12.73 12.48 All Payors / Plans All Payors / Plans 12.73 other 12.73 12.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 0338-0509-41 NDC 100 ML inpatient 17.68 17.33 All Payors / Plans All Payors / Plans 17.68 other 17.68 17.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 63323-578-05 NDC 50 ML inpatient 17.79 17.43 All Payors / Plans All Payors / Plans 17.79 other 17.79 17.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 70700-167-22 NDC 1.92 ML inpatient 0.35 0.34 All Payors / Plans All Payors / Plans 0.35 other 0.35 0.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 0264-9587-20 NDC 500 ML inpatient 37.79 37.03 All Payors / Plans All Payors / Plans 37.79 other 37.79 37.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 0338-0424-18 NDC 50 ML inpatient 18.39 18.02 All Payors / Plans All Payors / Plans 18.39 other 18.39 18.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 25021-400-10 NDC 50 ML inpatient 18.33 17.96 All Payors / Plans All Payors / Plans 18.33 other 18.33 18.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 25021-402-10 NDC 100 ML inpatient 12.75 12.5 All Payors / Plans All Payors / Plans 12.75 other 12.75 12.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 67457-384-31 NDC 500 ML inpatient 32.43 31.78 All Payors / Plans All Payors / Plans 32.43 other 32.43 32.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 42806-341-01 NDC JZ 250 ML inpatient 18.28 17.91 All Payors / Plans All Payors / Plans 18.28 other 18.28 18.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 0121-0638-05 NDC JZ 100 ML inpatient 17.91 17.55 All Payors / Plans All Payors / Plans 17.91 other 17.91 17.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7070 HCPCS 636 RC 63323-104-25 NDC 850 ML inpatient 15.21 14.91 All Payors / Plans All Payors / Plans 15.21 other 15.21 15.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7070 HCPCS 636 RC 70860-781-01 NDC 1000 ML inpatient 38.18 37.42 All Payors / Plans All Payors / Plans 38.18 other 38.18 38.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACTATED RINGERS PER 1000 ML ERX-636000000 CDM J7120 HCPCS 636 RC 60687-428-65 NDC JZ 60 ML inpatient 2.14 2.1 All Payors / Plans All Payors / Plans 2.14 other 2.14 2.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACTATED RINGERS PER 1000 ML ERX-636000000 CDM J7120 HCPCS 636 RC 0054-0011-20 NDC JZ 200 ML inpatient 3.62 3.55 All Payors / Plans All Payors / Plans 3.62 other 3.62 3.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACTATED RINGERS PER 1000 ML ERX-636000000 CDM J7120 HCPCS 636 RC 0054-0010-20 NDC JZ 90 ML inpatient 2.1 2.06 All Payors / Plans All Payors / Plans 2.1 other 2.1 2.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% IN LACTATED RINGERS PER 1000 ML ERX-636000000 CDM J7121 HCPCS 636 RC 50242-100-40 NDC 500 ML inpatient 17.92 17.56 All Payors / Plans All Payors / Plans 17.92 other 17.92 17.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% IN LACTATED RINGERS PER 1000 ML ERX-636000000 CDM J7121 HCPCS 636 RC 42023-168-01 NDC 1000 ML inpatient 17.99 17.63 All Payors / Plans All Payors / Plans 17.99 other 17.99 17.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% IN LACTATED RINGERS PER 1000 ML ERX-636000000 CDM J7121 HCPCS 636 RC 42023-315-01 NDC 250 ML inpatient 19.09 18.71 All Payors / Plans All Payors / Plans 19.09 other 19.09 19.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1240 UNIT) RECON SOLN" ERX-636000000 CDM J7168 HCPCS 636 RC 63323-285-13 NDC JZ 1 UN inpatient 1757.8 1722.64 All Payors / Plans All Payors / Plans 1757.8 other 1757.8 1757.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1240 UNIT) RECON SOLN" ERX-636000000 CDM J7168 HCPCS 636 RC 63323-285-28 NDC JZ 1 UN inpatient 2442.26 2393.41 All Payors / Plans All Payors / Plans 2442.26 other 2442.26 2442.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HUMAN PROTHROMBIN COMPLEX (PCC) 500 UNIT (400-620 UNIT) RECON SOLN ERX-636000000 CDM J7168 HCPCS 636 RC 0270-0556-15 NDC JZ 1 UN inpatient 1459.46 1430.27 All Payors / Plans All Payors / Plans 1459.46 other 1459.46 1459.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HUMAN PROTHROMBIN COMPLEX (PCC) 500 UNIT (400-620 UNIT) RECON SOLN ERX-636000000 CDM J7168 HCPCS 636 RC 0264-1800-31 NDC JZ 3 UN inpatient 3009.46 2949.27 All Payors / Plans All Payors / Plans 3009.46 other 3009.46 3009.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ANTIHEMOPHILIC FACTOR-VWF 1,000-1,000 UNIT RECON SOLN" ERX-636000000 CDM J7183 HCPCS 636 RC 50242-145-01 NDC JZ 4 UN inpatient 4484.46 4394.77 All Payors / Plans All Payors / Plans 4484.46 other 4484.46 4484.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANTIHEMOPHILIC FACTOR-VWF 500-500 UNIT RECON SOLN ERX-636000000 CDM J7183 HCPCS 636 RC 0641-0477-21 NDC JZ 1 UN inpatient 405 396.9 All Payors / Plans All Payors / Plans 405 other 405 405 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "COAGULATION FACTOR IX (RFIXFC) 1,000 UNIT RECON SOLN 1 EACH VIAL" ERX-636000000 CDM J7201 HCPCS 636 RC 0641-0928-21 NDC JZ 4 UN inpatient 64.46 63.17 All Payors / Plans All Payors / Plans 64.46 other 64.46 64.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COAGULATION FACTOR IX (RFIXFC) 500 UNIT RECON SOLN 1 EACH VIAL ERX-636000000 CDM J7201 HCPCS 636 RC 0641-1495-35 NDC JZ 1 UN inpatient 3.44 3.37 All Payors / Plans All Payors / Plans 3.44 other 3.44 3.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZATHIOPRINE PER 50 MG ERX-636000000 CDM J7500 HCPCS 636 RC 25021-673-77 NDC 1 UN inpatient 2.57 2.52 All Payors / Plans All Payors / Plans 2.57 other 2.57 2.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZATHIOPRINE PER 50 MG ERX-636000000 CDM J7500 HCPCS 636 RC 76329-3013-5 NDC 1 UN inpatient 2.57 2.52 All Payors / Plans All Payors / Plans 2.57 other 2.57 2.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOSPORINE MODIFIED PER 100 MG ERX-636000000 CDM J7502 HCPCS 636 RC 62135-712-42 NDC 1 UN inpatient 18.81 18.43 All Payors / Plans All Payors / Plans 18.81 other 18.81 18.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TACROLIMUS PER 1 MG ERX-636000000 CDM J7507 HCPCS 636 RC 10882-529-30 NDC 1 UN inpatient 9.95 9.75 All Payors / Plans All Payors / Plans 9.95 other 9.95 9.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TACROLIMUS PER 1 MG ERX-636000000 CDM J7507 HCPCS 636 RC 0904-6553-04 NDC 0.6 UN inpatient 10.01 9.81 All Payors / Plans All Payors / Plans 10.01 other 10.01 10.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TACROLIMUS PER 1 MG ERX-636000000 CDM J7507 HCPCS 636 RC 67877-419-33 NDC 1 UN inpatient 3.34 3.27 All Payors / Plans All Payors / Plans 3.34 other 3.34 3.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TACROLIMUS PER 1 MG ERX-636000000 CDM J7507 HCPCS 636 RC 60793-116-01 NDC 2 UN inpatient 6.95 6.81 All Payors / Plans All Payors / Plans 6.95 other 6.95 6.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TACROLIMUS PER 1 MG ERX-636000000 CDM J7507 HCPCS 636 RC 59762-1206-1 NDC 1 UN inpatient 3.48 3.41 All Payors / Plans All Payors / Plans 3.48 other 3.48 3.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE PER 4 MG ERX-636000000 CDM J7509 HCPCS 636 RC 63323-623-76 NDC JZ 1 UN inpatient 1.87 1.83 All Payors / Plans All Payors / Plans 1.87 other 1.87 1.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE PER 4 MG ERX-636000000 CDM J7509 HCPCS 636 RC 65219-470-05 NDC JZ 1 UN inpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 65219-190-30 NDC JZ 2 UN inpatient 2.17 2.13 All Payors / Plans All Payors / Plans 2.17 other 2.17 2.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 0409-4887-23 NDC JZ 1 UN inpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 63323-185-07 NDC JZ 0.5 UN inpatient 0.49 0.48 All Payors / Plans All Payors / Plans 0.49 other 0.49 0.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 0409-4887-10 NDC JZ 1 UN inpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 0409-4887-17 NDC JZ 0.5 UN inpatient 0.5 0.49 All Payors / Plans All Payors / Plans 0.5 other 0.5 0.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 63323-185-10 NDC JZ 0.5 UN inpatient 0.5 0.49 All Payors / Plans All Payors / Plans 0.5 other 0.5 0.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 0409-4887-20 NDC JZ 0.5 UN inpatient 0.51 0.5 All Payors / Plans All Payors / Plans 0.51 other 0.51 0.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 0487-6105-01 NDC JZ 0.5 UN inpatient 0.51 0.5 All Payors / Plans All Payors / Plans 0.51 other 0.51 0.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 0409-4887-24 NDC JZ 0.5 UN inpatient 0.47 0.46 All Payors / Plans All Payors / Plans 0.47 other 0.47 0.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOSPORINE MODIFIED PER 25 MG ERX-636000000 CDM J7515 HCPCS 636 RC 72888-125-26 NDC 2 UN inpatient 18.2 17.84 All Payors / Plans All Payors / Plans 18.2 other 18.2 18.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MYCOPHENOLATE MOFETIL PER 250 MG ERX-636000000 CDM J7517 HCPCS 636 RC 0168-0204-37 NDC 1 UN inpatient 2.74 2.69 All Payors / Plans All Payors / Plans 2.74 other 2.74 2.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MYCOPHENOLATE MOFETIL PER 250 MG ERX-636000000 CDM J7517 HCPCS 636 RC 38779-0082-4 NDC 1 UN inpatient 2.01 1.97 All Payors / Plans All Payors / Plans 2.01 other 2.01 2.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MYCOPHENOLATE SODIUM 360 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-636000000 CDM J7518 HCPCS 636 RC 51552-1345-1 NDC 1 UN inpatient 16.2 15.88 All Payors / Plans All Payors / Plans 16.2 other 16.2 16.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIROLIMUS PER 1 MG ERX-636000000 CDM J7520 HCPCS 636 RC 10882-528-30 NDC 1 UN inpatient 15.22 14.92 All Payors / Plans All Payors / Plans 15.22 other 15.22 15.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DORNASE ALFA PER 1 MG ERX-636000000 CDM J7639 HCPCS 636 RC 0409-4444-01 NDC 2.5 ML inpatient 148.16 145.2 All Payors / Plans All Payors / Plans 148.16 other 148.16 148.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DORNASE ALFA PER 1 MG ERX-636000000 CDM J7639 HCPCS 636 RC 0409-4444-24 NDC 2.5 ML inpatient 148.16 145.2 All Payors / Plans All Payors / Plans 148.16 other 148.16 148.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 0.25 MG ERX-636000000 CDM J8540 HCPCS 636 RC 0054-3505-47 NDC 2 UN inpatient 2.04 2 All Payors / Plans All Payors / Plans 2.04 other 2.04 2.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 0.25 MG ERX-636000000 CDM J8540 HCPCS 636 RC 23155-345-33 NDC JZ 1 UN inpatient 4.13 4.05 All Payors / Plans All Payors / Plans 4.13 other 4.13 4.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 0.25 MG ERX-636000000 CDM J8540 HCPCS 636 RC 25021-608-20 NDC JZ 1 UN inpatient 3.5 3.43 All Payors / Plans All Payors / Plans 3.5 other 3.5 3.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHOTREXATE PER 2.5 MG ERX-636000000 CDM J8610 HCPCS 636 RC 63323-623-74 NDC JZ 6 UN inpatient 15.69 15.38 All Payors / Plans All Payors / Plans 15.69 other 15.69 15.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXORUBICIN 50 MG/25 ML SOLUTION ERX-636000000 CDM J9000 HCPCS 636 RC 51079-374-01 NDC JW 8 ML inpatient 5.74 5.63 All Payors / Plans All Payors / Plans 5.74 other 5.74 5.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXORUBICIN 10 MG/5 ML SOLUTION ERX-636000000 CDM J9000 HCPCS 636 RC 82347-0405-4 NDC JZ 4 ML inpatient 5.6 5.49 All Payors / Plans All Payors / Plans 5.6 other 5.6 5.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXORUBICIN 50 MG/25 ML SOLUTION ERX-636000000 CDM J9000 HCPCS 636 RC 0904-6987-61 NDC JZ 25 ML inpatient 12.19 11.95 All Payors / Plans All Payors / Plans 12.19 other 12.19 12.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZACITIDINE 100 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J9025 HCPCS 636 RC 69374-902-05 NDC JW 0.4 UN inpatient 8.55 8.38 All Payors / Plans All Payors / Plans 8.55 other 8.55 8.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBOPLATIN PER 50 MG ERX-636000000 CDM J9045 HCPCS 636 RC 0338-0017-18 NDC 15 ML inpatient 106.12 104 All Payors / Plans All Payors / Plans 106.12 other 106.12 106.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBOPLATIN PER 50 MG ERX-636000000 CDM J9045 HCPCS 636 RC 0338-0017-31 NDC 15 ML inpatient 62.41 61.16 All Payors / Plans All Payors / Plans 62.41 other 62.41 62.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBOPLATIN PER 50 MG ERX-636000000 CDM J9045 HCPCS 636 RC 61314-547-01 NDC Q1 15 ML inpatient 31.24 30.62 All Payors / Plans All Payors / Plans 31.24 other 31.24 31.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CETUXIMAB PER 10 MG ERX-636000000 CDM J9055 HCPCS 636 RC 0121-1775-05 NDC JZ 300 ML inpatient 5165.95 5062.63 All Payors / Plans All Payors / Plans 5165.95 other 5165.95 5165.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CISPLATIN PER 50 MG ERX-636000000 CDM J9060 HCPCS 636 RC 0641-1410-31 NDC 25 ML inpatient 7.15 7.01 All Payors / Plans All Payors / Plans 7.15 other 7.15 7.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CISPLATIN PER 50 MG ERX-636000000 CDM J9060 HCPCS 636 RC 0641-0376-21 NDC 100 ML inpatient 138.33 135.56 All Payors / Plans All Payors / Plans 138.33 other 138.33 138.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CISPLATIN 50 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J9060 HCPCS 636 RC 0143-9542-10 NDC JW 0.36 UN inpatient 305.92 299.8 All Payors / Plans All Payors / Plans 305.92 other 305.92 305.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOPHOSPHAMIDE 500 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J9075 HCPCS 636 RC 0121-4950-40 NDC 0.36 UN inpatient 66.8 65.46 All Payors / Plans All Payors / Plans 66.8 other 66.8 66.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOPHOSPHAMIDE 1 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J9075 HCPCS 636 RC 0143-9689-01 NDC JW 0.2 UN inpatient 27.87 27.31 All Payors / Plans All Payors / Plans 27.87 other 27.87 27.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOPHOSPHAMIDE 1 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J9075 HCPCS 636 RC 0069-0209-10 NDC JZ 1 UN inpatient 439.05 430.27 All Payors / Plans All Payors / Plans 439.05 other 439.05 439.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOPHOSPHAMIDE 500 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J9075 HCPCS 636 RC 0409-4699-24 NDC JZ 0.08 UN inpatient 6.64 6.51 All Payors / Plans All Payors / Plans 6.64 other 6.64 6.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOCETAXEL 160 MG/16 ML (10 MG/ML) SOLUTION 16 ML VIAL ERX-636000000 CDM J9171 HCPCS 636 RC 0409-4264-11 NDC 16 ML inpatient 682.62 668.97 All Payors / Plans All Payors / Plans 682.62 other 682.62 682.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOCETAXEL 160 MG/8 ML (20 MG/ML) SOLUTION 8 ML VIAL ERX-636000000 CDM J9171 HCPCS 636 RC 0143-9622-01 NDC 4 ML inpatient 85.61 83.9 All Payors / Plans All Payors / Plans 85.61 other 85.61 85.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOPOSIDE 20 MG/ML SOLUTION 25 ML VIAL ERX-636000000 CDM J9181 HCPCS 636 RC 66794-219-63 NDC 9 ML inpatient 82.78 81.12 All Payors / Plans All Payors / Plans 82.78 other 82.78 82.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOPOSIDE 20 MG/ML SOLUTION 25 ML VIAL ERX-636000000 CDM J9181 HCPCS 636 RC 0264-4400-54 NDC 8.5 ML inpatient 63.4 62.13 All Payors / Plans All Payors / Plans 63.4 other 63.4 63.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOPOSIDE 20 MG/ML SOLUTION 50 ML VIAL ERX-636000000 CDM J9181 HCPCS 636 RC 67457-567-00 NDC 7.5 ML inpatient 64.77 63.47 All Payors / Plans All Payors / Plans 64.77 other 64.77 64.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOROURACIL PER 500 MG ERX-636000000 CDM J9190 HCPCS 636 RC 68084-782-61 NDC JZ 0.5 ML inpatient 0.12 0.12 All Payors / Plans All Payors / Plans 0.12 other 0.12 0.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOROURACIL PER 500 MG ERX-636000000 CDM J9190 HCPCS 636 RC 68084-313-01 NDC JZ 54 ML inpatient 12.07 11.83 All Payors / Plans All Payors / Plans 12.07 other 12.07 12.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GEMCITABINE PER 200 MG ERX-636000000 CDM J9201 HCPCS 636 RC 0904-0428-04 NDC JZ 26.3 ML inpatient 84.41 82.72 All Payors / Plans All Payors / Plans 84.41 other 84.41 84.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GEMCITABINE PER 200 MG ERX-636000000 CDM J9201 HCPCS 636 RC 50268-278-11 NDC JZ 2.63 ML inpatient 2.18 2.14 All Payors / Plans All Payors / Plans 2.18 other 2.18 2.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GOSERELIN ACETATE PER 3.6 MG ERX-636000000 CDM J9202 HCPCS 636 RC 43066-015-01 NDC JZ 1 UN inpatient 3468.09 3398.73 All Payors / Plans All Payors / Plans 3468.09 other 3468.09 3468.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GOSERELIN PER 3.6 MG ERX-636000000 CDM J9202 HCPCS 636 RC 43066-152-10 NDC JZ 1 UN inpatient 1677.28 1643.73 All Payors / Plans All Payors / Plans 1677.28 other 1677.28 1677.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRINOTECAN PER 20 MG ERX-636000000 CDM J9206 HCPCS 636 RC 0904-7193-61 NDC JZ 1 ML inpatient 1.73 1.7 All Payors / Plans All Payors / Plans 1.73 other 1.73 1.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRINOTECAN PER 20 MG ERX-636000000 CDM J9206 HCPCS 636 RC 60687-595-11 NDC JZ 10 ML inpatient 65.26 63.95 All Payors / Plans All Payors / Plans 65.26 other 65.26 65.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUPROLIDE (3 MONTH) 22.5 MG SYRINGE ERX-636000000 CDM J9217 HCPCS 636 RC 0338-0049-18 NDC JZ 1 UN inpatient 733.66 718.99 All Payors / Plans All Payors / Plans 733.66 other 733.66 733.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUPROLIDE (4 MONTH) 30 MG SYRINGE ERX-636000000 CDM J9217 HCPCS 636 RC 0338-0049-31 NDC JZ 1 UN inpatient 849.77 832.77 All Payors / Plans All Payors / Plans 849.77 other 849.77 849.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUPROLIDE 7.5 MG (1 MONTH) SYRINGE ERX-636000000 CDM J9217 HCPCS 636 RC 0338-0049-41 NDC JZ 1 UN inpatient 323.98 317.5 All Payors / Plans All Payors / Plans 323.98 other 323.98 323.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHOTREXATE SODIUM PER 5 MG ERX-636000000 CDM J9260 HCPCS 636 RC 60687-591-01 NDC JZ 0.48 ML inpatient 0.6 0.59 All Payors / Plans All Payors / Plans 0.6 other 0.6 0.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXALIPLATIN PER 0.5 MG ERX-636000000 CDM J9263 HCPCS 636 RC 69339-138-15 NDC JW 2 ML inpatient 3.72 3.65 All Payors / Plans All Payors / Plans 3.72 other 3.72 3.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXALIPLATIN PER 0.5 MG ERX-636000000 CDM J9263 HCPCS 636 RC 69339-138-19 NDC JW 2 ML inpatient 3.72 3.65 All Payors / Plans All Payors / Plans 3.72 other 3.72 3.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXALIPLATIN PER 0.5 MG ERX-636000000 CDM J9263 HCPCS 636 RC 0168-0080-31 NDC JZ 4 ML inpatient 2.16 2.12 All Payors / Plans All Payors / Plans 2.16 other 2.16 2.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACLITAXEL PROTEIN-BOUND PART PER 1 MG ERX-636000000 CDM J9264 HCPCS 636 RC 23155-688-31 NDC JW 0.25 UN inpatient 366.93 359.59 All Payors / Plans All Payors / Plans 366.93 other 366.93 366.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACLITAXEL PER 30 MG ERX-636000000 CDM J9267 HCPCS 636 RC 0338-0004-04 NDC 11 ML inpatient 65.22 63.92 All Payors / Plans All Payors / Plans 65.22 other 65.22 65.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACLITAXEL PER 30 MG ERX-636000000 CDM J9267 HCPCS 636 RC 0338-0004-03 NDC 13 ML inpatient 62.78 61.52 All Payors / Plans All Payors / Plans 62.78 other 62.78 62.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MITOMYCIN PER 5 MG ERX-636000000 CDM J9280 HCPCS 636 RC 0641-6176-01 NDC JW 0.25 UN inpatient 43.55 42.68 All Payors / Plans All Payors / Plans 43.55 other 43.55 43.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEMETREXED DISODIUM 100 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J9305 HCPCS 636 RC 25021-465-01 NDC JW 0.5 UN inpatient 5.2 5.1 All Payors / Plans All Payors / Plans 5.2 other 5.2 5.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEMETREXED PER 10 MG ERX-636000000 CDM J9305 HCPCS 636 RC 0409-3515-01 NDC JZ 1 UN inpatient 201.49 197.46 All Payors / Plans All Payors / Plans 201.49 other 201.49 201.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PERTUZUMAB 420 MG/14 ML (30 MG/ML) SOLUTION 14 ML VIAL ERX-636000000 CDM J9306 HCPCS 636 RC 60687-579-01 NDC JZ 14 ML inpatient 7211.24 7067.02 All Payors / Plans All Payors / Plans 7211.24 other 7211.24 7211.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOPOTECAN PER 4 MG ERX-636000000 CDM J9351 HCPCS 636 RC 0904-7130-61 NDC JW 1.6 ML inpatient 9.07 8.89 All Payors / Plans All Payors / Plans 9.07 other 9.07 9.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VINCRISTINE 2 MG/2 ML SOLUTION 2 ML VIAL ERX-636000000 CDM J9370 HCPCS 636 RC 60687-450-11 NDC JZ 2 ML inpatient 63.44 62.17 All Payors / Plans All Payors / Plans 63.44 other 63.44 63.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VINCRISTINE PER 1 MG ERX-636000000 CDM J9370 HCPCS 636 RC 63629-2214-1 NDC JZ 1 ML inpatient 63.49 62.22 All Payors / Plans All Payors / Plans 63.49 other 63.49 63.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FULVESTRANT PER 25 MG ERX-636000000 CDM J9395 HCPCS 636 RC 0121-1870-00 NDC JZ 10 ML inpatient 199.54 195.55 All Payors / Plans All Payors / Plans 199.54 other 199.54 199.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FULVESTRANT PER 25 MG ERX-636000000 CDM J9395 HCPCS 636 RC 0121-1870-10 NDC JZ 10 ML inpatient 310.05 303.85 All Payors / Plans All Payors / Plans 310.05 other 310.05 310.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FULVESTRANT PER 25 MG ERX-636000000 CDM J9395 HCPCS 636 RC 63739-976-01 NDC JZ 10 ML inpatient 310.05 303.85 All Payors / Plans All Payors / Plans 310.05 other 310.05 310.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FULVESTRANT PER 25 MG ERX-636000000 CDM J9395 HCPCS 636 RC 0904-7183-61 NDC JZ 10 ML inpatient 201.65 197.62 All Payors / Plans All Payors / Plans 201.65 other 201.65 201.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUMIN HUMAN 5% PER 50 ML ERX-250000000 CDM P9045 HCPCS 250 RC 51079-058-01 NDC JZ 250 ML inpatient 138.47 135.7 All Payors / Plans All Payors / Plans 138.47 other 138.47 138.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUMIN HUMAN 5% PER 50 ML ERX-250000000 CDM P9045 HCPCS 250 RC 0378-0213-01 NDC JZ 500 ML inpatient 195.82 191.9 All Payors / Plans All Payors / Plans 195.82 other 195.82 195.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUMIN HUMAN 5% PER 50 ML ERX-250000000 CDM P9045 HCPCS 250 RC 7733394825 NDC JZ 250 ML inpatient 138.47 135.7 All Payors / Plans All Payors / Plans 138.47 other 138.47 138.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUMIN HUMAN 5% PER 50 ML ERX-250000000 CDM P9045 HCPCS 250 RC 0087086644 NDC JZ 500 ML inpatient 195.82 191.9 All Payors / Plans All Payors / Plans 195.82 other 195.82 195.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUMIN HUMAN 25% PER 50 ML ERX-636000000 CDM P9047 HCPCS 636 RC 0904-6085-61 NDC JZ 50 ML inpatient 138.47 135.7 All Payors / Plans All Payors / Plans 138.47 other 138.47 138.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUMIN HUMAN 25% PER 50 ML ERX-636000000 CDM P9047 HCPCS 636 RC 65862-006-01 NDC JZ 50 ML inpatient 97.91 95.95 All Payors / Plans All Payors / Plans 97.91 other 97.91 97.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUMIN HUMAN 25% PER 50 ML ERX-636000000 CDM P9047 HCPCS 636 RC 76282-208-90 NDC JZ 50 ML inpatient 138.47 135.7 All Payors / Plans All Payors / Plans 138.47 other 138.47 138.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUMIN HUMAN 25% PER 50 ML ERX-636000000 CDM P9047 HCPCS 636 RC 50268-179-11 NDC JZ 50 ML inpatient 97.91 95.95 All Payors / Plans All Payors / Plans 97.91 other 97.91 97.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE PER 50 MG ERX-636000000 CDM Q0163 HCPCS 636 RC 25021-608-50 NDC JZ 1 UN inpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOSPHENYTOIN 500 MG PE/10 ML SOLUTION 10 ML VIAL ERX-636000000 CDM Q2009 HCPCS 636 RC 68084-313-11 NDC JZ 26 ML inpatient 217.13 212.79 All Payors / Plans All Payors / Plans 217.13 other 217.13 217.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXORUBICIN LIPOSOMAL PER 10 MG ERX-636000000 CDM Q2050 HCPCS 636 RC 60687-369-11 NDC JZ 17 ML inpatient 299.37 293.38 All Payors / Plans All Payors / Plans 299.37 other 299.37 299.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXORUBICIN LIPOSOMAL PER 10 MG ERX-636000000 CDM Q2050 HCPCS 636 RC 0054-0622-63 NDC JZ 25 ML inpatient 825.58 809.07 All Payors / Plans All Payors / Plans 825.58 other 825.58 825.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXORUBICIN LIPOSOMAL PER 10 MG ERX-636000000 CDM Q2050 HCPCS 636 RC 17856-0623-1 NDC JZ 23 ML inpatient 235.02 230.32 All Payors / Plans All Payors / Plans 235.02 other 235.02 235.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FILGRASTIM-SNDZ PER 1 MCG ERX-636000000 CDM Q5101 HCPCS 636 RC 0832-7124-89 NDC JZ 0.5 ML inpatient 340.4 333.59 All Payors / Plans All Payors / Plans 340.4 other 340.4 340.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FILGRASTIM-SNDZ PER 1 MCG ERX-636000000 CDM Q5101 HCPCS 636 RC 29300-140-01 NDC JZ 0.8 ML inpatient 597.36 585.41 All Payors / Plans All Payors / Plans 597.36 other 597.36 597.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "EPOETIN ALFA-EPBX 40,000 UNIT/ML SOLUTION" ERX-635000000 CDM Q5106 HCPCS 636 RC 0904-7083-61 NDC JZ 1 ML inpatient 749.95 734.95 All Payors / Plans All Payors / Plans 749.95 other 749.95 749.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BEVACIZUMAB-AWWB 25 MG/ML SOLUTION 16 ML VIAL ERX-636000000 CDM Q5107 HCPCS 636 RC 0228-2127-10 NDC JZ 16 ML inpatient 3310.41 3244.2 All Payors / Plans All Payors / Plans 3310.41 other 3310.41 3310.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BEVACIZUMAB-AWWB 25 MG/ML SOLUTION 4 ML VIAL ERX-636000000 CDM Q5107 HCPCS 636 RC 60687-113-01 NDC JZ 8 ML inpatient 1313 1286.74 All Payors / Plans All Payors / Plans 1313 other 1313 1313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEGFILGRASTIM-JMDB 6 MG/0.6 ML SYRINGE ERX-636000000 CDM Q5108 HCPCS 636 RC 51079-597-20 NDC JG 0.2 ML inpatient 785.5 769.79 All Payors / Plans All Payors / Plans 785.5 other 785.5 785.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEGFILGRASTIM-CBQV 6 MG/0.6 ML SYRINGE ERX-636000000 CDM Q5111 HCPCS 636 RC 0832-6017-00 NDC JW 0.2 ML inpatient 754.53 739.44 All Payors / Plans All Payors / Plans 754.53 other 754.53 754.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PEGFILGRASTIM-CBQV 6 MG/0.6 ML SYRINGE, W/ WEARABLE INJECTOR" ERX-636000000 CDM Q5111 HCPCS 636 RC 42858-301-25 NDC JZ 0.6 ML inpatient 3841.79 3764.95 All Payors / Plans All Payors / Plans 3841.79 other 3841.79 3841.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRASTUZUMAB-QYYP 420 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM Q5116 HCPCS 636 RC 70069-071-10 NDC JG 0.40476 UN inpatient 1669.7 1636.31 All Payors / Plans All Payors / Plans 1669.7 other 1669.7 1669.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRASTUZUMAB-QYYP 420 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM Q5116 HCPCS 636 RC 76045-383-30 NDC JG 0.02385 UN inpatient 58.06 56.9 All Payors / Plans All Payors / Plans 58.06 other 58.06 58.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRASTUZUMAB-ANNS 420 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM Q5117 HCPCS 636 RC 70069-071-01 NDC JG 0.1429 UN inpatient 512.03 501.79 All Payors / Plans All Payors / Plans 512.03 other 512.03 512.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BEVACIZUMAB-BVZR 25 MG/ML SOLUTION 16 ML VIAL ERX-636000000 CDM Q5118 HCPCS 636 RC 60687-113-11 NDC JZ 16 ML inpatient 2835.97 2779.25 All Payors / Plans All Payors / Plans 2835.97 other 2835.97 2835.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BEVACIZUMAB-BVZR 25 MG/ML SOLUTION 4 ML VIAL ERX-636000000 CDM Q5118 HCPCS 636 RC 0378-0871-16 NDC JZ 8 ML inpatient 1075.74 1054.23 All Payors / Plans All Payors / Plans 1075.74 other 1075.74 1075.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RITUXIMAB-PVVR 10 MG/ML SOLUTION 50 ML VIAL ERX-636000000 CDM Q5119 HCPCS 636 RC 69238-1058-1 NDC JW 5 ML inpatient 264.22 258.94 All Payors / Plans All Payors / Plans 264.22 other 264.22 264.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RITUXIMAB-PVVR 10 MG/ML SOLUTION 10 ML VIAL ERX-636000000 CDM Q5119 HCPCS 636 RC 4467710202 NDC JZ 10 ML inpatient 528.43 517.86 All Payors / Plans All Payors / Plans 528.43 other 528.43 528.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BEVACIZUMAB-MALY 25 MG/ML SOLUTION 16 ML VIAL ERX-636000000 CDM Q5126 HCPCS 636 RC 0228-2128-10 NDC JZ 16 ML inpatient 2664.06 2610.78 All Payors / Plans All Payors / Plans 2664.06 other 2664.06 2664.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BEVACIZUMAB-MALY 25 MG/ML SOLUTION 4 ML VIAL ERX-636000000 CDM Q5126 HCPCS 636 RC 60687-124-11 NDC JZ 4 ML inpatient 880.22 862.62 All Payors / Plans All Payors / Plans 880.22 other 880.22 880.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRRT DIALYSATE 4/3 ERX-250000000 CDM 250 RC 0000-0000-09 NDC 5000 ML outpatient 102.19 100.15 All Payors / Plans All Payors / Plans 102.19 other 102.19 102.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE-PRILOCAINE 2.5-2.5 % CREAM 30 G TUBE ERX-250000000 CDM 250 RC 0990-7990-09 NDC 30 GR outpatient 64.98 63.68 All Payors / Plans All Payors / Plans 64.98 other 64.98 64.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE-PRILOCAINE 2.5-2.5 % CREAM 5 G TUBE ERX-250000000 CDM 250 RC 54643-5649-1 NDC 5 GR outpatient 30.93 30.31 All Payors / Plans All Payors / Plans 30.93 other 30.93 30.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCHLOROSENE RECON SOLN ERX-250000000 CDM 250 RC 0338-1138-03 NDC 2 GR outpatient 30.56 29.95 All Payors / Plans All Payors / Plans 30.56 other 30.56 30.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZINC OXIDE-CORN STARCH 15-81 % POWDER 142 G BOTTLE ERX-250000000 CDM 250 RC 0338-0180-01 NDC 142 GR outpatient 16.12 15.8 All Payors / Plans All Payors / Plans 16.12 other 16.12 16.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADULT 2-IN-1 TPN INFUSION ERX-250000000 CDM 250 RC 51754-4250-1 NDC 321.4 ML outpatient 288 282.24 All Payors / Plans All Payors / Plans 288 other 288 288 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ADULT MULTIVITAMIN 3,300 UNIT- 150 MCG/10 ML SOLUTION 10 ML VIAL" ERX-250000000 CDM 250 RC 51754-4250-3 NDC 10 ML outpatient 0.57 0.56 All Payors / Plans All Payors / Plans 0.57 other 0.57 0.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMINO ACID 5 %-DEXTROSE 20 % (CLINIMIX) 5 % PARENTERAL SOLUTION 1,000 ML BAG" ERX-250000000 CDM 250 RC 0143-9310-01 NDC 1000 ML outpatient 104.51 102.42 All Payors / Plans All Payors / Plans 104.51 other 104.51 104.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMINO ACID 8 % IN D14W (CLINIMIX) 8-14 % PARENTERAL SOLUTION 1,000 ML BAG" ERX-250000000 CDM 250 RC 0143-9506-01 NDC 1000 ML outpatient 137.74 134.99 All Payors / Plans All Payors / Plans 137.74 other 137.74 137.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMINO ACID 8%-D14W-ELECTROLYTES (CLINIMIX E) 8-14 % PARENTERAL SOLUTION 1,000 ML BAG" ERX-250000000 CDM 250 RC 0143-9506-10 NDC 1000 ML outpatient 141.85 139.01 All Payors / Plans All Payors / Plans 141.85 other 141.85 141.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMINO ACIDS 4.25%-LYTES-CA-D10 (CLINIMIX E) 4.25 % PARENTERAL SOLUTION 1,000 ML BAG" ERX-250000000 CDM 250 RC 0143-9507-01 NDC 1000 ML outpatient 104.54 102.45 All Payors / Plans All Payors / Plans 104.54 other 104.54 104.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMINO ACIDS 5 %-LYTES-CA-D20W (CLINIMIX E) 5 % PARENTERAL SOLUTION 1,000 ML BAG" ERX-250000000 CDM 250 RC 55150-221-10 NDC 1000 ML outpatient 105.7 103.59 All Payors / Plans All Payors / Plans 105.7 other 105.7 105.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMINOCAPROIC ACID PER 5 G ERX-250000000 CDM 250 RC 65219-445-01 NDC 20 ML outpatient 25.44 24.93 All Payors / Plans All Payors / Plans 25.44 other 25.44 25.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMIODARONE PER 30 MG ERX-250000000 CDM 250 RC 63037-100-05 NDC 9 ML outpatient 30.43 29.82 All Payors / Plans All Payors / Plans 30.43 other 30.43 30.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMIODARONE PER 30 MG ERX-250000000 CDM 250 RC 90000-002-29 NDC 6 ML outpatient 40.96 40.14 All Payors / Plans All Payors / Plans 40.96 other 40.96 40.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 63323-184-11 NDC 10 ML outpatient 20.64 20.23 All Payors / Plans All Payors / Plans 20.64 other 20.64 20.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 0009-1040-06 NDC 30 ML outpatient 35.92 35.2 All Payors / Plans All Payors / Plans 35.92 other 35.92 35.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 6371301974 NDC 10 ML outpatient 21.24 20.82 All Payors / Plans All Payors / Plans 21.24 other 21.24 21.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 6371301972 NDC 25 ML outpatient 35.77 35.05 All Payors / Plans All Payors / Plans 35.77 other 35.77 35.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAFFEINE CITRATE PER 5 MG ERX-250000000 CDM 250 RC 0132-0079-12 NDC 1.45 ML outpatient 25.96 25.44 All Payors / Plans All Payors / Plans 25.96 other 25.96 25.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM CHLORIDE 100 MG/ML (10 %) SOLUTION ERX-250000000 CDM 250 RC 58980-409-12 NDC 10 ML outpatient 39.89 39.09 All Payors / Plans All Payors / Plans 39.89 other 39.89 39.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM CHLORIDE 100 MG/ML (10 %) SOLUTION 10 ML VIAL ERX-250000000 CDM 250 RC 71288-402-30 NDC 10 ML outpatient 39.89 39.09 All Payors / Plans All Payors / Plans 39.89 other 39.89 39.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM CHLORIDE 100 MG/ML (10 %) SYRINGE ERX-250000000 CDM 250 RC 0054-0045-44 NDC 10 ML outpatient 50.03 49.03 All Payors / Plans All Payors / Plans 50.03 other 50.03 50.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM GLUCONATE PER 10 MG ERX-250000000 CDM 250 RC 42023-113-10 NDC 4.8 ML outpatient 6.01 5.89 All Payors / Plans All Payors / Plans 6.01 other 6.01 6.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBOPROST 250 MCG/ML SOLUTION ERX-250000000 CDM 250 RC 65219-184-01 NDC 1 ML outpatient 204 199.92 All Payors / Plans All Payors / Plans 204 other 204 204 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARDIOPLEGIC SOLUTION 29 MMOL/L (POTASSIUM) SOLUTION ERX-250000000 CDM 250 RC 0409-2051-05 NDC 1000 ML outpatient 196.82 192.88 All Payors / Plans All Payors / Plans 196.82 other 196.82 196.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARDIOPLEGIC SOLUTION HIGH POTASSIUM ERX-250000000 CDM 250 RC 0143-9508-01 NDC 806 ML outpatient 61.22 60 All Payors / Plans All Payors / Plans 61.22 other 61.22 61.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARDIOPLEGIC SOLUTION LOW POTASSIUM ERX-250000000 CDM 250 RC 0143-9508-10 NDC 793 ML outpatient 61.22 60 All Payors / Plans All Payors / Plans 61.22 other 61.22 61.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHONDROITIN SULF-SOD HYALURON 3 %-4 %(0.5 ML) 1 % (0.55 ML) SYRINGE ERX-250000000 CDM 250 RC 42023-114-10 NDC 1.05 ML outpatient 310.94 304.72 All Payors / Plans All Payors / Plans 310.94 other 310.94 310.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHONDROITIN SULF-SOD HYALURON 4-3 % (40-30 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 0409-2339-24 NDC 0.5 ML outpatient 202.04 198 All Payors / Plans All Payors / Plans 202.04 other 202.04 202.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) SOLUTION 20 ML VIAL ERX-250000000 CDM 250 RC 0409-2339-34 NDC 20 ML outpatient 136.83 134.09 All Payors / Plans All Payors / Plans 136.83 other 136.83 136.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CISATRACURIUM 2 MG/ML SOLUTION ERX-250000000 CDM 250 RC 69374-946-04 NDC 10 ML outpatient 104.12 102.04 All Payors / Plans All Payors / Plans 104.12 other 104.12 104.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLEVIDIPINE 0.5 MG/ML EMULSION ERX-250000000 CDM 250 RC 0409-1323-05 NDC 50 ML outpatient 235.07 230.37 All Payors / Plans All Payors / Plans 235.07 other 235.07 235.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLEVIDIPINE 25 MG/50 ML EMULSION ERX-250000000 CDM 250 RC 0409-1323-15 NDC 50 ML outpatient 208.31 204.14 All Payors / Plans All Payors / Plans 208.31 other 208.31 208.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLEVIDIPINE 25 MG/50 ML EMULSION ERX-250000000 CDM 250 RC 76329-3390-1 NDC 100 ML outpatient 359.56 352.37 All Payors / Plans All Payors / Plans 359.56 other 359.56 359.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLEVIDIPINE 50 MG/100 ML EMULSION ERX-250000000 CDM 250 RC 0409-4276-01 NDC 100 ML outpatient 414.35 406.06 All Payors / Plans All Payors / Plans 414.35 other 414.35 414.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRRT DIALYSATE 2/3 ERX-250000000 CDM 250 RC 55150-251-10 NDC 5000 ML outpatient 102.19 100.15 All Payors / Plans All Payors / Plans 102.19 other 102.19 102.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRRT DIALYSATE 4/3 ERX-250000000 CDM 250 RC 63323-201-03 NDC 5000 ML outpatient 102.19 100.15 All Payors / Plans All Payors / Plans 102.19 other 102.19 102.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility D5 %-0.45 % SODIUM CHLORIDE PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-486-27 NDC 500 ML outpatient 17.88 17.52 All Payors / Plans All Payors / Plans 17.88 other 17.88 17.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXMEDETOMIDINE 4 MCG/ML SOLUTION ERX-250000000 CDM 250 RC 76329-6300-5 NDC 5.9245 ML outpatient 64.36 63.07 All Payors / Plans All Payors / Plans 64.36 other 64.36 64.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXMEDETOMIDINE HCL 100 MCG/ML SOLUTION ERX-250000000 CDM 250 RC 55150-164-02 NDC 0.12 ML outpatient 11.27 11.04 All Payors / Plans All Payors / Plans 11.27 other 11.27 11.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXMEDETOMIDINE HCL 100 MCG/ML SOLUTION ERX-250000000 CDM 250 RC 63323-496-97 NDC 0.12 ML outpatient 30.75 30.14 All Payors / Plans All Payors / Plans 30.75 other 30.75 30.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 63323-495-09 NDC 50 ML outpatient 63.71 62.44 All Payors / Plans All Payors / Plans 63.71 other 63.71 63.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 0143-9594-25 NDC 100 ML outpatient 62.78 61.52 All Payors / Plans All Payors / Plans 62.78 other 62.78 62.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 63323-487-17 NDC 100 ML outpatient 101.42 99.39 All Payors / Plans All Payors / Plans 101.42 other 101.42 101.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXMEDETOMIDINE IN DEXTROSE 5% 400 MCG/100 ML (4 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 63323-487-37 NDC 100 ML outpatient 83.46 81.79 All Payors / Plans All Payors / Plans 83.46 other 83.46 83.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 10 % PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-488-07 NDC 500 ML outpatient 18.3 17.93 All Payors / Plans All Payors / Plans 18.3 other 18.3 18.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 10 % PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-488-37 NDC 1000 ML outpatient 18.43 18.06 All Payors / Plans All Payors / Plans 18.43 other 18.43 18.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 10 % PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-489-02 NDC 1000 ML outpatient 37.77 37.01 All Payors / Plans All Payors / Plans 37.77 other 37.77 37.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 20% 20 % PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-489-17 NDC 500 ML outpatient 47.29 46.34 All Payors / Plans All Payors / Plans 47.29 other 47.29 47.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% AND 0.45% SODIUM CHLORIDE PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 0409-3177-01 NDC 1000 ML outpatient 18.01 17.65 All Payors / Plans All Payors / Plans 18.01 other 18.01 18.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% LACTATED RINGER'S WITH KCL 20 MEQ/L 20 MEQ/L PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-482-03 NDC 1000 ML outpatient 45.05 44.15 All Payors / Plans All Payors / Plans 45.05 other 45.05 45.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5%-0.2 % SOD CHLORIDE PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-482-27 NDC 1000 ML outpatient 18 17.64 All Payors / Plans All Payors / Plans 18 other 18 18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5%-0.2 % SOD CHLORIDE PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-483-27 NDC 1000 ML outpatient 37.77 37.01 All Payors / Plans All Payors / Plans 37.77 other 37.77 37.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 50 % IN WATER (D50W) 50 % SYRINGE ERX-250000000 CDM 250 RC 0168-0357-30 NDC 25 ML outpatient 62.72 61.47 All Payors / Plans All Payors / Plans 62.72 other 62.72 62.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 50 % IN WATER (D50W) 50 % SYRINGE ERX-250000000 CDM 250 RC 62332-582-04 NDC 25 ML outpatient 65.49 64.18 All Payors / Plans All Payors / Plans 65.49 other 65.49 65.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 50% PER 500 ML ERX-250000000 CDM 250 RC 47335-992-01 NDC 3 ML outpatient 21.15 20.73 All Payors / Plans All Payors / Plans 21.15 other 21.15 21.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DEXTROSE 70% 70 % PARENTERAL SOLUTION 2,000 ML BAG" ERX-250000000 CDM 250 RC 63323-106-02 NDC 13.7 ML outpatient 0.31 0.3 All Payors / Plans All Payors / Plans 0.31 other 0.31 0.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE-SOD CITRATE-CITRIC AC 2.45-2.2 GRAM- 800 MG/100 ML SOLUTION ERX-250000000 CDM 250 RC 0338-0357-02 NDC 750 ML outpatient 81.79 80.15 All Payors / Plans All Payors / Plans 81.79 other 81.79 81.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE-SOD CITRATE-CITRIC AC 2.45-2.2 GRAM- 800 MG/100 ML SOLUTION ERX-250000000 CDM 250 RC 0990-7715-12 NDC 750 ML outpatient 63.7 62.43 All Payors / Plans All Payors / Plans 63.7 other 63.7 63.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILTIAZEM 125 MG/125 ML (1 MG/ML) SOLUTION ERX-250000000 CDM 250 RC 58160-955-09 NDC 125 ML outpatient 65.2 63.9 All Payors / Plans All Payors / Plans 65.2 other 65.2 65.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILTIAZEM 5 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0517-0374-05 NDC 3 ML outpatient 15.99 15.67 All Payors / Plans All Payors / Plans 15.99 other 15.99 15.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILTIAZEM 5 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0517-0374-01 NDC 4 ML outpatient 11.13 10.91 All Payors / Plans All Payors / Plans 11.13 other 11.13 11.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILTIAZEM 5 MG/ML SOLUTION ERX-250000000 CDM 250 RC 65649-551-02 NDC 4 ML outpatient 11.13 10.91 All Payors / Plans All Payors / Plans 11.13 other 11.13 11.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTROLYTE-A ERX-250000000 CDM 250 RC 0143-9660-01 NDC 1000 ML outpatient 50.78 49.76 All Payors / Plans All Payors / Plans 50.78 other 50.78 50.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTROLYTE-A PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 36000-033-10 NDC 1000 ML outpatient 23.07 22.61 All Payors / Plans All Payors / Plans 23.07 other 23.07 23.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENALAPRILAT 1.25 MG/ML SOLUTION ERX-250000000 CDM 250 RC 44567-221-10 NDC 0.5 ML outpatient 40.22 39.42 All Payors / Plans All Payors / Plans 40.22 other 40.22 40.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENALAPRILAT 1.25 MG/ML SOLUTION ERX-250000000 CDM 250 RC 44567-222-10 NDC 2 ML outpatient 40.22 39.42 All Payors / Plans All Payors / Plans 40.22 other 40.22 40.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPHEDRINE 50 MG/ML SOLUTION ERX-250000000 CDM 250 RC 55150-123-15 NDC 0.1 ML outpatient 3.63 3.56 All Payors / Plans All Payors / Plans 3.63 other 3.63 3.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPHEDRINE SULFATE 25 MG/5 ML (5 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 63323-328-20 NDC 1 ML outpatient 8.01 7.85 All Payors / Plans All Payors / Plans 8.01 other 8.01 8.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPHEDRINE SULFATE 25 MG/5 ML (5 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 70860-117-41 NDC 1 ML outpatient 12.33 12.08 All Payors / Plans All Payors / Plans 12.33 other 12.33 12.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPHEDRINE SULFATE 25 MG/5 ML (5 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 39822-1201-5 NDC 0.5 ML outpatient 6.17 6.05 All Payors / Plans All Payors / Plans 6.17 other 6.17 6.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOMIDATE 2 MG/ML SOLUTION ERX-250000000 CDM 250 RC 49281-575-00 NDC 10 ML outpatient 31.68 31.05 All Payors / Plans All Payors / Plans 31.68 other 31.68 31.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOMIDATE 2 MG/ML SOLUTION ERX-250000000 CDM 250 RC 70069-261-01 NDC 5 ML outpatient 31.11 30.49 All Payors / Plans All Payors / Plans 31.11 other 31.11 31.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOMIDATE 2 MG/ML SOLUTION ERX-250000000 CDM 250 RC 81298-9655-1 NDC 10 ML outpatient 31.11 30.49 All Payors / Plans All Payors / Plans 31.11 other 31.11 31.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOMIDATE 2 MG/ML SOLUTION ERX-250000000 CDM 250 RC 81298-9655-3 NDC 12 ML outpatient 35.63 34.92 All Payors / Plans All Payors / Plans 35.63 other 35.63 35.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOMIDATE 2 MG/ML SOLUTION ERX-250000000 CDM 250 RC 43066-997-10 NDC 8 ML outpatient 15.62 15.31 All Payors / Plans All Payors / Plans 15.62 other 15.62 15.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOMIDATE 2 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0338-0108-20 NDC 10 ML outpatient 15.67 15.36 All Payors / Plans All Payors / Plans 15.67 other 15.67 15.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL 10 MCG/ML SOLUTION ERX-250000000 CDM 250 RC 8290306546 NDC 100 ML outpatient 65.7 64.39 All Payors / Plans All Payors / Plans 65.7 other 65.7 65.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL 10 MCG/ML SOLUTION ERX-250000000 CDM 250 RC 0409-4888-02 NDC 100 ML outpatient 0.84 0.82 All Payors / Plans All Payors / Plans 0.84 other 0.84 0.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUMAZENIL 0.1 MG/ML SOLUTION ERX-250000000 CDM 250 RC 63323-186-01 NDC 4 ML outpatient 20.31 19.9 All Payors / Plans All Payors / Plans 20.31 other 20.31 20.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLIC ACID 5 MG/ML SOLUTION ERX-250000000 CDM 250 RC 63323-186-10 NDC 0.2 ML outpatient 0.59 0.58 All Payors / Plans All Payors / Plans 0.59 other 0.59 0.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLIC ACID 5 MG/ML SOLUTION 10 ML VIAL ERX-250000000 CDM 250 RC 0327-0001-10 NDC 0.2 ML outpatient 0.78 0.76 All Payors / Plans All Payors / Plans 0.78 other 0.78 0.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "IPRATROPIUM 21 MCG (0.03 %) SPRAY,NON-AEROSOL 30 ML CANISTER" ERX-250000000 CDM 250 RC 0143-9284-01 NDC 30 ML outpatient 142.47 139.62 All Payors / Plans All Payors / Plans 142.47 other 142.47 142.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "IPRATROPIUM 42 MCG (0.06 %) SPRAY,NON-AEROSOL 15 ML CANISTER" ERX-250000000 CDM 250 RC 55150-202-00 NDC 15 ML outpatient 142.47 139.62 All Payors / Plans All Payors / Plans 142.47 other 142.47 142.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "IPRATROPIUM 42 MCG (0.06 %) SPRAY,NON-AEROSOL 15 ML CANISTER" ERX-250000000 CDM 250 RC 67850-150-00 NDC 15 ML outpatient 62.72 61.47 All Payors / Plans All Payors / Plans 62.72 other 62.72 62.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOPROTERENOL IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 67850-150-25 NDC 12.45416667 ML outpatient 313.84 307.56 All Payors / Plans All Payors / Plans 313.84 other 313.84 313.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETAMINE 10 MG/ML SOLUTION ERX-250000000 CDM 250 RC 70095-024-01 NDC 1 ML outpatient 44.59 43.7 All Payors / Plans All Payors / Plans 44.59 other 44.59 44.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETAMINE 10 MG/ML SOLUTION 20 ML VIAL ERX-250000000 CDM 250 RC 70095-024-02 NDC 2 ML outpatient 49.95 48.95 All Payors / Plans All Payors / Plans 49.95 other 49.95 49.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETAMINE 10 MG/ML SOLUTION 20 ML VIAL ERX-250000000 CDM 250 RC 0338-1130-03 NDC 1.2 ML outpatient 44.59 43.7 All Payors / Plans All Payors / Plans 44.59 other 44.59 44.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETAMINE 100 MG/ML SOLUTION 5 ML VIAL ERX-250000000 CDM 250 RC 54643-5646-1 NDC 10 ML outpatient 79.51 77.92 All Payors / Plans All Payors / Plans 79.51 other 79.51 79.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETAMINE 50 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0941-0424-52 NDC 2 ML outpatient 30.6 29.99 All Payors / Plans All Payors / Plans 30.6 other 30.6 30.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETAMINE 50 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0941-0430-52 NDC 1 ML outpatient 30.6 29.99 All Payors / Plans All Payors / Plans 30.6 other 30.6 30.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETAMINE 50 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0225-0805-47 NDC 0.75 ML outpatient 35.82 35.1 All Payors / Plans All Payors / Plans 35.82 other 35.82 35.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 20 MG/4 ML (5 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 0641-6189-01 NDC 4 ML outpatient 36.64 35.91 All Payors / Plans All Payors / Plans 36.64 other 36.64 36.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 20 MG/4 ML (5 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 70004-825-40 NDC 2 ML outpatient 40.43 39.62 All Payors / Plans All Payors / Plans 40.43 other 40.43 40.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 20 MG/4 ML (5 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 42852-893-25 NDC 1 ML outpatient 35.91 35.19 All Payors / Plans All Payors / Plans 35.91 other 35.91 35.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE (CARDIAC) 100 MG/5 ML (2 %) SYRINGE ERX-250000000 CDM 250 RC 63323-321-10 NDC 1 ML outpatient 5.24 5.14 All Payors / Plans All Payors / Plans 5.24 other 5.24 5.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE (CARDIAC) 100 MG/5 ML (2 %) SYRINGE ERX-250000000 CDM 250 RC 0409-8183-11 NDC 2.5 ML outpatient 13.09 12.83 All Payors / Plans All Payors / Plans 13.09 other 13.09 13.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE (CARDIAC) 100 MG/5 ML (2 %) SYRINGE ERX-250000000 CDM 250 RC 0338-0669-04 NDC 2.5 ML outpatient 31.5 30.87 All Payors / Plans All Payors / Plans 31.5 other 31.5 31.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 10 MG/ML (1 %) SOLUTION ERX-250000000 CDM 250 RC 0338-0671-04 NDC 12 ML outpatient 5.97 5.85 All Payors / Plans All Payors / Plans 5.97 other 5.97 5.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 10 MG/ML (1 %) SOLUTION ERX-250000000 CDM 250 RC 0338-0675-04 NDC 20 ML outpatient 5.97 5.85 All Payors / Plans All Payors / Plans 5.97 other 5.97 5.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 10 MG/ML (1 %) SOLUTION ERX-250000000 CDM 250 RC 0338-0803-04 NDC 10 ML outpatient 5.86 5.74 All Payors / Plans All Payors / Plans 5.86 other 5.86 5.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 10 MG/ML (1 %) SOLUTION ERX-250000000 CDM 250 RC 0990-7107-09 NDC 5 ML outpatient 7.73 7.58 All Payors / Plans All Payors / Plans 7.73 other 7.73 7.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 20 MG/ML (2 %) SOLUTION ERX-250000000 CDM 250 RC 0338-0807-04 NDC 12 ML outpatient 20.8 20.38 All Payors / Plans All Payors / Plans 20.8 other 20.8 20.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 4 % SOLUTION ERX-250000000 CDM 250 RC 70004-841-40 NDC 1 ML outpatient 132.84 130.18 All Payors / Plans All Payors / Plans 132.84 other 132.84 132.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 20 MG/ML (2 %) SOLUTION ERX-250000000 CDM 250 RC 0409-7295-11 NDC 1 ML outpatient 2.95 2.89 All Payors / Plans All Payors / Plans 2.95 other 2.95 2.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 20 MG/ML (2 %) SOLUTION ERX-250000000 CDM 250 RC 65219-054-09 NDC 7 ML outpatient 25.1 24.6 All Payors / Plans All Payors / Plans 25.1 other 25.1 25.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 20 MG/ML (2 %) SOLUTION 2 ML VIAL ERX-250000000 CDM 250 RC 0143-9392-01 NDC 6.6 ML outpatient 35.74 35.03 All Payors / Plans All Payors / Plans 35.74 other 35.74 35.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 20 MG/ML (2 %) SOLUTION 5 ML VIAL ERX-250000000 CDM 250 RC 67457-198-05 NDC 5 ML outpatient 5.91 5.79 All Payors / Plans All Payors / Plans 5.91 other 5.91 5.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 39822-4200-5 NDC 10 ML outpatient 20.86 20.44 All Payors / Plans All Payors / Plans 20.86 other 20.86 20.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 66794-229-02 NDC 30 ML outpatient 21.19 20.77 All Payors / Plans All Payors / Plans 21.19 other 21.19 21.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 71839-141-10 NDC 0.2 ML outpatient 0.25 0.25 All Payors / Plans All Payors / Plans 0.25 other 0.25 0.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 67457-228-10 NDC 3 ML outpatient 3.63 3.56 All Payors / Plans All Payors / Plans 3.63 other 3.63 3.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 69374-924-05 NDC 10 ML outpatient 36.22 35.5 All Payors / Plans All Payors / Plans 36.22 other 36.22 36.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 0409-7299-73 NDC 10 ML outpatient 20.99 20.57 All Payors / Plans All Payors / Plans 20.99 other 20.99 20.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 SOLUTION" ERX-250000000 CDM 250 RC 0409-6625-14 NDC 20 ML outpatient 15.4 15.09 All Payors / Plans All Payors / Plans 15.4 other 15.4 15.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE 1 %-1:100,000 SOLUTION" ERX-250000000 CDM 250 RC 0409-6625-22 NDC 20 ML outpatient 21.24 20.82 All Payors / Plans All Payors / Plans 21.24 other 21.24 21.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE 1 %-1:100,000 SOLUTION" ERX-250000000 CDM 250 RC 51754-5001-1 NDC 5 ML outpatient 16.11 15.79 All Payors / Plans All Payors / Plans 16.11 other 16.11 16.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-EPINEPHRINE 2 %-1:100,000 SOLUTION" ERX-250000000 CDM 250 RC 0409-6637-14 NDC 20 ML outpatient 25.34 24.83 All Payors / Plans All Payors / Plans 25.34 other 25.34 25.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 40 MG/ML (NEO/PED) 40 MG/ML SYRINGE ERX-250000000 CDM 250 RC 0409-6637-24 NDC 15 ML outpatient 4.77 4.67 All Payors / Plans All Payors / Plans 4.77 other 4.77 4.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 40 MG/ML (NEO/PED) 40 MG/ML SYRINGE ERX-250000000 CDM 250 RC 76329-3352-1 NDC 12 ML outpatient 4.92 4.82 All Payors / Plans All Payors / Plans 4.92 other 4.92 4.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANNITOL 20 % PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 0264-7802-00 NDC 125 ML outpatient 65.18 63.88 All Payors / Plans All Payors / Plans 65.18 other 65.18 65.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANNITOL 20 % PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 0338-0043-04 NDC 250 ML outpatient 101.36 99.33 All Payors / Plans All Payors / Plans 101.36 other 101.36 101.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLENE BLUE 5 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0338-0043-03 NDC 8 ML outpatient 250.06 245.06 All Payors / Plans All Payors / Plans 250.06 other 250.06 250.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLENE BLUE 5 MG/ML SOLUTION 10 ML AMPUL ERX-250000000 CDM 250 RC 0904-3865-75 NDC 39 ML outpatient 1000.24 980.24 All Payors / Plans All Payors / Plans 1000.24 other 1000.24 1000.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLNALTREXONE 12 MG/0.6 ML SOLUTION ERX-250000000 CDM 250 RC 0338-0048-04 NDC 0.6 ML outpatient 356.77 349.63 All Payors / Plans All Payors / Plans 356.77 other 356.77 356.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL 5 MG/5 ML SOLUTION ERX-250000000 CDM 250 RC 0338-0054-03 NDC 5 ML outpatient 0.8 0.78 All Payors / Plans All Payors / Plans 0.8 other 0.8 0.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL 5 MG/5 ML SOLUTION ERX-250000000 CDM 250 RC 63323-530-21 NDC 5 ML outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NEOMYCIN-POLYMYXIN B GU 40 MG-200,000 UNIT/ML SOLUTION 1 ML AMPUL" ERX-250000000 CDM 250 RC 63323-093-01 NDC 1 ML outpatient 49.76 48.76 All Payors / Plans All Payors / Plans 49.76 other 49.76 49.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIRSEVIMAB-ALIP 50 MG/0.5 ML SYRINGE ERX-250000000 CDM 250 RC 63323-881-01 NDC 0.5 ML outpatient 858.46 841.29 All Payors / Plans All Payors / Plans 858.46 other 858.46 858.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROPRUSSIDE 25 MG/ML SOLUTION 2 ML VIAL ERX-250000000 CDM 250 RC 52268-011-01 NDC 4 ML outpatient 124.9 122.4 All Payors / Plans All Payors / Plans 124.9 other 124.9 124.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NOREPINEPHRINE 8 MG/250 ML (32 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 0000-0000-54 NDC 250 ML outpatient 135.64 132.93 All Payors / Plans All Payors / Plans 135.64 other 135.64 135.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NOREPINEPHRINE 8 MG/250 ML (32 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 0006-5423-02 NDC 250 ML outpatient 135.64 132.93 All Payors / Plans All Payors / Plans 135.64 other 135.64 135.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NOREPINEPHRINE BITARTRATE 1 MG/ML SOLUTION 4 ML VIAL ERX-250000000 CDM 250 RC 0006-5425-15 NDC 8 ML outpatient 42.21 41.37 All Payors / Plans All Payors / Plans 42.21 other 42.21 42.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NOREPINEPHRINE IN D5W 8 MG/250 ML (32 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 70069-362-01 NDC 250 ML outpatient 132.95 130.29 All Payors / Plans All Payors / Plans 132.95 other 132.95 132.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORMAL SALINE 0.9% SOLUTION 10 ML SYRINGE ERX-250000000 CDM 250 RC 0143-9638-01 NDC 10 ML outpatient 0.11 0.11 All Payors / Plans All Payors / Plans 0.11 other 0.11 0.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORMAL SALINE 0.9% SOLUTION 10 ML VIAL ERX-250000000 CDM 250 RC 55150-173-01 NDC 1.125 ML outpatient 0.07 0.07 All Payors / Plans All Payors / Plans 0.07 other 0.07 0.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORMAL SALINE 0.9% SOLUTION 10 ML VIAL ERX-250000000 CDM 250 RC 63323-273-01 NDC 10 ML outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORMAL SALINE 0.9% SOLUTION 10 ML VIAL ERX-250000000 CDM 250 RC 60793-217-20 NDC 10 ML outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PARENTERAL AMINO ACID 10% 10 % PARENTERAL SOLUTION 500 ML FLEX CONT ERX-250000000 CDM 250 RC 60793-215-05 NDC 41 ML outpatient 10.65 10.44 All Payors / Plans All Payors / Plans 10.65 other 10.65 10.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEDIATRIC MULTIVITAMIN 80 MG-400 UNIT- 200 MCG/5 ML SOLUTION 5 ML VIAL ERX-250000000 CDM 250 RC 0338-0326-01 NDC 2.5 ML outpatient 0.48 0.47 All Payors / Plans All Payors / Plans 0.48 other 0.48 0.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PERITONEAL DIALYSATE #6 1.5% CA 2.5 MEQ/L- MG 0.5 MEQ/L SOLUTION ERX-250000000 CDM 250 RC 0338-0322-01 NDC 2000 ML outpatient 147.43 144.48 All Payors / Plans All Payors / Plans 147.43 other 147.43 147.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PERITONEAL DIALYSATE 2.5% CA 2.5 MEQ/L- MG 0.5 MEQ/L SOLUTION ERX-250000000 CDM 250 RC 61953-0014-1 NDC 1500 ML outpatient 151.33 148.3 All Payors / Plans All Payors / Plans 151.33 other 151.33 151.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PHENYLEPHRINE 0.5 % SPRAY,NON-AEROSOL 15 ML SQUEEZ BTL" ERX-250000000 CDM 250 RC 0186-0776-60 NDC 15 ML outpatient 20.46 20.05 All Payors / Plans All Payors / Plans 20.46 other 20.46 20.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPHRINE IN D5W 40 MG/250 ML (160 MCG/ML) SOLUTION ERX-250000000 CDM 250 RC 0517-9305-01 NDC 3.25 ML outpatient 140.13 137.33 All Payors / Plans All Payors / Plans 140.13 other 140.13 140.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM ACETATE 2 MEQ/ML SOLUTION 20 ML VIAL ERX-250000000 CDM 250 RC 23155-166-31 NDC 0.06 ML outpatient 0.07 0.07 All Payors / Plans All Payors / Plans 0.07 other 0.07 0.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORID-D5-0.45%NACL 10 MEQ/L PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 23155-166-41 NDC 1000 ML outpatient 15.96 15.64 All Payors / Plans All Payors / Plans 15.96 other 15.96 15.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORID-D5-0.45%NACL 20 MEQ/L PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 81284-611-00 NDC 1000 ML outpatient 11.05 10.83 All Payors / Plans All Payors / Plans 11.05 other 11.05 11.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORID-D5-0.45%NACL 40 MEQ/L PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 51754-0108-1 NDC 1000 ML outpatient 15.96 15.64 All Payors / Plans All Payors / Plans 15.96 other 15.96 15.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE-D5-0.9%NACL 20 MEQ/L PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 80830-2329-1 NDC 1000 ML outpatient 15.48 15.17 All Payors / Plans All Payors / Plans 15.48 other 15.48 15.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE-D5-0.9%NACL 20 MEQ/L PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 80830-2329-2 NDC 1000 ML outpatient 36.31 35.58 All Payors / Plans All Payors / Plans 36.31 other 36.31 36.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE-D5-0.9%NACL 40 MEQ/L PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 0143-9785-01 NDC 1000 ML outpatient 15.95 15.63 All Payors / Plans All Payors / Plans 15.95 other 15.95 15.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM PHOSPHATE IN 0.9 % NACL 15 MMOL/250 ML SOLUTION ERX-250000000 CDM 250 RC 63323-494-05 NDC 250 ML outpatient 140.27 137.46 All Payors / Plans All Payors / Plans 140.27 other 140.27 140.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM PHOSPHATES 3 MMOL/ML SOLUTION 15 ML VIAL ERX-250000000 CDM 250 RC 55150-235-10 NDC 7.3 ML outpatient 64.13 62.85 All Payors / Plans All Payors / Plans 64.13 other 64.13 64.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM PHOSPHATES 3 MMOL/ML SOLUTION 15 ML VIAL ERX-250000000 CDM 250 RC 51754-0204-4 NDC 6.9 ML outpatient 148.8 145.82 All Payors / Plans All Payors / Plans 148.8 other 148.8 148.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROCURONIUM 10 MG/ML SOLUTION ERX-250000000 CDM 250 RC 70069-271-25 NDC 10 ML outpatient 30.46 29.85 All Payors / Plans All Payors / Plans 30.46 other 30.46 30.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROCURONIUM 10 MG/ML SOLUTION ERX-250000000 CDM 250 RC 6373611151 NDC 8 ML outpatient 20.29 19.88 All Payors / Plans All Payors / Plans 20.29 other 20.29 20.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROCURONIUM 10 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0143-9386-01 NDC 5 ML outpatient 11.09 10.87 All Payors / Plans All Payors / Plans 11.09 other 11.09 11.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROCURONIUM 50 MG/5 ML (10 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 36000-306-60 NDC 5 ML outpatient 20.4 19.99 All Payors / Plans All Payors / Plans 20.4 other 20.4 20.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROCURONIUM 50 MG/5 ML (10 MG/ML) SYRINGE ERX-250000000 CDM 250 RC 67457-940-10 NDC 5 ML outpatient 39.95 39.15 All Payors / Plans All Payors / Plans 39.95 other 39.95 39.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM ACETATE 2 MEQ/ML SOLUTION 20 ML VIAL ERX-250000000 CDM 250 RC 55150-113-10 NDC 10 ML outpatient 10.59 10.38 All Payors / Plans All Payors / Plans 10.59 other 10.59 10.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 1 MEQ/ML (8.4 %) SOLUTION ERX-250000000 CDM 250 RC 67457-351-10 NDC 50 ML outpatient 44.6 43.71 All Payors / Plans All Payors / Plans 44.6 other 44.6 44.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 1 MEQ/ML (8.4 %) SOLUTION ERX-250000000 CDM 250 RC 68084-229-01 NDC 50 ML outpatient 44.6 43.71 All Payors / Plans All Payors / Plans 44.6 other 44.6 44.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 1 MEQ/ML (8.4 %) SOLUTION 50 ML VIAL ERX-250000000 CDM 250 RC 68084-229-11 NDC 50 ML outpatient 30.46 29.85 All Payors / Plans All Payors / Plans 30.46 other 30.46 30.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 8.4 % (1 MEQ/ML) SYRINGE ERX-250000000 CDM 250 RC 55150-174-10 NDC 50 ML outpatient 64.29 63 All Payors / Plans All Payors / Plans 64.29 other 64.29 64.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 8.4 % (1 MEQ/ML) SYRINGE ERX-250000000 CDM 250 RC 78206-118-01 NDC 50 ML outpatient 64.29 63 All Payors / Plans All Payors / Plans 64.29 other 64.29 64.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 8.4 % (1 MEQ/ML) SYRINGE ERX-250000000 CDM 250 RC 0641-6007-01 NDC 50 ML outpatient 80.92 79.3 All Payors / Plans All Payors / Plans 80.92 other 80.92 80.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 0.45% 0.45 % PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 63323-465-01 NDC 1000 ML outpatient 32.28 31.63 All Payors / Plans All Payors / Plans 32.28 other 32.28 32.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 0.45% 0.45 % PARENTERAL SOLUTION ERX-250000000 CDM 250 RC 0409-1610-50 NDC 1000 ML outpatient 18.01 17.65 All Payors / Plans All Payors / Plans 18.01 other 18.01 18.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 0.45% 0.45 % PARENTERAL SOLUTION 500 ML BAG ERX-250000000 CDM 250 RC 50742-447-45 NDC 475 ML outpatient 17.8 17.44 All Payors / Plans All Payors / Plans 17.8 other 17.8 17.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SODIUM CHLORIDE 0.65 % AEROSOL,SPRAY 44 ML SQUEEZ BTL" ERX-250000000 CDM 250 RC 63323-172-60 NDC 44 ML outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SODIUM CHLORIDE 0.9 % SOLUTION 1,000 ML BOTTLE" ERX-250000000 CDM 250 RC 0143-9983-03 NDC 500 ML outpatient 9.04 8.86 All Payors / Plans All Payors / Plans 9.04 other 9.04 9.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 3% 3 % PARENTERAL SOLUTION 500 ML BAG ERX-250000000 CDM 250 RC 0264-3103-11 NDC 500 ML outpatient 18.28 17.91 All Payors / Plans All Payors / Plans 18.28 other 18.28 18.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 3% 3 % PARENTERAL SOLUTION 500 ML FLEX CONT ERX-250000000 CDM 250 RC 0264-3105-11 NDC 500 ML outpatient 18.39 18.02 All Payors / Plans All Payors / Plans 18.39 other 18.39 18.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 4 MEQ/ML SOLUTION 30 ML VIAL ERX-250000000 CDM 250 RC 0338-3503-41 NDC 40 ML outpatient 25.75 25.24 All Payors / Plans All Payors / Plans 25.75 other 25.75 25.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM PHOSPHATE 3 MMOL/ML SOLUTION 15 ML VIAL ERX-250000000 CDM 250 RC 0338-3508-41 NDC 0.18 ML outpatient 144.75 141.86 All Payors / Plans All Payors / Plans 144.75 other 144.75 144.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SODIUM, POTASSIUM, AND MAGNESIUM SULFATES 17.5-3.13-1.6 GRAM RECON SOLN 177 ML BOTTLE" ERX-250000000 CDM 250 RC 0781-3210-46 NDC 177 ML outpatient 104.86 102.76 All Payors / Plans All Payors / Plans 104.86 other 104.86 104.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STANDARD NEONATAL TPN ERX-250000000 CDM 250 RC 44567-703-01 NDC 250 ML outpatient 104.7 102.61 All Payors / Plans All Payors / Plans 104.7 other 104.7 104.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUGAMMADEX 100 MG/ML SOLUTION ERX-250000000 CDM 250 RC 63323-476-37 NDC 2 ML outpatient 327.45 320.9 All Payors / Plans All Payors / Plans 327.45 other 327.45 327.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUGAMMADEX 100 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0409-2300-01 NDC 2 ML outpatient 203.14 199.08 All Payors / Plans All Payors / Plans 203.14 other 203.14 203.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML SOLUTION 10 ML VIAL ERX-250000000 CDM 250 RC 25021-114-87 NDC 25 ML outpatient 106.88 104.74 All Payors / Plans All Payors / Plans 106.88 other 106.88 106.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SOLUTION ERX-250000000 CDM 250 RC 25021-192-82 NDC 0.5 ML outpatient 21.01 20.59 All Payors / Plans All Payors / Plans 21.01 other 21.01 21.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SOLUTION ERX-250000000 CDM 250 RC 16729-288-38 NDC 0.5 ML outpatient 20.7 20.29 All Payors / Plans All Payors / Plans 20.7 other 20.7 20.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SOLUTION ERX-250000000 CDM 250 RC 63323-103-65 NDC 0.5 ML outpatient 30.93 30.31 All Payors / Plans All Payors / Plans 30.93 other 30.93 30.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THROMBIN(HUMAN)-FIBRIN-CALCIUM 500 UNIT-80 MG /ML (10 ML) SYRINGE ERX-250000000 CDM 250 RC 0143-9621-01 NDC 10 ML outpatient 1197.91 1173.95 All Payors / Plans All Payors / Plans 1197.91 other 1197.91 1197.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "TRACE ELEMENT ZN-CU-MN-SE 1,000MCG-60MCG- 3 MCG-6 MCG/ML SOLUTION 1 ML VIAL" ERX-250000000 CDM 250 RC 70121-1238-1 NDC 0.5 ML outpatient 41.95 41.11 All Payors / Plans All Payors / Plans 41.95 other 41.95 41.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRACE ELEMENTS ZN-CU-MN-SE 3 MG-0.3 MG-55 MCG-60 MCG/ML SOLUTION 1 ML VIAL ERX-250000000 CDM 250 RC 0078-0248-61 NDC 1 ML outpatient 102.15 100.11 All Payors / Plans All Payors / Plans 102.15 other 102.15 102.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) SOLUTION 10 ML VIAL" ERX-250000000 CDM 250 RC 0078-0246-61 NDC 10 ML outpatient 15.35 15.04 All Payors / Plans All Payors / Plans 15.35 other 15.35 15.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) SOLUTION 10 ML VIAL" ERX-250000000 CDM 250 RC 0054-8179-25 NDC 10 ML outpatient 15.35 15.04 All Payors / Plans All Payors / Plans 15.35 other 15.35 15.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) SOLUTION 10 ML VIAL" ERX-250000000 CDM 250 RC 67457-421-00 NDC 10 ML outpatient 30.85 30.23 All Payors / Plans All Payors / Plans 30.85 other 30.85 30.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "TRANEXAMIC ACID IN NACL 1,000 MG/100 ML (10 MG/ML) PIGGYBACK" ERX-250000000 CDM 250 RC 67457-422-00 NDC 100 ML outpatient 36.33 35.6 All Payors / Plans All Payors / Plans 36.33 other 36.33 36.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "TRANEXAMIC ACID IN NACL 1,000 MG/100 ML (10 MG/ML) PIGGYBACK" ERX-250000000 CDM 250 RC 0338-0551-18 NDC 100 ML outpatient 39.74 38.95 All Payors / Plans All Payors / Plans 39.74 other 39.74 39.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "TRANEXAMIC ACID IN NACL 1,000 MG/100 ML (10 MG/ML) PIGGYBACK" ERX-250000000 CDM 250 RC 0338-9147-30 NDC 100 ML outpatient 39.74 38.95 All Payors / Plans All Payors / Plans 39.74 other 39.74 39.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALPROATE 500 MG/5 ML (100 MG/ML) SOLUTION ERX-250000000 CDM 250 RC 0409-7100-69 NDC 5 ML outpatient 25.94 25.42 All Payors / Plans All Payors / Plans 25.94 other 25.94 25.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALPROATE 500 MG/5 ML (100 MG/ML) SOLUTION ERX-250000000 CDM 250 RC 0409-7100-04 NDC 5 ML outpatient 10.96 10.74 All Payors / Plans All Payors / Plans 10.96 other 10.96 10.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERAPAMIL 2.5 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0338-0125-03 NDC 1.6 ML outpatient 23.3 22.83 All Payors / Plans All Payors / Plans 23.3 other 23.3 23.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERAPAMIL 2.5 MG/ML SOLUTION ERX-250000000 CDM 250 RC 0338-0125-04 NDC 1 ML outpatient 20.44 20.03 All Payors / Plans All Payors / Plans 20.44 other 20.44 20.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDIGOTINDISULFONATE 8 MG/ML (0.8 %) SOLUTION ERX-250000000 CDM 250 RC 0088-2160-30 NDC 5 ML outpatient 701.15 687.13 All Payors / Plans All Payors / Plans 701.15 other 701.15 701.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IODINE STRONG 5 % SOLUTION ERX-250000000 CDM 250 RC 50268-478-11 NDC 1 ML outpatient 137.93 135.17 All Payors / Plans All Payors / Plans 137.93 other 137.93 137.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILTIAZEM 100 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 62332-062-30 NDC 1 UN outpatient 49.63 48.64 All Payors / Plans All Payors / Plans 49.63 other 49.63 49.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DINOPROSTONE 10 MG INSERT, EXTENDED RELEASE" ERX-250000000 CDM 250 RC 70748-130-06 NDC 1 UN outpatient 483.43 473.76 All Payors / Plans All Payors / Plans 483.43 other 483.43 483.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DINOPROSTONE 10 MG INSERT, EXTENDED RELEASE" ERX-250000000 CDM 250 RC 50268-476-11 NDC 1 UN outpatient 483.43 473.76 All Payors / Plans All Payors / Plans 483.43 other 483.43 483.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXYCYCLINE 100 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 59651-180-30 NDC 1 UN outpatient 61.94 60.7 All Payors / Plans All Payors / Plans 61.94 other 61.94 61.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXYCYCLINE 100 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 68084-859-01 NDC 1 UN outpatient 61.02 59.8 All Payors / Plans All Payors / Plans 61.02 other 61.02 61.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXYCYCLINE 100 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 68084-859-11 NDC 1 UN outpatient 81.4 79.77 All Payors / Plans All Payors / Plans 81.4 other 81.4 81.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "GELATIN SPONGE,ABSORBABLE SYRINGE" ERX-250000000 CDM 250 RC 0904-7124-61 NDC 1 UN outpatient 67.95 66.59 All Payors / Plans All Payors / Plans 67.95 other 67.95 67.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "GELATIN SPONGE,ABSORB-PORCINE 100 SPONGE 6 EACH PACKET" ERX-250000000 CDM 250 RC 51079-821-01 NDC 1 UN outpatient 144.87 141.97 All Payors / Plans All Payors / Plans 144.87 other 144.87 144.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "GELATIN SPONGE,ABSORB-PORCINE 12-7 MM SPONGE" ERX-250000000 CDM 250 RC 60687-657-11 NDC 1 UN outpatient 61.17 59.95 All Payors / Plans All Payors / Plans 61.17 other 61.17 61.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLYCERIN SUPPOSITORY ERX-250000000 CDM 250 RC 0121-4799-05 NDC 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLYCERIN SUPPOSITORY ERX-250000000 CDM 250 RC 60687-249-40 NDC 0.5 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MENINGOCOCCAL A / C / Y AND W-135 DIPHTHERIA CONJUGATE 10-5 MCG/0.5 ML KIT ERX-250000000 CDM 250 RC 0904-6352-61 NDC 1 UN outpatient 310.73 304.52 All Payors / Plans All Payors / Plans 310.73 other 310.73 310.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAFCILLIN 1 GRAM RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 0904-6353-61 NDC 0.64 UN outpatient 22.9 22.44 All Payors / Plans All Payors / Plans 22.9 other 22.9 22.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAFCILLIN 2 GRAM RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 60687-497-11 NDC 1 UN outpatient 39.57 38.78 All Payors / Plans All Payors / Plans 39.57 other 39.57 39.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAFCILLIN 2 GRAM RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 42292-039-01 NDC 1 UN outpatient 36.29 35.56 All Payors / Plans All Payors / Plans 36.29 other 36.29 36.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAFCILLIN 2 GRAM RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 60687-508-11 NDC 1 UN outpatient 30.92 30.3 All Payors / Plans All Payors / Plans 30.92 other 30.92 30.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAFCILLIN 2 GRAM RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 51079-443-01 NDC 1 UN outpatient 35.73 35.02 All Payors / Plans All Payors / Plans 35.73 other 35.73 35.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PANTOPRAZOLE 40 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 42292-041-01 NDC 1 UN outpatient 10.81 10.59 All Payors / Plans All Payors / Plans 10.81 other 10.81 10.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PANTOPRAZOLE 40 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 42292-041-20 NDC 1 UN outpatient 31.27 30.64 All Payors / Plans All Payors / Plans 31.27 other 31.27 31.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PANTOPRAZOLE 40 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 0904-6956-61 NDC 1 UN outpatient 10.61 10.4 All Payors / Plans All Payors / Plans 10.61 other 10.61 10.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PANTOPRAZOLE 40 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 51079-445-01 NDC 1 UN outpatient 20.89 20.47 All Payors / Plans All Payors / Plans 20.89 other 20.89 20.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PANTOPRAZOLE 40 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 60687-530-11 NDC 1 UN outpatient 20.8 20.38 All Payors / Plans All Payors / Plans 20.8 other 20.8 20.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PANTOPRAZOLE 40 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 0904-6957-61 NDC 1 UN outpatient 10.53 10.32 All Payors / Plans All Payors / Plans 10.53 other 10.53 10.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PANTOPRAZOLE 40 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 60687-541-11 NDC 1 UN outpatient 10.53 10.32 All Payors / Plans All Payors / Plans 10.53 other 10.53 10.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POLYMYXIN B 500,000 UNIT RECON SOLN 1 EACH VIAL" ERX-250000000 CDM 250 RC 60687-552-11 NDC 1 UN outpatient 21.1 20.68 All Payors / Plans All Payors / Plans 21.1 other 21.1 21.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility REMIFENTANIL 2 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 51079-444-01 NDC 1 UN outpatient 240.5 235.69 All Payors / Plans All Payors / Plans 240.5 other 240.5 240.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility REMIFENTANIL 2 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM 250 RC 51079-444-20 NDC 0.5 UN outpatient 246.67 241.74 All Payors / Plans All Payors / Plans 246.67 other 246.67 246.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "THROMBIN (BOVINE) 20,000 UNIT RECON SOLN" ERX-250000000 CDM 250 RC 60687-453-11 NDC 0.5 UN outpatient 243.05 238.19 All Payors / Plans All Payors / Plans 243.05 other 243.05 243.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "THROMBIN (BOVINE) 5,000 UNIT RECON SOLN" ERX-250000000 CDM 250 RC 51079-440-01 NDC 1 UN outpatient 150.02 147.02 All Payors / Plans All Payors / Plans 150.02 other 150.02 150.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "THROMBIN (RECOMBINANT) 20,000 UNIT RECON SOLN" ERX-250000000 CDM 250 RC 51079-440-20 NDC 1 UN outpatient 639.57 626.78 All Payors / Plans All Payors / Plans 639.57 other 639.57 639.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "THROMBIN (RECOMBINANT) 5,000 UNIT RECON SOLN" ERX-250000000 CDM 250 RC 60687-464-11 NDC 1 UN outpatient 195.38 191.47 All Payors / Plans All Payors / Plans 195.38 other 195.38 195.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TICAGRELOR 60 MG TABLET ERX-250000000 CDM 250 RC 51079-441-01 NDC 1 UN outpatient 15.83 15.51 All Payors / Plans All Payors / Plans 15.83 other 15.83 15.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TICAGRELOR 90 MG TABLET ERX-250000000 CDM 250 RC 51079-441-20 NDC 1 UN outpatient 15.83 15.51 All Payors / Plans All Payors / Plans 15.83 other 15.83 15.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VECURONIUM 10 MG RECON SOLN ERX-250000000 CDM 250 RC 0904-6952-61 NDC 1 UN outpatient 15.44 15.13 All Payors / Plans All Payors / Plans 15.44 other 15.44 15.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDOCYANINE GREEN 25 MG RECON SOLN ERX-250000000 CDM 250 RC 70100-424-02 NDC 0.1 UN outpatient 321.27 314.84 All Payors / Plans All Payors / Plans 321.27 other 321.27 321.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDOCYANINE GREEN 25 MG RECON SOLN ERX-250000000 CDM 250 RC 48433-230-15 NDC 1 UN outpatient 321.27 314.84 All Payors / Plans All Payors / Plans 321.27 other 321.27 321.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE HCL IN 0.9 % NACL 4 MG/250 ML (16 MCG/ML) SOLUTION ERX-636000000 CDM 636 RC 36000-048-24 NDC 250 ML outpatient 185.82 182.1 All Payors / Plans All Payors / Plans 185.82 other 185.82 185.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE HCL IN 0.9 % NACL 4 MG/250 ML (16 MCG/ML) SOLUTION ERX-636000000 CDM 636 RC 0264-9594-10 NDC 250 ML outpatient 185.82 182.1 All Payors / Plans All Payors / Plans 185.82 other 185.82 185.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RABIES IMMUNE GLOBULIN PER 150 INT'L UNITS ERX-636000000 CDM 90377 CPT 636 RC 60687-704-11 NDC JZ 1.4 ML outpatient 584.73 573.04 All Payors / Plans All Payors / Plans 584.73 other 584.73 584.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RABIES IMMUNE GLOBULIN PER 150 INT'L UNITS ERX-636000000 CDM 90377 CPT 636 RC 0904-7007-61 NDC JZ 10 ML outpatient 2934.46 2875.77 All Payors / Plans All Payors / Plans 2934.46 other 2934.46 2934.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML SYRINGE" ERX-636000000 CDM 90620 CPT 636 RC 65162-698-90 NDC JZ 0.5 ML outpatient 417.85 409.49 All Payors / Plans All Payors / Plans 417.85 other 417.85 417.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HAEMOPHILUS B CONJUGATE 10 MCG/0.5 ML RECON SOLN ERX-636000000 CDM 90648 CPT 636 RC 55150-198-30 NDC JZ 1 UN outpatient 61.85 60.61 All Payors / Plans All Payors / Plans 61.85 other 61.85 61.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INFLUENZA TRIVALENT (6 MOS UP) 45 MCG (15 MCG X 3)/0.5 ML SYRINGE ERX-636000000 CDM 90656 CPT 636 RC 60687-373-21 NDC JZ 0.5 ML outpatient 85.18 83.48 All Payors / Plans All Payors / Plans 85.18 other 85.18 85.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RABIES VACCINE PER 1 ML ERX-636000000 CDM 90675 CPT 636 RC 81284-315-05 NDC JZ 1 UN outpatient 715.27 700.96 All Payors / Plans All Payors / Plans 715.27 other 715.27 715.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PNEUMOCOCCAL CONJUGATE PCV20 0.5 ML SYRINGE ERX-636000000 CDM 90677 CPT 636 RC 50268-398-50 NDC JZ 0.5 ML outpatient 610.96 598.74 All Payors / Plans All Payors / Plans 610.96 other 610.96 610.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INFLUENZA QUADRIVALENT 60 MCG (15 MCG X 4)/0.5 ML SYRINGE ERX-636000000 CDM 90686 CPT 636 RC 60687-373-11 NDC JZ 0.5 ML outpatient 84.32 82.63 All Payors / Plans All Payors / Plans 84.32 other 84.32 84.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MEASLES, MUMPS & RUBELLA VAC PER 0.5 ML" ERX-636000000 CDM 90707 CPT 636 RC 63323-623-61 NDC JZ 1 UN outpatient 204.79 200.69 All Payors / Plans All Payors / Plans 204.79 other 204.79 204.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TETANUS AND DIPHTHERIA TOXIN 5-2 LF UNIT/0.5 ML SYRINGE ERX-636000000 CDM 90714 CPT 636 RC 0904-7109-61 NDC JZ 0.5 ML outpatient 139.64 136.85 All Payors / Plans All Payors / Plans 139.64 other 139.64 139.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML SYRINGE" ERX-636000000 CDM 90715 CPT 636 RC 0536-1211-95 NDC JZ 0.5 ML outpatient 141.06 138.24 All Payors / Plans All Payors / Plans 141.06 other 141.06 141.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML SYRINGE" ERX-636000000 CDM 90715 CPT 636 RC 61314-014-05 NDC JZ 0.5 ML outpatient 141.06 138.24 All Payors / Plans All Payors / Plans 141.06 other 141.06 141.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TETANUS-DIPHTH-ACELL PERTUSSIS PER 0.5 ML ERX-636000000 CDM 90715 CPT 636 RC 60687-439-11 NDC JZ 0.5 ML outpatient 148.92 145.94 All Payors / Plans All Payors / Plans 148.92 other 148.92 148.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DTAP-HEPATITIS B RECOMBINANT-IPV 10 MCG-25LF-25 MCG-10LF/0.5 ML SYRINGE ERX-636000000 CDM 90723 CPT 636 RC 0904-5921-61 NDC JZ 0.5 ML outpatient 193.46 189.59 All Payors / Plans All Payors / Plans 193.46 other 193.46 193.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML SYRINGE ERX-636000000 CDM 90744 CPT 636 RC 60687-451-11 NDC JZ 0.5 ML outpatient 84.42 82.73 All Payors / Plans All Payors / Plans 84.42 other 84.42 84.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML SYRINGE ERX-636000000 CDM 90744 CPT 636 RC 64380-737-06 NDC JZ 0.5 ML outpatient 84.42 82.73 All Payors / Plans All Payors / Plans 84.42 other 84.42 84.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML SYRINGE ERX-250000000 CDM 90746 CPT 250 RC 49884-465-64 NDC JZ 1 ML outpatient 149.1 146.12 All Payors / Plans All Payors / Plans 149.1 other 149.1 149.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "WATER FOR INJECTION, STERILE SOLUTION" ERX-636000000 CDM A4216 CPT 636 RC 0904-7245-68 NDC JZ 0.83 ML outpatient 0.25 0.25 All Payors / Plans All Payors / Plans 0.25 other 0.25 0.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "WATER FOR INJECTION, STERILE SOLUTION" ERX-636000000 CDM A4216 CPT 636 RC 67877-734-60 NDC JZ 0.9 ML outpatient 0.53 0.52 All Payors / Plans All Payors / Plans 0.53 other 0.53 0.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "WATER FOR INJECTION, STERILE SOLUTION 10 ML VIAL" ERX-636000000 CDM A4216 CPT 636 RC 67877-733-60 NDC JZ 10 ML outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "WATER FOR INJECTION, STERILE SOLUTION 10 ML VIAL" ERX-636000000 CDM A4216 CPT 636 RC 04910-0381-64 NDC JZ 10 ML outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "WATER FOR INJECTION, STERILE SOLUTION 10 ML VIAL" ERX-636000000 CDM A4216 CPT 636 RC 0121-1154-30 NDC JZ 10 ML outpatient 5.86 5.74 All Payors / Plans All Payors / Plans 5.86 other 5.86 5.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "WATER FOR INJECTION, STERILE SOLUTION 20 ML VIAL" ERX-636000000 CDM A4216 CPT 636 RC 45963-439-65 NDC JZ 20 ML outpatient 6.02 5.9 All Payors / Plans All Payors / Plans 6.02 other 6.02 6.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "WATER FOR INJECTION, STERILE SOLUTION 5 ML VIAL" ERX-636000000 CDM A4216 CPT 636 RC 62135-003-47 NDC JZ 5 ML outpatient 11.13 10.91 All Payors / Plans All Payors / Plans 11.13 other 11.13 11.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "WATER FOR INJECTION, STERILE SOLUTION 50 ML VIAL" ERX-636000000 CDM A4216 CPT 636 RC 57237-274-24 NDC JZ 1.68 ML outpatient 0.37 0.36 All Payors / Plans All Payors / Plans 0.37 other 0.37 0.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "STERILE WATER PARENTERAL SOLUTION 2,000 ML BAG" ERX-636000000 CDM A4217 CPT 636 RC 16714-309-01 NDC 35.43 ML outpatient 0.57 0.56 All Payors / Plans All Payors / Plans 0.57 other 0.57 0.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STERILE WATER SOLUTION ERX-636000000 CDM A4217 CPT 636 RC 63323-203-01 NDC 3 ML outpatient 0.2 0.2 All Payors / Plans All Payors / Plans 0.2 other 0.2 0.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "STERILE WATER SOLUTION 1,000 ML BOTTLE" ERX-636000000 CDM A4217 CPT 636 RC 63323-203-20 NDC 10 ML outpatient 0.18 0.18 All Payors / Plans All Payors / Plans 0.18 other 0.18 0.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STERILE WATER SOLUTION 500 ML BOTTLE ERX-636000000 CDM A4217 CPT 636 RC 55150-370-25 NDC 10 ML outpatient 0.36 0.35 All Payors / Plans All Payors / Plans 0.36 other 0.36 0.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "STERILE WATER PARENTERAL SOLUTION 1,000 ML BAG" ERX-636000000 CDM A4217 CPT 636 RC 45802-465-64 NDC JZ 27.5 ML outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUTEROL 1 (ONE) 90 MCG/PUFF INHALER 8 G INHALER ERX-637000000 CDM A9270 CPT 637 RC 0338-0202-01 NDC GY 8 GR outpatient 102.01 99.97 All Payors / Plans All Payors / Plans 102.01 other 102.01 102.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMMONIUM LACTATE 12 % LOTION 225 G BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0338-1145-03 NDC GY 225 GR outpatient 63.88 62.6 All Payors / Plans All Payors / Plans 63.88 other 63.88 63.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BACITRACIN 500 UNIT/GRAM OINTMENT 14 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0338-1148-03 NDC GY 14 GR outpatient 15.76 15.44 All Payors / Plans All Payors / Plans 15.76 other 15.76 15.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BACITRACIN 500 UNIT/GRAM OINTMENT 14 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0409-4346-73 NDC GY 14 GR outpatient 6.05 5.93 All Payors / Plans All Payors / Plans 6.05 other 6.05 6.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BACITRACIN 500 UNIT/GRAM OINTMENT 3.5 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 63323-616-09 NDC GY 3.5 GR outpatient 314.57 308.28 All Payors / Plans All Payors / Plans 314.57 other 314.57 314.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BECLOMETHASONE 40 MCG/ACTUATION HFA AEROSOL BREATH ACTIVATED 10.6 G AER BR.ACT ERX-637000000 CDM A9270 CPT 637 RC 67457-153-03 NDC GY 10.6 GR outpatient 457.03 447.89 All Payors / Plans All Payors / Plans 457.03 other 457.03 457.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BENZOCAINE 20 % AEROSOL,SPRAY 57 G CAN" ERX-637000000 CDM A9270 CPT 637 RC 15082-001-10 NDC GY 0.285 GR outpatient 0.25 0.25 All Payors / Plans All Payors / Plans 0.25 other 0.25 0.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZOCAINE-MENTHOL 20-0.5 % AEROSOL 78 G CANISTER ERX-637000000 CDM A9270 CPT 637 RC 63323-466-37 NDC GY 78 GR outpatient 26.33 25.8 All Payors / Plans All Payors / Plans 26.33 other 26.33 26.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZOCAINE-MENTHOL 20-0.5 % AEROSOL 85 G CANISTER ERX-637000000 CDM A9270 CPT 637 RC 0409-1746-10 NDC GY 85 GR outpatient 26.17 25.65 All Payors / Plans All Payors / Plans 26.17 other 26.17 26.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BETAMETHASONE DIPROPIONATE 0.05 % CREAM 45 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 63323-468-37 NDC GY 45 GR outpatient 202.25 198.21 All Payors / Plans All Payors / Plans 202.25 other 202.25 202.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN 2 % CREAM 40 G TUBE/KIT ERX-637000000 CDM A9270 CPT 637 RC 0409-1749-10 NDC GY 40 GR outpatient 195.9 191.98 All Payors / Plans All Payors / Plans 195.9 other 195.9 195.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOTRIMAZOLE 1 % CREAM 28 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 63323-462-03 NDC GY 28 GR outpatient 10.88 10.66 All Payors / Plans All Payors / Plans 10.88 other 10.88 10.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOTRIMAZOLE 1 % CREAM 30 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 63323-407-03 NDC GY 30 GR outpatient 10.47 10.26 All Payors / Plans All Payors / Plans 10.47 other 10.47 10.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOTRIMAZOLE 2 % CREAM 21 G TUBE/KIT ERX-637000000 CDM A9270 CPT 637 RC 0517-6710-10 NDC GY 21 GR outpatient 25.99 25.47 All Payors / Plans All Payors / Plans 25.99 other 25.99 25.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % CREAM 15 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0517-6710-01 NDC GY 15 GR outpatient 35.64 34.93 All Payors / Plans All Payors / Plans 35.64 other 35.64 35.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COLLAGENASE 250 UNIT/GRAM OINTMENT 30 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0409-1631-10 NDC GY 30 GR outpatient 660.57 647.36 All Payors / Plans All Payors / Plans 660.57 other 660.57 660.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CONJUGATED ESTROGENS 0.625 MG/GRAM CREAM 30 G TUBE/KIT ERX-637000000 CDM A9270 CPT 637 RC 44567-620-01 NDC GY 30 GR outpatient 803.37 787.3 All Payors / Plans All Payors / Plans 803.37 other 803.37 803.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 15G ORAL 40 % GEL ERX-637000000 CDM A9270 CPT 637 RC 44567-621-01 NDC GY 0.4 GR outpatient 9.5 9.31 All Payors / Plans All Payors / Plans 9.5 other 9.5 9.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 15G ORAL 40 % GEL ERX-637000000 CDM A9270 CPT 637 RC 44567-621-24 NDC GY 15 GR outpatient 9.53 9.34 All Payors / Plans All Payors / Plans 9.53 other 9.53 9.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIBUCAINE 1 % OINTMENT 28 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0143-9180-01 NDC GY 28 GR outpatient 15.9 15.58 All Payors / Plans All Payors / Plans 15.9 other 15.9 15.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERYTHROMYCIN 1 (ONE) 1 G TUBE 1 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0143-9184-01 NDC GY 1 GR outpatient 39.7 38.91 All Payors / Plans All Payors / Plans 39.7 other 39.7 39.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERYTHROMYCIN 5 MG/GRAM (0.5 %) OINTMENT ERX-637000000 CDM A9270 CPT 637 RC 0009-0856-08 NDC GY 1 GR outpatient 39.5 38.71 All Payors / Plans All Payors / Plans 39.5 other 39.5 39.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERYTHROMYCIN 5 MG/GRAM (0.5 %) OINTMENT ERX-637000000 CDM A9270 CPT 637 RC 69374-984-10 NDC GY 1 GR outpatient 49.67 48.68 All Payors / Plans All Payors / Plans 49.67 other 49.67 49.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERYTHROMYCIN 5 MG/GRAM (0.5 %) OINTMENT ERX-637000000 CDM A9270 CPT 637 RC 0000-0000-59 NDC GY 1 GR outpatient 30.93 30.31 All Payors / Plans All Payors / Plans 30.93 other 30.93 30.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERYTHROMYCIN 5 MG/GRAM (0.5 %) OINTMENT 1 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0000-0000-58 NDC GY 1 GR outpatient 40.14 39.34 All Payors / Plans All Payors / Plans 40.14 other 40.14 40.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOCINONIDE 0.05 % CREAM 60 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 8065183150 NDC GY 60 GR outpatient 155.52 152.41 All Payors / Plans All Payors / Plans 155.52 other 155.52 155.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUTICASONE HFA 110 MCG/ACTUATION HFA AEROSOL INHALER 12 G AER W/ADAP ERX-637000000 CDM A9270 CPT 637 RC 8065183905 NDC GY 0.0002 GR outpatient 0.12 0.12 All Payors / Plans All Payors / Plans 0.12 other 0.12 0.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUTICASONE HFA 44 MCG/ACTUATION HFA AEROSOL INHALER 10.6 G AER W/ADAP ERX-637000000 CDM A9270 CPT 637 RC 70069-151-01 NDC GY 10.6 GR outpatient 430.16 421.56 All Payors / Plans All Payors / Plans 430.16 other 430.16 430.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUTICASONE HFA 44 MCG/ACTUATION HFA AEROSOL INHALER 10.6 G AER W/ADAP ERX-637000000 CDM A9270 CPT 637 RC 0703-2056-01 NDC GY 0.0001 GR outpatient 0.12 0.12 All Payors / Plans All Payors / Plans 0.12 other 0.12 0.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN 0.1 % CREAM 15 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 10122-610-10 NDC GY 15 GR outpatient 85.65 83.94 All Payors / Plans All Payors / Plans 85.65 other 85.65 85.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN 0.1 % CREAM 15 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 10122-610-01 NDC GY 15 GR outpatient 138.94 136.16 All Payors / Plans All Payors / Plans 138.94 other 138.94 138.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN 0.1 % CREAM 15 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 10122-611-01 NDC GY 15 GR outpatient 143.19 140.33 All Payors / Plans All Payors / Plans 143.19 other 143.19 143.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 1 % CREAM 28.35 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 10122-611-10 NDC GY 28 GR outpatient 15.63 15.32 All Payors / Plans All Payors / Plans 15.63 other 15.63 15.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 2.5 % CREAM 30 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0338-9553-24 NDC GY 30 GR outpatient 10.91 10.69 All Payors / Plans All Payors / Plans 10.91 other 10.91 10.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 2.5 % CREAM 30 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0000-0000-10 NDC GY 30 GR outpatient 15.69 15.38 All Payors / Plans All Payors / Plans 15.69 other 15.69 15.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 2.5 % OINTMENT 28.35 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 2289-1012-65 NDC GY 28.35 GR outpatient 16.02 15.7 All Payors / Plans All Payors / Plans 16.02 other 16.02 16.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOCONAZOLE 2 % CREAM 15 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0338-0085-03 NDC GY 15 GR outpatient 132.18 129.54 All Payors / Plans All Payors / Plans 132.18 other 132.18 132.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LANOLIN 100 % CREAM 7 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 42023-187-10 NDC GY 7 GR outpatient 15.24 14.94 All Payors / Plans All Payors / Plans 15.24 other 15.24 15.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 4 % GEL 10 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 16729-239-30 NDC GY 10 GR outpatient 45.5 44.59 All Payors / Plans All Payors / Plans 45.5 other 45.5 45.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 5 % OINTMENT 35.44 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 71288-505-03 NDC GY 35.44 GR outpatient 253.66 248.59 All Payors / Plans All Payors / Plans 253.66 other 253.66 253.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE HCL (BULK) 100 % POWDER ERX-637000000 CDM A9270 CPT 637 RC 42023-186-20 NDC GY 3 GR outpatient 10.56 10.35 All Payors / Plans All Payors / Plans 10.56 other 10.56 10.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MENTHOL-ZINC OXIDE 0.44-20.6 % OINTMENT IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 0338-9557-12 NDC GY 3.5 GR outpatient 1.87 1.83 All Payors / Plans All Payors / Plans 1.87 other 1.87 1.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYL SALICYLATE-MENTHOL 29-7.6 % OINTMENT 99.2 G JAR ERX-637000000 CDM A9270 CPT 637 RC 55150-297-01 NDC GY 99.2 GR outpatient 26.19 25.67 All Payors / Plans All Payors / Plans 26.19 other 26.19 26.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICONAZOLE 2 % CREAM 14 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 44567-603-24 NDC GY 14 GR outpatient 21.15 20.73 All Payors / Plans All Payors / Plans 21.15 other 21.15 21.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICONAZOLE 2 % CREAM 45 G TUBE/KIT ERX-637000000 CDM A9270 CPT 637 RC 0338-0023-03 NDC GY 45 GR outpatient 20.61 20.2 All Payors / Plans All Payors / Plans 20.61 other 20.61 20.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MUPIROCIN 2 % OINTMENT 22 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0338-0023-04 NDC GY 22 GR outpatient 15.49 15.18 All Payors / Plans All Payors / Plans 15.49 other 15.49 15.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MUPIROCIN 2 % OINTMENT 22 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0990-7930-09 NDC GY 22 GR outpatient 16.16 15.84 All Payors / Plans All Payors / Plans 16.16 other 16.16 16.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MUPIROCIN 2 % OINTMENT 22 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0990-7935-19 NDC GY 22 GR outpatient 15.8 15.48 All Payors / Plans All Payors / Plans 15.8 other 15.8 15.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MUPIROCIN 2 % OINTMENT 22 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0338-0085-04 NDC GY 22 GR outpatient 25.63 25.12 All Payors / Plans All Payors / Plans 25.63 other 25.63 25.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5MG-400 UNIT- 5,000 UNIT/GRAM OINTMENT 28.4 G TUBE" ERX-637000000 CDM A9270 CPT 637 RC 0990-7111-09 NDC GY 28.4 GR outpatient 10.94 10.72 All Payors / Plans All Payors / Plans 10.94 other 10.94 10.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5 MG/G-10,000 UNIT/G-0.1 % OINTMENT 3.5 G TUBE" ERX-637000000 CDM A9270 CPT 637 RC 0338-0077-04 NDC GY 3.5 GR outpatient 81.59 79.96 All Payors / Plans All Payors / Plans 81.59 other 81.59 81.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROGLYCERIN 2 % OINTMENT ERX-637000000 CDM A9270 CPT 637 RC 0990-7924-09 NDC GY 0.5 GR outpatient 4.43 4.34 All Payors / Plans All Payors / Plans 4.43 other 4.43 4.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NITROGLYCERIN 400 MCG/SPRAY SPRAY,NON-AEROSOL 12 G BOTTLE" ERX-637000000 CDM A9270 CPT 637 RC 0409-7517-16 NDC GY 12 GR outpatient 426.74 418.21 All Payors / Plans All Payors / Plans 426.74 other 426.74 426.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/GRAM CREAM 30 G TUBE" ERX-637000000 CDM A9270 CPT 637 RC 76329-3302-1 NDC GY 30 GR outpatient 31.21 30.59 All Payors / Plans All Payors / Plans 31.21 other 31.21 31.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/GRAM OINTMENT 15 G TUBE" ERX-637000000 CDM A9270 CPT 637 RC 0409-6648-02 NDC GY 15 GR outpatient 16.16 15.84 All Payors / Plans All Payors / Plans 16.16 other 16.16 16.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/GRAM POWDER 15 G SQUEEZ BTL" ERX-637000000 CDM A9270 CPT 637 RC 0338-0719-06 NDC GY 15 GR outpatient 25.94 25.42 All Payors / Plans All Payors / Plans 25.94 other 25.94 25.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/GRAM POWDER 15 G SQUEEZ BTL" ERX-637000000 CDM A9270 CPT 637 RC 14537-817-75 NDC GY 15 GR outpatient 45.21 44.31 All Payors / Plans All Payors / Plans 45.21 other 45.21 45.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/GRAM POWDER 15 G SQUEEZ BTL" ERX-637000000 CDM A9270 CPT 637 RC 14537-967-75 NDC GY 15 GR outpatient 39.88 39.08 All Payors / Plans All Payors / Plans 39.88 other 39.88 39.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % OINTMENT 28 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0409-4350-13 NDC GY 28 GR outpatient 31.18 30.56 All Payors / Plans All Payors / Plans 31.18 other 31.18 31.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POVIDONE-IODINE 10 % OINTMENT ERX-637000000 CDM A9270 CPT 637 RC 63037-119-05 NDC GY 1 GR outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POVIDONE-IODINE 10 % OINTMENT ERX-637000000 CDM A9270 CPT 637 RC 0641-6013-01 NDC GY 1 GR outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SILVER SULFADIAZINE 1 % CREAM 50 G JAR ERX-637000000 CDM A9270 CPT 637 RC 70860-301-05 NDC GY 50 GR outpatient 35.98 35.26 All Payors / Plans All Payors / Plans 35.98 other 35.98 35.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRETINOIN 0.05 % CREAM 20 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 70860-301-41 NDC GY 20 GR outpatient 82.68 81.03 All Payors / Plans All Payors / Plans 82.68 other 82.68 82.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRIAMCINOLONE 0.1 % CREAM 15 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 55566-2800-0 NDC GY 15 GR outpatient 15.74 15.43 All Payors / Plans All Payors / Plans 15.74 other 15.74 15.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRIAMCINOLONE 0.1 % CREAM 80 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 55566-2800-1 NDC GY 80 GR outpatient 31.11 30.49 All Payors / Plans All Payors / Plans 31.11 other 31.11 31.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRIAMCINOLONE 0.5 % CREAM 15 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0143-9381-01 NDC GY 15 GR outpatient 49.67 48.68 All Payors / Plans All Payors / Plans 49.67 other 49.67 49.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VITAMIN A & D WITH LANOLIN OINTMENT 42.5 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 63323-130-02 NDC GY 42.5 GR outpatient 15.24 14.94 All Payors / Plans All Payors / Plans 15.24 other 15.24 15.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WHITE PETROLATUM 41 % OINTMENT 80 G JAR ERX-637000000 CDM A9270 CPT 637 RC 67457-437-00 NDC GY 80 GR outpatient 30.85 30.23 All Payors / Plans All Payors / Plans 30.85 other 30.85 30.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WHITE PETROLATUM-MINERAL OIL 94-3 % OINTMENT 3.5 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 65219-389-02 NDC GY 3.5 GR outpatient 36.05 35.33 All Payors / Plans All Payors / Plans 36.05 other 36.05 36.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WHITE PETROLATUM-MINERAL OIL-LANOLIN-CERESIN CREAM 113 G JAR ERX-637000000 CDM A9270 CPT 637 RC 0338-0221-04 NDC GY 113 GR outpatient 10.91 10.69 All Payors / Plans All Payors / Plans 10.91 other 10.91 10.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZINC OXIDE-COD LIVER OIL 40 % PASTE 28 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0143-9786-01 NDC GY 28 GR outpatient 15.81 15.49 All Payors / Plans All Payors / Plans 15.81 other 15.81 15.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZINC OXIDE-COD LIVER OIL 40 % PASTE 57 G TUBE ERX-637000000 CDM A9270 CPT 637 RC 0143-9786-10 NDC GY 28 GR outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "FLUTICASONE PROPIONATE 50 MCG/ACTUATION SPRAY,SUSPENSION 16 G AER W/ADAP" ERX-637000000 CDM A9270 CPT 637 RC 16714-037-25 NDC GY 16000 ME outpatient 25.94 25.42 All Payors / Plans All Payors / Plans 25.94 other 25.94 25.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "FLUTICASONE PROPIONATE 50 MCG/ACTUATION SPRAY,SUSPENSION 16 G AER W/ADAP" ERX-637000000 CDM A9270 CPT 637 RC 14789-250-10 NDC GY 16000 ME outpatient 20.74 20.33 All Payors / Plans All Payors / Plans 20.74 other 20.74 20.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 160 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 45802-730-32 NDC GY 15.99015385 ML outpatient 13.78 13.5 All Payors / Plans All Payors / Plans 13.78 other 13.78 13.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 160 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0406-0484-23 NDC GY 10.15 ML outpatient 4.92 4.82 All Payors / Plans All Payors / Plans 4.92 other 4.92 4.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 160 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0904-6663-61 NDC GY 3.3 ML outpatient 2.64 2.59 All Payors / Plans All Payors / Plans 2.64 other 2.64 2.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 160 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 29033-030-01 NDC GY 5 ML outpatient 2.64 2.59 All Payors / Plans All Payors / Plans 2.64 other 2.64 2.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 325 MG/10.15 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 60687-578-11 NDC GY 10.15 ML outpatient 3.47 3.4 All Payors / Plans All Payors / Plans 3.47 other 3.47 3.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACTIVATED CHARCOAL 50 GRAM/240 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 7985404097 NDC GY 240 ML outpatient 83.22 81.56 All Payors / Plans All Payors / Plans 83.22 other 83.22 83.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACTIVATED CHARCOAL-SORBITOL 50 GRAM/240 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0574-0521-76 NDC GY 240 ML outpatient 83.44 81.77 All Payors / Plans All Payors / Plans 83.44 other 83.44 83.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0574-0520-76 NDC GY 30 ML outpatient 6.72 6.59 All Payors / Plans All Payors / Plans 6.72 other 6.72 6.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0904-5789-61 NDC GY 30 ML outpatient 0.3 0.29 All Payors / Plans All Payors / Plans 0.3 other 0.3 0.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 72578-002-01 NDC GY 30 ML outpatient 0.36 0.35 All Payors / Plans All Payors / Plans 0.36 other 0.36 0.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 68084-109-11 NDC GY 28 ML outpatient 8.57 8.4 All Payors / Plans All Payors / Plans 8.57 other 8.57 8.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 31722-935-02 NDC GY 30 ML outpatient 9.19 9.01 All Payors / Plans All Payors / Plans 9.19 other 9.19 9.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0173-0682-24 NDC GY 30 ML outpatient 8.85 8.67 All Payors / Plans All Payors / Plans 8.85 other 8.85 8.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0904-7041-61 NDC GY 30 ML outpatient 0.28 0.27 All Payors / Plans All Payors / Plans 0.28 other 0.28 0.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 1 (ONE) 100 ML BOTTLE 100 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 16714-576-02 NDC GY 100 ML outpatient 25.63 25.12 All Payors / Plans All Payors / Plans 25.63 other 25.63 25.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 125 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 51079-205-01 NDC GY 10 ML outpatient 0.42 0.41 All Payors / Plans All Payors / Plans 0.42 other 0.42 0.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 250 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 51079-205-20 NDC GY 7.5 ML outpatient 0.44 0.43 All Payors / Plans All Payors / Plans 0.44 other 0.44 0.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 250 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 0904-6572-61 NDC GY 9.5 ML outpatient 0.31 0.3 All Payors / Plans All Payors / Plans 0.31 other 0.31 0.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 250 MG/5 ML SUSPENSION FOR RECONSTITUTION 80 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 51079-206-01 NDC GY 80 ML outpatient 10.94 10.72 All Payors / Plans All Payors / Plans 10.94 other 10.94 10.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 400 MG/5 ML SUSPENSION FOR RECONSTITUTION 100 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0228-2027-10 NDC GY 100 ML outpatient 35.95 35.23 All Payors / Plans All Payors / Plans 35.95 other 35.95 35.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 400 MG/5 ML SUSPENSION FOR RECONSTITUTION 100 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0781-1061-01 NDC GY 100 ML outpatient 20.69 20.28 All Payors / Plans All Payors / Plans 20.69 other 20.69 20.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 59762-3719-1 NDC GY 4.9 ML outpatient 20.37 19.96 All Payors / Plans All Payors / Plans 20.37 other 20.37 20.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 600-42.9 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 0781-1077-01 NDC GY 4 ML outpatient 10.67 10.46 All Payors / Plans All Payors / Plans 10.67 other 10.67 10.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 1 MG/ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0781-1079-01 NDC GY 5 ML outpatient 39.82 39.02 All Payors / Plans All Payors / Plans 39.82 other 39.82 39.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARTIFICIAL TEARS(HYPROMELLOSE) 0.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0121-1761-30 NDC GY 15 ML outpatient 132.44 129.79 All Payors / Plans All Payors / Plans 132.44 other 132.44 132.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARTIFICIAL TEARS(HYPROMELLOSE) 0.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0536-1293-83 NDC GY 15 ML outpatient 105.87 103.75 All Payors / Plans All Payors / Plans 105.87 other 105.87 105.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATOVAQUONE 750 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0536-1317-83 NDC GY 5 ML outpatient 18.89 18.51 All Payors / Plans All Payors / Plans 18.89 other 18.89 18.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATOVAQUONE 750 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0904-7325-62 NDC GY 5 ML outpatient 18.4 18.03 All Payors / Plans All Payors / Plans 18.4 other 18.4 18.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE 1 % DROPS 2 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0904-7325-73 NDC GY 2 ML outpatient 83.72 82.05 All Payors / Plans All Payors / Plans 83.72 other 83.72 83.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE 1 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 17856-0630-1 NDC GY 5 ML outpatient 185.03 181.33 All Payors / Plans All Payors / Plans 185.03 other 185.03 185.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE 1 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 57896-629-12 NDC GY 5 ML outpatient 106.14 104.02 All Payors / Plans All Payors / Plans 106.14 other 106.14 106.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN 100 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 0254-3012-78 NDC GY 5.15 ML outpatient 26.14 25.62 All Payors / Plans All Payors / Plans 26.14 other 26.14 26.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN 200 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 0591-2312-45 NDC GY 2.11 ML outpatient 36.05 35.33 All Payors / Plans All Payors / Plans 36.05 other 36.05 36.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN 200 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 50268-069-11 NDC GY 25 ML outpatient 117.89 115.53 All Payors / Plans All Payors / Plans 117.89 other 117.89 117.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN 200 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 0574-0292-01 NDC GY 1.65 ML outpatient 0.83 0.81 All Payors / Plans All Payors / Plans 0.83 other 0.83 0.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALANCED SALT SOLN NO.1 IRRIG. SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0245-0144-89 NDC GY 250 ML outpatient 196.22 192.3 All Payors / Plans All Payors / Plans 196.22 other 196.22 196.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALANCED SALT SOLUTION SOLUTION 15 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0245-0147-89 NDC GY 10 ML outpatient 30.94 30.32 All Payors / Plans All Payors / Plans 30.94 other 30.94 30.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALANCED SALT SOLUTION SOLUTION 500 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0904-6993-61 NDC GY 500 ML outpatient 61.36 60.13 All Payors / Plans All Payors / Plans 61.36 other 61.36 61.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BISMUTH SUBSALICYLATE 262 MG/15 ML SUSPENSION 118 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 63739-051-10 NDC GY 118 ML outpatient 10.79 10.57 All Payors / Plans All Payors / Plans 10.79 other 10.79 10.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRILLIANT BLUE 0.025 % SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 50268-037-11 NDC GY 0.5 ML outpatient 148.87 145.89 All Payors / Plans All Payors / Plans 148.87 other 148.87 148.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRIMONIDINE 0.15 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 70756-201-11 NDC GY 5 ML outpatient 201.39 197.36 All Payors / Plans All Payors / Plans 201.39 other 201.39 201.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BRINZOLAMIDE 1 % DROPS,SUSPENSION 10 ML DROP BTL" ERX-637000000 CDM A9270 CPT 637 RC 60687-433-11 NDC GY 10 ML outpatient 678.13 664.57 All Payors / Plans All Payors / Plans 678.13 other 678.13 678.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 60687-444-11 NDC GY 2.31 ML outpatient 16.65 16.32 All Payors / Plans All Payors / Plans 16.65 other 16.65 16.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALAMINE-ZINC OXIDE 8-8 % LOTION 177 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0904-6371-61 NDC GY 177 ML outpatient 10.58 10.37 All Payors / Plans All Payors / Plans 10.58 other 10.58 10.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CALCITONIN 200 UNIT/ACTUATION SPRAY,NON-AEROSOL 3.7 ML SQUEEZ BTL" ERX-637000000 CDM A9270 CPT 637 RC 60687-496-01 NDC GY 3.7 ML outpatient 183.87 180.19 All Payors / Plans All Payors / Plans 183.87 other 183.87 183.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CALCIUM CARBONATE 500 MG/5 ML (1,250 MG/5 ML) SUSPENSION" ERX-637000000 CDM A9270 CPT 637 RC 60687-496-11 NDC GY 2 ML outpatient 8.68 8.51 All Payors / Plans All Payors / Plans 8.68 other 8.68 8.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBAMIDE PEROXIDE 6.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0904-6369-61 NDC GY 15 ML outpatient 10.56 10.35 All Payors / Plans All Payors / Plans 10.56 other 10.56 10.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBAMIDE PEROXIDE 6.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0378-5209-77 NDC GY 15 ML outpatient 15.23 14.93 All Payors / Plans All Payors / Plans 15.23 other 15.23 15.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBOXYMETHYLCELLULOSE 0.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0904-6370-61 NDC GY 15 ML outpatient 38.24 37.48 All Payors / Plans All Payors / Plans 38.24 other 38.24 38.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFDINIR 125 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 45802-419-54 NDC GY 3.9 ML outpatient 10.5 10.29 All Payors / Plans All Payors / Plans 10.5 other 10.5 10.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFDINIR 250 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 0781-6157-46 NDC GY 6 ML outpatient 15.32 15.01 All Payors / Plans All Payors / Plans 15.32 other 15.32 15.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEPHALEXIN 125 MG/5 ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 0781-6039-46 NDC GY 3.8 ML outpatient 0.57 0.56 All Payors / Plans All Payors / Plans 0.57 other 0.57 0.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CETIRIZINE 5 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 16714-298-01 NDC GY 5 ML outpatient 6.99 6.85 All Payors / Plans All Payors / Plans 6.99 other 6.99 6.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORHEXIDINE 0.12 % MOUTHWASH ERX-637000000 CDM A9270 CPT 637 RC 0093-4155-73 NDC GY 15 ML outpatient 3.39 3.32 All Payors / Plans All Payors / Plans 3.39 other 3.39 3.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORHEXIDINE 0.12 % MOUTHWASH ERX-637000000 CDM A9270 CPT 637 RC 65862-707-01 NDC GY 15 ML outpatient 3.39 3.32 All Payors / Plans All Payors / Plans 3.39 other 3.39 3.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORHEXIDINE 0.12 % MOUTHWASH ERX-637000000 CDM A9270 CPT 637 RC 65862-707-80 NDC GY 15 ML outpatient 5.04 4.94 All Payors / Plans All Payors / Plans 5.04 other 5.04 5.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORHEXIDINE 0.12 % MOUTHWASH ERX-637000000 CDM A9270 CPT 637 RC 0143-9887-01 NDC GY 15 ML outpatient 4.95 4.85 All Payors / Plans All Payors / Plans 4.95 other 4.95 4.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHOLECALCIFEROL 10 MCG/ML (400 UNIT/ML) DROPS ERX-637000000 CDM A9270 CPT 637 RC 65862-071-01 NDC GY 1 ML outpatient 0.33 0.32 All Payors / Plans All Payors / Plans 0.33 other 0.33 0.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHOLECALCIFEROL 10 MCG/ML (400 UNIT/ML) DROPS ERX-637000000 CDM A9270 CPT 637 RC 16714-299-03 NDC GY 1 ML outpatient 0.22 0.22 All Payors / Plans All Payors / Plans 0.22 other 0.22 0.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN 0.3 % DROPS 2.5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0781-1874-31 NDC GY 2.5 ML outpatient 21.01 20.59 All Payors / Plans All Payors / Plans 21.01 other 21.01 21.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % DROPS,SUSPENSION 7.5 ML DROP BTL" ERX-637000000 CDM A9270 CPT 637 RC 59651-026-75 NDC GY 7.5 ML outpatient 255.75 250.64 All Payors / Plans All Payors / Plans 255.75 other 255.75 255.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % DROPS,SUSPENSION 7.5 ML DROP BTL" ERX-637000000 CDM A9270 CPT 637 RC 0093-2274-34 NDC GY 7.5 ML outpatient 357.87 350.71 All Payors / Plans All Payors / Plans 357.87 other 357.87 357.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN 75 MG/5 ML RECON SOLN ERX-637000000 CDM A9270 CPT 637 RC 0781-1831-01 NDC GY 6.9 ML outpatient 10.48 10.27 All Payors / Plans All Payors / Plans 10.48 other 10.48 10.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN PALMITATE HCL 75 MG/5 ML RECON SOLN ERX-637000000 CDM A9270 CPT 637 RC 65862-502-20 NDC GY 15 ML outpatient 5.03 4.93 All Payors / Plans All Payors / Plans 5.03 other 5.03 5.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CODEINE-GUAIFENESIN 10-100 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 0093-8675-78 NDC GY 5 ML outpatient 9.1 8.92 All Payors / Plans All Payors / Plans 9.1 other 9.1 9.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPOUND VEHICLE SUSP SF NO.20 SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0781-1852-01 NDC GY 3 ML outpatient 0.22 0.22 All Payors / Plans All Payors / Plans 0.22 other 0.22 0.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPOUNDING VEHICLE SYRUP NO23 SYRUP ERX-637000000 CDM A9270 CPT 637 RC 65862-503-01 NDC GY 2.5 ML outpatient 0.2 0.2 All Payors / Plans All Payors / Plans 0.2 other 0.2 0.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOPENTOLATE 1 % DROPS 2 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 81964-221-14 NDC GY 2 ML outpatient 62.8 61.54 All Payors / Plans All Payors / Plans 62.8 other 62.8 62.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE ERX-637000000 CDM A9270 CPT 637 RC 54092-383-01 NDC GY 1.45 ML outpatient 0.31 0.3 All Payors / Plans All Payors / Plans 0.31 other 0.31 0.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE 0.1 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 54092-381-01 NDC GY 5 ML outpatient 154.17 151.09 All Payors / Plans All Payors / Plans 154.17 other 154.17 154.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE 1 MG/ML DROPS 30 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0781-2145-01 NDC GY 8 ML outpatient 30.8 30.18 All Payors / Plans All Payors / Plans 30.8 other 30.8 30.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML SYRUP ERX-637000000 CDM A9270 CPT 637 RC 51991-620-33 NDC GY 5 ML outpatient 6.58 6.45 All Payors / Plans All Payors / Plans 6.58 other 6.58 6.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML SYRUP ERX-637000000 CDM A9270 CPT 637 RC 60687-112-11 NDC GY 10 ML outpatient 5.06 4.96 All Payors / Plans All Payors / Plans 5.06 other 5.06 5.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML SYRUP ERX-637000000 CDM A9270 CPT 637 RC 0003-0893-31 NDC GY 5 ML outpatient 4.15 4.07 All Payors / Plans All Payors / Plans 4.15 other 4.15 4.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 15 GRAM/59 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 0003-0894-31 NDC GY 59 ML outpatient 4.82 4.72 All Payors / Plans All Payors / Plans 4.82 other 4.82 4.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) SOLUTION" ERX-637000000 CDM A9270 CPT 637 RC 0781-2321-06 NDC GY 1 ML outpatient 2.66 2.61 All Payors / Plans All Payors / Plans 2.66 other 2.66 2.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICLOFENAC 0.1 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 68462-583-40 NDC GY 5 ML outpatient 30.55 29.94 All Payors / Plans All Payors / Plans 30.55 other 30.55 30.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE 10 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 60505-0404-5 NDC GY 10 ML outpatient 10.7 10.49 All Payors / Plans All Payors / Plans 10.7 other 10.7 10.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE 10 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 60687-179-01 NDC GY 5 ML outpatient 7.02 6.88 All Payors / Plans All Payors / Plans 7.02 other 7.02 7.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE 12.5 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 60687-179-11 NDC GY 2.5 ML outpatient 0.62 0.61 All Payors / Plans All Payors / Plans 0.62 other 0.62 0.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE 12.5 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 60687-191-11 NDC GY 30 ML outpatient 0.29 0.28 All Payors / Plans All Payors / Plans 0.29 other 0.29 0.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE 12.5 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 50268-087-11 NDC GY 2.95 ML outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE 12.5 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 60687-157-11 NDC GY 30 ML outpatient 0.62 0.61 All Payors / Plans All Payors / Plans 0.62 other 0.62 0.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE PER 50 MG ERX-637000000 CDM A9270 CPT 637 RC 50268-088-11 NDC GY 5 ML outpatient 5.03 4.93 All Payors / Plans All Payors / Plans 5.03 other 5.03 5.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE-LIDO-AL HYDROX-MAG HYDROX-SIMETHICONE 119 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 50268-088-15 NDC GY 119 ML outpatient 232.41 227.76 All Payors / Plans All Payors / Plans 232.41 other 232.41 232.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOCUSATE 50 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 60687-168-11 NDC GY 10 ML outpatient 5.02 4.92 All Payors / Plans All Payors / Plans 5.02 other 5.02 5.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOCUSATE 50 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 63739-070-10 NDC GY 10 ML outpatient 5.02 4.92 All Payors / Plans All Payors / Plans 5.02 other 5.02 5.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOCUSATE 50 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 0065-0408-72 NDC GY 10 ML outpatient 3.36 3.29 All Payors / Plans All Payors / Plans 3.36 other 3.36 3.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DORZOLAMIDE 2 % DROPS 10 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0998-0408-15 NDC GY 10 ML outpatient 44.81 43.91 All Payors / Plans All Payors / Plans 44.81 other 44.81 44.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DORZOLAMIDE 2 % DROPS 10 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0904052361 NDC GY 10 ML outpatient 63.24 61.98 All Payors / Plans All Payors / Plans 63.24 other 63.24 63.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML DROPS 10 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 51991-360-60 NDC GY 10 ML outpatient 36.47 35.74 All Payors / Plans All Payors / Plans 36.47 other 36.47 36.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML DROPS 10 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0574-7034-12 NDC GY 10 ML outpatient 85.91 84.19 All Payors / Plans All Payors / Plans 85.91 other 85.91 85.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ERGOCALCIFEROL 200 MCG/ML (8,000 UNIT/ML) DROPS" ERX-637000000 CDM A9270 CPT 637 RC 0113-0416-78 NDC GY 6 ML outpatient 3.66 3.59 All Payors / Plans All Payors / Plans 3.66 other 3.66 3.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FAMOTIDINE 40 MG/5 ML (8 MG/ML) SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 66553-001-01 NDC GY 2.5 ML outpatient 10.67 10.46 All Payors / Plans All Payors / Plans 10.67 other 10.67 10.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FAMOTIDINE 40 MG/5 ML (8 MG/ML) SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 57896-921-01 NDC GY 2.5 ML outpatient 10.35 10.14 All Payors / Plans All Payors / Plans 10.35 other 10.35 10.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FERRIC SUBSULFATE 0.2 TO 0.22 GRAM/ML SOLUTION WITH APPLICATOR ERX-637000000 CDM A9270 CPT 637 RC 70677-0071-1 NDC GY 1 ML outpatient 61.47 60.24 All Payors / Plans All Payors / Plans 61.47 other 61.47 61.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FERROUS SULFATE 15 MG IRON (75 MG)/ML DROPS ERX-637000000 CDM A9270 CPT 637 RC 0904-4040-73 NDC GY 0.5 ML outpatient 0.18 0.18 All Payors / Plans All Payors / Plans 0.18 other 0.18 0.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ELIXIR ERX-637000000 CDM A9270 CPT 637 RC 0904-6794-80 NDC GY 5 ML outpatient 0.21 0.21 All Payors / Plans All Payors / Plans 0.21 other 0.21 0.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUCONAZOLE 40 MG/ML SUSPENSION FOR RECONSTITUTION 35 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 63739-434-02 NDC GY 2.5 ML outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOXETINE 20 MG/5 ML (4 MG/ML) SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 66553-002-01 NDC GY 5 ML outpatient 1.47 1.44 All Payors / Plans All Payors / Plans 1.47 other 1.47 1.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE 40 MG/4 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 49483-481-10 NDC GY 0.48 ML outpatient 7.78 7.62 All Payors / Plans All Payors / Plans 7.78 other 7.78 7.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 250 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 63739-212-02 NDC GY 10 ML outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 250 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 65162-596-06 NDC GY 2 ML outpatient 0.19 0.19 All Payors / Plans All Payors / Plans 0.19 other 0.19 0.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN 0.3 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 29300-410-01 NDC GY 5 ML outpatient 30.61 30 All Payors / Plans All Payors / Plans 30.61 other 30.61 30.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUAIFENESIN 100 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 51079-759-01 NDC GY 10 ML outpatient 6.68 6.55 All Payors / Plans All Payors / Plans 6.68 other 6.68 6.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUAIFENESIN 100 MG/5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 51079-684-01 NDC GY 10 ML outpatient 10.03 9.83 All Payors / Plans All Payors / Plans 10.03 other 10.03 10.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 60687-567-11 NDC GY 5 ML outpatient 9.59 9.4 All Payors / Plans All Payors / Plans 9.59 other 9.59 9.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 100 MG/60 ML ENEMA ERX-637000000 CDM A9270 CPT 637 RC 0904-6908-04 NDC GY 60 ML outpatient 28.78 28.2 All Payors / Plans All Payors / Plans 28.78 other 28.78 28.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE 2 MG/ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 51079-208-01 NDC GY 5 ML outpatient 17.67 17.32 All Payors / Plans All Payors / Plans 17.67 other 17.67 17.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYPROMELLOSE 2.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 51079-208-20 NDC GY 15 ML outpatient 131.5 128.87 All Payors / Plans All Payors / Plans 131.5 other 131.5 131.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 100 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0904-6291-61 NDC GY 5.3 ML outpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 100 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 68084-098-01 NDC GY 4.2 ML outpatient 1.44 1.41 All Payors / Plans All Payors / Plans 1.44 other 1.44 1.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 100 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 0904-6292-61 NDC GY 3.8 ML outpatient 2.59 2.54 All Payors / Plans All Payors / Plans 2.59 other 2.59 2.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 100 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 60687-534-40 NDC GY 4.2 ML outpatient 1.79 1.75 All Payors / Plans All Payors / Plans 1.79 other 1.79 1.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 100 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 63739-203-01 NDC GY 3.6 ML outpatient 2.65 2.6 All Payors / Plans All Payors / Plans 2.65 other 2.65 2.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN GLARGINE (U-100) 100 UNIT/ML (3 ML) INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 60505-6226-0 NDC GY 3 ML outpatient 104.34 102.25 All Payors / Plans All Payors / Plans 104.34 other 104.34 104.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN GLARGINE PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 0065-0817-01 NDC GY 0.03 ML outpatient 0.29 0.28 All Payors / Plans All Payors / Plans 0.29 other 0.29 0.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN GLARGINE PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 60219-1749-3 NDC GY 0.35 ML outpatient 15.98 15.66 All Payors / Plans All Payors / Plans 15.98 other 15.98 15.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO (HUMAN) PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 70710-1457-1 NDC GY 0.1 ML outpatient 0.16 0.16 All Payors / Plans All Payors / Plans 0.16 other 0.16 0.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO (HUMAN) PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 0069-3120-19 NDC GY 0.01 ML outpatient 0.14 0.14 All Payors / Plans All Payors / Plans 0.14 other 0.14 0.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO (HUMAN) PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 59762-3120-1 NDC GY 0.02 ML outpatient 0.19 0.19 All Payors / Plans All Payors / Plans 0.19 other 0.19 0.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO (U-100) 100 UNIT/ML INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 59762-3140-1 NDC GY 3 ML outpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO (U-100) 100 UNIT/ML INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 0069-4061-89 NDC GY 0.05 ML outpatient 0.47 0.46 All Payors / Plans All Payors / Plans 0.47 other 0.47 0.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO (U-100) 100 UNIT/ML INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 0904-7350-06 NDC GY 3 ML outpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO (U-100) 100 UNIT/ML INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 60687-742-11 NDC GY 3 ML outpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO PROTAMIN-LISPRO 100 UNIT/ML (75-25) INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 65862-641-69 NDC GY 3 ML outpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN LISPRO PROTAMIN-LISPRO 100 UNIT/ML (75-25) INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 0472-1105-34 NDC GY 3 ML outpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN NPH ISOPH U-100 HUMAN 100 UNIT/ML (3 ML) INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 45802-060-01 NDC GY 3 ML outpatient 154.86 151.76 All Payors / Plans All Payors / Plans 154.86 other 154.86 154.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN NPH ISOPH U-100 HUMAN 100 UNIT/ML (3 ML) INSULIN PEN 3 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 0574-4022-35 NDC GY 3 ML outpatient 82.84 81.18 All Payors / Plans All Payors / Plans 82.84 other 82.84 82.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN REGULAR HUMAN PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 45802-060-00 NDC GY 0.02 ML outpatient 0.14 0.14 All Payors / Plans All Payors / Plans 0.14 other 0.14 0.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN REGULAR HUMAN PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 0904-8804-67 NDC GY 0.05 ML outpatient 0.19 0.19 All Payors / Plans All Payors / Plans 0.19 other 0.19 0.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN REGULAR HUMAN PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 0904-6475-61 NDC GY 0.05 ML outpatient 0.18 0.18 All Payors / Plans All Payors / Plans 0.18 other 0.18 0.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSULIN REGULAR HUMAN PER 5 UNITS ERX-637000000 CDM A9270 CPT 637 RC 63739-479-10 NDC GY 4 ML outpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOCONAZOLE 2 % SHAMPOO 120 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 68084-855-11 NDC GY 120 ML outpatient 62.72 61.47 All Payors / Plans All Payors / Plans 62.72 other 62.72 62.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC 0.5 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0065-0800-50 NDC GY 5 ML outpatient 26.09 25.57 All Payors / Plans All Payors / Plans 26.09 other 26.09 26.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC 0.5 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0065-0795-15 NDC GY 5 ML outpatient 30.37 29.76 All Payors / Plans All Payors / Plans 30.37 other 30.37 30.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACTULOSE 10 GRAM/15 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0065-0795-50 NDC GY 15 ML outpatient 2.71 2.66 All Payors / Plans All Payors / Plans 2.71 other 2.71 2.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACTULOSE 10 GRAM/15 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 59310-302-40 NDC GY 300 ML outpatient 20.26 19.85 All Payors / Plans All Payors / Plans 20.26 other 20.26 20.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACTULOSE 10 GRAM/15 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0283-0679-02 NDC GY 300 ML outpatient 17.42 17.07 All Payors / Plans All Payors / Plans 17.42 other 17.42 17.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LAMIVUDINE 10 MG/ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 63824-732-16 NDC GY 0.57 ML outpatient 0.3 0.29 All Payors / Plans All Payors / Plans 0.3 other 0.3 0.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LANSOPRAZOLE ERX-637000000 CDM A9270 CPT 637 RC 0904-6255-49 NDC GY 2.5 ML outpatient 25.36 24.85 All Payors / Plans All Payors / Plans 25.36 other 25.36 25.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LATANOPROST 0.005 % DROPS 2.5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 16864-680-01 NDC GY 2.5 ML outpatient 25.54 25.03 All Payors / Plans All Payors / Plans 25.54 other 25.54 25.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LATANOPROST 0.005 % DROPS 2.5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 16864-680-03 NDC GY 2.5 ML outpatient 40.17 39.37 All Payors / Plans All Payors / Plans 40.17 other 40.17 40.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETIRACETAM 500 MG/5 ML (5 ML) SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0904-7153-61 NDC GY 5 ML outpatient 8.93 8.75 All Payors / Plans All Payors / Plans 8.93 other 8.93 8.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETIRACETAM 500 MG/5 ML (5 ML) SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 68084-214-11 NDC GY 5 ML outpatient 9.6 9.41 All Payors / Plans All Payors / Plans 9.6 other 9.6 9.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 2 % JELLY IN APPLICATOR ERX-637000000 CDM A9270 CPT 637 RC 68084-388-01 NDC GY 5 ML outpatient 15.22 14.92 All Payors / Plans All Payors / Plans 15.22 other 15.22 15.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 2 % JELLY IN APPLICATOR ERX-637000000 CDM A9270 CPT 637 RC 68084-388-11 NDC GY 5 ML outpatient 14.87 14.57 All Payors / Plans All Payors / Plans 14.87 other 14.87 14.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 2 % JELLY IN APPLICATOR ERX-637000000 CDM A9270 CPT 637 RC 69315-137-01 NDC GY 5 ML outpatient 17.07 16.73 All Payors / Plans All Payors / Plans 17.07 other 17.07 17.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 2 % SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 68084-389-11 NDC GY 10 ML outpatient 20.68 20.27 All Payors / Plans All Payors / Plans 20.68 other 20.68 20.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 2 % SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0713-0659-37 NDC GY 5 ML outpatient 25.8 25.28 All Payors / Plans All Payors / Plans 25.8 other 25.8 25.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 2 % SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 61958-2501-1 NDC GY 5 ML outpatient 25.8 25.28 All Payors / Plans All Payors / Plans 25.8 other 25.8 25.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 2 % SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0574-7050-12 NDC GY 10 ML outpatient 50.6 49.59 All Payors / Plans All Payors / Plans 50.6 other 50.6 50.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 2 % SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0904-6407-61 NDC GY 10 ML outpatient 6.04 5.92 All Payors / Plans All Payors / Plans 6.04 other 6.04 6.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 4 % (40 MG/ML) SOLUTION 50 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0149003904 NDC GY 50 ML outpatient 105.31 103.2 All Payors / Plans All Payors / Plans 105.31 other 105.31 105.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE 4 % (40 MG/ML) SOLUTION 50 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 29300-126-01 NDC GY 50 ML outpatient 133.07 130.41 All Payors / Plans All Payors / Plans 133.07 other 133.07 133.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE-EPI-TETRACAINE 4-0.18-0.5 % SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 50268-127-11 NDC GY 3 ML outpatient 10.18 9.98 All Payors / Plans All Payors / Plans 10.18 other 10.18 10.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOPERAMIDE 1 MG/7.5 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 68803-722-25 NDC GY 15 ML outpatient 0.51 0.5 All Payors / Plans All Payors / Plans 0.51 other 0.51 0.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGIC MOUTHWASH #3 90 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 60505-0564-1 NDC GY 90 ML outpatient 10.75 10.54 All Payors / Plans All Payors / Plans 10.75 other 10.75 10.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM CITRATE SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0781-6014-70 NDC GY 296 ML outpatient 5.03 4.93 All Payors / Plans All Payors / Plans 5.03 other 5.03 5.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM CITRATE SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0574-0106-03 NDC GY 148 ML outpatient 6.97 6.83 All Payors / Plans All Payors / Plans 6.97 other 6.97 6.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM CITRATE SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0574-9855-10 NDC GY 296 ML outpatient 6.97 6.83 All Payors / Plans All Payors / Plans 6.97 other 6.97 6.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM HYDROXIDE 400 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 50268-131-11 NDC GY 30 ML outpatient 3.42 3.35 All Payors / Plans All Payors / Plans 3.42 other 3.42 3.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM HYDROXIDE 400 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 50268-132-11 NDC GY 30 ML outpatient 3.35 3.28 All Payors / Plans All Payors / Plans 3.35 other 3.35 3.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM HYDROXIDE 400 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 42858-501-03 NDC GY 30 ML outpatient 3.35 3.28 All Payors / Plans All Payors / Plans 3.35 other 3.35 3.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM HYDROXIDE 400 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 50268-145-11 NDC GY 30 ML outpatient 5.09 4.99 All Payors / Plans All Payors / Plans 5.09 other 5.09 5.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHADONE 10 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 50268-145-15 NDC GY 10 ML outpatient 10.17 9.97 All Payors / Plans All Payors / Plans 10.17 other 10.17 10.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHADONE 10 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 60687-351-11 NDC GY 10 ML outpatient 18.66 18.29 All Payors / Plans All Payors / Plans 18.66 other 18.66 18.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE 5 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0904-6635-61 NDC GY 5 ML outpatient 9.62 9.43 All Payors / Plans All Payors / Plans 9.62 other 9.62 9.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM 10 MG/5 ML (2 MG/ML) SYRUP ERX-637000000 CDM A9270 CPT 637 RC 68084-697-11 NDC GY 2.91 ML outpatient 11.51 11.28 All Payors / Plans All Payors / Plans 11.51 other 11.51 11.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM 10 MG/5 ML (2 MG/ML) SYRUP ERX-637000000 CDM A9270 CPT 637 RC 42806-425-01 NDC GY 3 ML outpatient 11.51 11.28 All Payors / Plans All Payors / Plans 11.51 other 11.51 11.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 10 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 68084-708-95 NDC GY 2.5 ML outpatient 3.45 3.38 All Payors / Plans All Payors / Plans 3.45 other 3.45 3.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MOXIFLOXACIN 0.5 % DROPS 3 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0904-7084-04 NDC GY 3 ML outpatient 45.61 44.7 All Payors / Plans All Payors / Plans 45.61 other 45.61 45.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MOXIFLOXACIN 0.5 % DROPS 3 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 16729-443-10 NDC GY 3 ML outpatient 64.63 63.34 All Payors / Plans All Payors / Plans 64.63 other 64.63 64.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MYLANTA, LIDOCAINE VISCOUS, DICYCLOMINE" ERX-637000000 CDM A9270 CPT 637 RC 16729-202-16 NDC GY 50 ML outpatient 18.62 18.25 All Payors / Plans All Payors / Plans 18.62 other 18.62 18.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAPHAZOLINE-PHENIRAMINE 0.025-0.3 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 51079-986-01 NDC GY 15 ML outpatient 39.73 38.94 All Payors / Plans All Payors / Plans 39.73 other 39.73 39.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NEOMYCIN-POLYMYXIN-DEXAMETHASONE 3.5MG/ML-10,000 UNIT/ML-0.1 % DROPS,SUSPENSION 5 ML DROP BTL" ERX-637000000 CDM A9270 CPT 637 RC 51079-985-01 NDC GY 5 ML outpatient 63.26 61.99 All Payors / Plans All Payors / Plans 63.26 other 63.26 63.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% DROPS,SUSPENSION 10 ML DROP BTL" ERX-637000000 CDM A9270 CPT 637 RC 0904-6938-06 NDC GY 10 ML outpatient 156.15 153.03 All Payors / Plans All Payors / Plans 156.15 other 156.15 156.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NEOMYCIN-POLYMYXIN-HC 3.5-10,000-10 MG-UNIT-MG/ML DROPS,SUSPENSION 7.5 ML DROP BTL" ERX-637000000 CDM A9270 CPT 637 RC 50268-553-11 NDC GY 7.5 ML outpatient 332.48 325.83 All Payors / Plans All Payors / Plans 332.48 other 332.48 332.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEVIRAPINE 50 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 50268-553-13 NDC GY 1.7 ML outpatient 10.17 9.97 All Payors / Plans All Payors / Plans 10.17 other 10.17 10.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIMODIPINE 60 MG/10 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 69367-203-01 NDC GY 10 ML outpatient 102.86 100.8 All Payors / Plans All Payors / Plans 102.86 other 102.86 102.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/ML SUSPENSION" ERX-637000000 CDM A9270 CPT 637 RC 4601701816 NDC GY 5 ML outpatient 4.11 4.03 All Payors / Plans All Payors / Plans 4.11 other 4.11 4.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/ML SUSPENSION" ERX-637000000 CDM A9270 CPT 637 RC 51754-0501-3 NDC GY 30 ML outpatient 31.03 30.41 All Payors / Plans All Payors / Plans 31.03 other 31.03 31.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/ML SUSPENSION" ERX-637000000 CDM A9270 CPT 637 RC 0904-2533-21 NDC GY 5 ML outpatient 2.68 2.63 All Payors / Plans All Payors / Plans 2.68 other 2.68 2.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NYSTATIN 100,000 UNIT/ML SUSPENSION" ERX-637000000 CDM A9270 CPT 637 RC 60505-0823-6 NDC GY 5 ML outpatient 10.78 10.56 All Payors / Plans All Payors / Plans 10.78 other 10.78 10.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OFLOXACIN 0.3 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 60687-345-11 NDC GY 5 ML outpatient 84.9 83.2 All Payors / Plans All Payors / Plans 84.9 other 84.9 84.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 8 MG ERX-637000000 CDM A9270 CPT 637 RC 64380-723-06 NDC GY 1.05 ML outpatient 10.9 10.68 All Payors / Plans All Payors / Plans 10.9 other 10.9 10.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 8 MG ERX-637000000 CDM A9270 CPT 637 RC 0054-0088-26 NDC GY 5 ML outpatient 10.17 9.97 All Payors / Plans All Payors / Plans 10.17 other 10.17 10.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 8 MG ERX-637000000 CDM A9270 CPT 637 RC 68084-479-11 NDC GY 5 ML outpatient 15.65 15.34 All Payors / Plans All Payors / Plans 15.65 other 15.65 15.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OSELTAMIVIR 6 MG/ML SUSPENSION FOR RECONSTITUTION ERX-637000000 CDM A9270 CPT 637 RC 66553-004-01 NDC GY 10 ML outpatient 6.07 5.95 All Payors / Plans All Payors / Plans 6.07 other 6.07 6.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXCARBAZEPINE ERX-637000000 CDM A9270 CPT 637 RC 70677-0137-1 NDC GY 10 ML outpatient 20.29 19.88 All Payors / Plans All Payors / Plans 20.29 other 20.29 20.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE 5 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0904188361 NDC GY 5 ML outpatient 14.23 13.95 All Payors / Plans All Payors / Plans 14.23 other 14.23 14.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OXYMETAZOLINE 0.05 % SPRAY,NON-AEROSOL 30 ML SQUEEZ BTL" ERX-637000000 CDM A9270 CPT 637 RC 0121-4766-05 NDC GY 30 ML outpatient 15.42 15.11 All Payors / Plans All Payors / Plans 15.42 other 15.42 15.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OXYMETAZOLINE 0.05 % SPRAY,NON-AEROSOL 30 ML SQUEEZ BTL" ERX-637000000 CDM A9270 CPT 637 RC 0904-7106-61 NDC GY 30 ML outpatient 15.43 15.12 All Payors / Plans All Payors / Plans 15.43 other 15.43 15.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OXYMETAZOLINE 0.05 % SPRAY,NON-AEROSOL 30 ML SQUEEZ BTL" ERX-637000000 CDM A9270 CPT 637 RC 0904-6172-61 NDC GY 30 ML outpatient 10.19 9.99 All Payors / Plans All Payors / Plans 10.19 other 10.19 10.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OXYMETAZOLINE 0.05 % SPRAY,NON-AEROSOL 30 ML SQUEEZ BTL" ERX-637000000 CDM A9270 CPT 637 RC 51672-4123-1 NDC GY 30 ML outpatient 10.83 10.61 All Payors / Plans All Payors / Plans 10.83 other 10.83 10.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEDIATRIC MULTIVIT NO.189-IRON 11 MG IRON/ML DROPS ERX-637000000 CDM A9270 CPT 637 RC 0832-6024-11 NDC GY 1 ML outpatient 0.27 0.26 All Payors / Plans All Payors / Plans 0.27 other 0.27 0.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEDIATRIC MULTIVITAMIN LIQUID ERX-637000000 CDM A9270 CPT 637 RC 60687-594-11 NDC GY 15 ML outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PENICILLIN V POTASSIUM 250 MG/5 ML RECON SOLN ERX-637000000 CDM A9270 CPT 637 RC 0904-6627-35 NDC GY 5 ML outpatient 0.47 0.46 All Payors / Plans All Payors / Plans 0.47 other 0.47 0.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PERMETHRIN 1 % LIQUID 59 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 70677-1154-1 NDC GY 59 ML outpatient 16.12 15.8 All Payors / Plans All Payors / Plans 16.12 other 16.12 16.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PHENOL 1.4 % AEROSOL,SPRAY 177 ML BOTTLE" ERX-637000000 CDM A9270 CPT 637 RC 0093-9701-01 NDC GY 177 ML outpatient 21.15 20.73 All Payors / Plans All Payors / Plans 21.15 other 21.15 21.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPHRINE 2.5 % DROPS 2 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0378-0085-01 NDC GY 2 ML outpatient 139.43 136.64 All Payors / Plans All Payors / Plans 139.43 other 139.43 139.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POLYETHYLENE GLYCOL 236-22.74-6.74 -5.86 GRAM RECON SOLN ERX-637000000 CDM A9270 CPT 637 RC 0904-7257-61 NDC GY 2000 ML outpatient 62.08 60.84 All Payors / Plans All Payors / Plans 62.08 other 62.08 62.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE 20 MEQ/15 ML LIQUID ERX-637000000 CDM A9270 CPT 637 RC 0904-7501-61 NDC GY 15 ML outpatient 5.87 5.75 All Payors / Plans All Payors / Plans 5.87 other 5.87 5.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM IODIDE 1 GRAM/ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 60687-661-11 NDC GY 0.1 ML outpatient 2 1.96 All Payors / Plans All Payors / Plans 2 other 2 2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAMOXINE-CAMPHOR-ZINC ACETATE LOTION 177 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 16729-078-01 NDC GY 177 ML outpatient 15.35 15.04 All Payors / Plans All Payors / Plans 15.35 other 15.35 15.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISOLONE 15 MG/5 ML (5 ML) SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 51079-978-01 NDC GY 4.3 ML outpatient 7.78 7.62 All Payors / Plans All Payors / Plans 7.78 other 7.78 7.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PREDNISOLONE ACETATE 1 % DROPS,SUSPENSION 5 ML DROP BTL" ERX-637000000 CDM A9270 CPT 637 RC 0904-6238-61 NDC GY 5 ML outpatient 105.07 102.97 All Payors / Plans All Payors / Plans 105.07 other 105.07 105.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROMETHAZINE-DM 6.25-15 MG/5 ML SYRUP ERX-637000000 CDM A9270 CPT 637 RC 60687-836-11 NDC GY 5 ML outpatient 4.65 4.56 All Payors / Plans All Payors / Plans 4.65 other 4.65 4.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPARACAINE 0.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0023-0798-15 NDC GY 15 ML outpatient 146.46 143.53 All Payors / Plans All Payors / Plans 146.46 other 146.46 146.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPARACAINE 0.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0904-6302-61 NDC GY 15 ML outpatient 105.97 103.85 All Payors / Plans All Payors / Plans 105.97 other 105.97 105.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SALIVA STIMULANT COMB. NO.3 SPRAY,NON-AEROSOL 44.3 ML BOTTLE" ERX-637000000 CDM A9270 CPT 637 RC 68382-094-01 NDC GY 44.3 ML outpatient 25.34 24.83 All Payors / Plans All Payors / Plans 25.34 other 25.34 25.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SENNOSIDES 8.8 MG/5 ML SYRUP ERX-637000000 CDM A9270 CPT 637 RC 0093-7296-01 NDC GY 2.5 ML outpatient 5.84 5.72 All Payors / Plans All Payors / Plans 5.84 other 5.84 5.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIMPLE SYRUP SYRUP ERX-637000000 CDM A9270 CPT 637 RC 0904-6303-61 NDC GY 0.415 ML outpatient 0.12 0.12 All Payors / Plans All Payors / Plans 0.12 other 0.12 0.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 0904-7308-61 NDC GY 15 ML outpatient 11.23 11.01 All Payors / Plans All Payors / Plans 11.23 other 11.23 11.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM HYPOCHLORITE 0.125 % SOLUTION 473 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0904-6300-61 NDC GY 473 ML outpatient 60.75 59.54 All Payors / Plans All Payors / Plans 60.75 other 60.75 60.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM HYPOCHLORITE 0.25 % SOLUTION 473 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 0904-7305-61 NDC GY 473 ML outpatient 62.78 61.52 All Payors / Plans All Payors / Plans 62.78 other 62.78 62.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM HYPOCHLORITE 0.25 % SOLUTION 473 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 68382-092-01 NDC GY 473 ML outpatient 60.75 59.54 All Payors / Plans All Payors / Plans 60.75 other 60.75 60.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM PHOSPHATES 19-7 GRAM/118 ML ENEMA ERX-637000000 CDM A9270 CPT 637 RC 0904-6301-61 NDC GY 133 ML outpatient 10.25 10.05 All Payors / Plans All Payors / Plans 10.25 other 10.25 10.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM PHOSPHATES 9.5-3.5 GRAM/59 ML ENEMA ERX-637000000 CDM A9270 CPT 637 RC 68084-854-01 NDC GY 33 ML outpatient 10.29 10.08 All Payors / Plans All Payors / Plans 10.29 other 10.29 10.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM PHOSPHATES 9.5-3.5 GRAM/59 ML ENEMA ERX-637000000 CDM A9270 CPT 637 RC 68084-854-11 NDC GY 66 ML outpatient 10.24 10.04 All Payors / Plans All Payors / Plans 10.24 other 10.24 10.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCRALFATE 100 MG/ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 68462-163-01 NDC GY 10 ML outpatient 14 13.72 All Payors / Plans All Payors / Plans 14 other 14 14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCRALFATE 100 MG/ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 72888-035-01 NDC GY 10 ML outpatient 14.49 14.2 All Payors / Plans All Payors / Plans 14.49 other 14.49 14.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCRALFATE 100 MG/ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 65862-218-60 NDC GY 10 ML outpatient 14.75 14.46 All Payors / Plans All Payors / Plans 14.75 other 14.75 14.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCRALFATE 100 MG/ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 68180-723-04 NDC GY 10 ML outpatient 14.18 13.9 All Payors / Plans All Payors / Plans 14.18 other 14.18 14.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCRALFATE 100 MG/ML SUSPENSION 10 ML CUP ERX-637000000 CDM A9270 CPT 637 RC 0093-3160-06 NDC GY 20 ML outpatient 22.76 22.3 All Payors / Plans All Payors / Plans 22.76 other 22.76 22.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFACETAMIDE 1 (ONE) 15 ML BOTTLE ERX-637000000 CDM A9270 CPT 637 RC 60687-699-11 NDC GY 15 ML outpatient 137.45 134.7 All Payors / Plans All Payors / Plans 137.45 other 137.45 137.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFACETAMIDE 10 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 67877-543-60 NDC GY 15 ML outpatient 150.98 147.96 All Payors / Plans All Payors / Plans 150.98 other 150.98 150.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 60687-272-11 NDC GY 20 ML outpatient 22.49 22.04 All Payors / Plans All Payors / Plans 22.49 other 22.49 22.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML SUSPENSION ERX-637000000 CDM A9270 CPT 637 RC 60687-272-94 NDC GY 20 ML outpatient 10.95 10.73 All Payors / Plans All Payors / Plans 10.95 other 10.95 10.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TETRACAINE HCL (PF) 0.5 % DROPS 4 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 16714-401-02 NDC GY 4 ML outpatient 38.58 37.81 All Payors / Plans All Payors / Plans 38.58 other 38.58 38.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TETRAHYDROZOLINE 0.05 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0904-6502-61 NDC GY 15 ML outpatient 6.04 5.92 All Payors / Plans All Payors / Plans 6.04 other 6.04 6.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIMOLOL 0.5 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 0904-6503-61 NDC GY 5 ML outpatient 35.87 35.15 All Payors / Plans All Payors / Plans 35.87 other 35.87 35.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOBRAMYCIN 0.3 % DROPS 5 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 50268-169-15 NDC GY 5 ML outpatient 21.13 20.71 All Payors / Plans All Payors / Plans 21.13 other 21.13 21.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % DROPS,SUSPENSION 10 ML DROP BTL" ERX-637000000 CDM A9270 CPT 637 RC 0093-4175-73 NDC GY 10 ML outpatient 410.91 402.69 All Payors / Plans All Payors / Plans 410.91 other 410.91 410.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROPICAMIDE 0.5 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 60687-152-01 NDC GY 15 ML outpatient 85.91 84.19 All Payors / Plans All Payors / Plans 85.91 other 85.91 85.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROPICAMIDE 1 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 60687-152-11 NDC GY 15 ML outpatient 35.77 35.05 All Payors / Plans All Payors / Plans 35.77 other 35.77 35.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROPICAMIDE 1 % DROPS 15 ML DROP BTL ERX-637000000 CDM A9270 CPT 637 RC 50268-152-11 NDC GY 15 ML outpatient 31.62 30.99 All Payors / Plans All Payors / Plans 31.62 other 31.62 31.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALPROATE 250 MG/5 ML SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 60687-163-11 NDC GY 7.6 ML outpatient 0.35 0.34 All Payors / Plans All Payors / Plans 0.35 other 0.35 0.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALPROIC ACID 250 MG/5 ML (5 ML) SOLUTION ERX-637000000 CDM A9270 CPT 637 RC 68180-122-01 NDC GY 5 ML outpatient 4.15 4.07 All Payors / Plans All Payors / Plans 4.15 other 4.15 4.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 25 MG/ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 0904-6717-60 NDC GY 5 ML outpatient 2.14 2.1 All Payors / Plans All Payors / Plans 2.14 other 2.14 2.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 50 MG/ML RECON SOLN ERX-637000000 CDM A9270 CPT 637 RC 0904-6717-61 NDC GY 2.5 ML outpatient 15.46 15.15 All Payors / Plans All Payors / Plans 15.46 other 15.46 15.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZIDOVUDINE PER 100 MG ERX-637000000 CDM A9270 CPT 637 RC 51079-597-01 NDC GY 1.15 ML outpatient 0.21 0.21 All Payors / Plans All Payors / Plans 0.21 other 0.21 0.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 120 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 68180-981-01 NDC GY 0.1458 UN outpatient 0.28 0.27 All Payors / Plans All Payors / Plans 0.28 other 0.28 0.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 120 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 0904-6797-61 NDC GY 1 UN outpatient 1.87 1.83 All Payors / Plans All Payors / Plans 1.87 other 1.87 1.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 325 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 0054-8526-25 NDC GY 0.5 UN outpatient 1.32 1.29 All Payors / Plans All Payors / Plans 1.32 other 1.32 1.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 325 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 0054-2527-25 NDC GY 1 UN outpatient 2.64 2.59 All Payors / Plans All Payors / Plans 2.64 other 2.64 2.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0054-8527-25 NDC GY 1 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN 650 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 68084-655-11 NDC GY 0.5 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAMINOPHEN-CODEINE 300-30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 1093991144 NDC GY 1 UN outpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAZOLAMIDE 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-690-01 NDC GY 1 UN outpatient 8.74 8.57 All Payors / Plans All Payors / Plans 8.74 other 8.74 8.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ACETAZOLAMIDE 500 MG CAPSULE, EXTENDED RELEASE" ERX-637000000 CDM A9270 CPT 637 RC 0904-6007-61 NDC GY 1 UN outpatient 4.36 4.27 All Payors / Plans All Payors / Plans 4.36 other 4.36 4.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ACETAZOLAMIDE 500 MG CAPSULE, EXTENDED RELEASE" ERX-637000000 CDM A9270 CPT 637 RC 69315-904-05 NDC GY 1 UN outpatient 11.16 10.94 All Payors / Plans All Payors / Plans 11.16 other 11.16 11.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETYLCYSTEINE 600 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904-6008-61 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACYCLOVIR 200 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 13107-084-05 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACYCLOVIR 200 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0093-3427-01 NDC GY 2 UN outpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACYCLOVIR 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 13107-085-01 NDC GY 0.5 UN outpatient 2.72 2.67 All Payors / Plans All Payors / Plans 2.72 other 2.72 2.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBENDAZOLE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-649-11 NDC GY 2 UN outpatient 77.74 76.19 All Payors / Plans All Payors / Plans 77.74 other 77.74 77.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOPURINOL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-346-11 NDC GY 1 UN outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOPURINOL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-505-11 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOPURINOL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-686-10 NDC GY 1 UN outpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOPURINOL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-468-30 NDC GY 1 UN outpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOPURINOL 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68180-468-01 NDC GY 1 UN outpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOPURINOL 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0591-0369-01 NDC GY 1 UN outpatient 1.87 1.83 All Payors / Plans All Payors / Plans 1.87 other 1.87 1.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALPRAZOLAM 0.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-747-11 NDC GY 1 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALPRAZOLAM 0.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63402-302-30 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALPRAZOLAM 0.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7356-61 NDC GY 0.5 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALPRAZOLAM 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63402-304-30 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALPRAZOLAM 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72205-208-30 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALVIMOPAN 12 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0603-1393-64 NDC GY 1 UN outpatient 124.34 121.85 All Payors / Plans All Payors / Plans 124.34 other 124.34 124.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALVIMOPAN 12 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 6858500575 NDC GY 1 UN outpatient 121.38 118.95 All Payors / Plans All Payors / Plans 121.38 other 121.38 121.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMANTADINE 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 69452-390-98 NDC GY 1 UN outpatient 4.11 4.03 All Payors / Plans All Payors / Plans 4.11 other 4.11 4.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMILORIDE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70677-1111-1 NDC GY 1 UN outpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMIODARONE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70677-1112-1 NDC GY 2 UN outpatient 3.88 3.8 All Payors / Plans All Payors / Plans 3.88 other 3.88 3.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMIODARONE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0121-0431-30 NDC GY 1 UN outpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMIODARONE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-196-01 NDC GY 1 UN outpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMIODARONE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-196-10 NDC GY 2 UN outpatient 2.08 2.04 All Payors / Plans All Payors / Plans 2.08 other 2.08 2.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMITRIPTYLINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 66689-053-01 NDC GY 1 UN outpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMITRIPTYLINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 1000670028 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMITRIPTYLINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6516-61 NDC GY 1 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMITRIPTYLINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-775-01 NDC GY 0.5 UN outpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMLODIPINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-775-11 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMLODIPINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0049-2110-66 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMLODIPINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7376-61 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMLODIPINE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-730-11 NDC GY 1 UN outpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMLODIPINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0555-0779-02 NDC GY 1 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMLODIPINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59762-0056-1 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 250 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 60687-105-11 NDC GY 2 UN outpatient 1.83 1.79 All Payors / Plans All Payors / Plans 1.83 other 1.83 1.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN 500 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0555-0872-02 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 250-125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7236-61 NDC GY 2 UN outpatient 10.09 9.89 All Payors / Plans All Payors / Plans 10.09 other 10.09 10.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 500-125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0832-1112-60 NDC GY 1 UN outpatient 4.98 4.88 All Payors / Plans All Payors / Plans 4.98 other 4.98 4.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 500-125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6505-61 NDC GY 1 UN outpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 500-125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 4687600050 NDC GY 1 UN outpatient 1.98 1.94 All Payors / Plans All Payors / Plans 1.98 other 1.98 1.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 875-125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69918-560-30 NDC GY 1 UN outpatient 1.94 1.9 All Payors / Plans All Payors / Plans 1.94 other 1.94 1.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 875-125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0023-5853-18 NDC GY 1 UN outpatient 2.02 1.98 All Payors / Plans All Payors / Plans 2.02 other 2.02 2.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMOXICILLIN-POT CLAVULANATE 875-125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68382-435-28 NDC GY 1 UN outpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMPHETAMINE-DEXTROAMPHETAMINE XR 10 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 0904-7162-61 NDC GY 1 UN outpatient 15.49 15.18 All Payors / Plans All Payors / Plans 15.49 other 15.49 15.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMPHETAMINE-DEXTROAMPHETAMINE XR 5 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 65862-008-01 NDC GY 1 UN outpatient 15.49 15.18 All Payors / Plans All Payors / Plans 15.49 other 15.49 15.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN 500 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 70010-063-01 NDC GY 1 UN outpatient 1.96 1.92 All Payors / Plans All Payors / Plans 1.96 other 1.96 1.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANASTROZOLE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-143-11 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANASTROZOLE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0054-0710-20 NDC GY 1 UN outpatient 2.76 2.7 All Payors / Plans All Payors / Plans 2.76 other 2.76 2.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APIXABAN 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-5771-23 NDC GY 1 UN outpatient 4.96 4.86 All Payors / Plans All Payors / Plans 4.96 other 4.96 4.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APIXABAN 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6530-61 NDC GY 1 UN outpatient 4.96 4.86 All Payors / Plans All Payors / Plans 4.96 other 4.96 4.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APREPITANT PER 5 MG ERX-637000000 CDM A9270 CPT 637 RC 0054-3556-63 NDC GY 1 UN outpatient 33.45 32.78 All Payors / Plans All Payors / Plans 33.45 other 33.45 33.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APREPITANT PER 5 MG ERX-637000000 CDM A9270 CPT 637 RC 66689-712-16 NDC GY 1 UN outpatient 68.99 67.61 All Payors / Plans All Payors / Plans 68.99 other 68.99 68.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-5755-23 NDC GY 1 UN outpatient 13.93 13.65 All Payors / Plans All Payors / Plans 13.93 other 13.93 13.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0574-0791-01 NDC GY 1 UN outpatient 13.93 13.65 All Payors / Plans All Payors / Plans 13.93 other 13.93 13.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62559-241-01 NDC GY 1 UN outpatient 14.99 14.69 All Payors / Plans All Payors / Plans 14.99 other 14.99 14.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 23155-071-01 NDC GY 1 UN outpatient 8.89 8.71 All Payors / Plans All Payors / Plans 8.89 other 8.89 8.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-680-11 NDC GY 1 UN outpatient 11.07 10.85 All Payors / Plans All Payors / Plans 11.07 other 11.07 11.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 23155-070-01 NDC GY 1 UN outpatient 2.54 2.49 All Payors / Plans All Payors / Plans 2.54 other 2.54 2.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 4116700879 NDC GY 1 UN outpatient 2.54 2.49 All Payors / Plans All Payors / Plans 2.54 other 2.54 2.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0054-0639-05 NDC GY 1 UN outpatient 10.15 9.95 All Payors / Plans All Payors / Plans 10.15 other 10.15 10.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARIPIPRAZOLE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-823-11 NDC GY 1 UN outpatient 10.39 10.18 All Payors / Plans All Payors / Plans 10.39 other 10.39 10.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ASCORBIC ACID (VITAMIN C) 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62175-310-37 NDC GY 0.5 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASENAPINE MALEATE 10 MG TABLET, SUBLINGUAL" ERX-637000000 CDM A9270 CPT 637 RC 0406-0127-01 NDC GY 1 UN outpatient 9.06 8.88 All Payors / Plans All Payors / Plans 9.06 other 9.06 9.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ASPIRIN 300 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 68084-805-11 NDC GY 1 UN outpatient 4.07 3.99 All Payors / Plans All Payors / Plans 4.07 other 4.07 4.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ASPIRIN 325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-888-01 NDC GY 1 UN outpatient 0.88 0.86 All Payors / Plans All Payors / Plans 0.88 other 0.88 0.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ASPIRIN 325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-886-01 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN 325 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 0121-1576-10 NDC GY 1 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN 325 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 0185-5600-01 NDC GY 1 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN 81 MG TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 69292-566-01 NDC GY 4 UN outpatient 4.14 4.06 All Payors / Plans All Payors / Plans 4.14 other 4.14 4.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN 81 MG TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 51079-023-01 NDC GY 4 UN outpatient 3.51 3.44 All Payors / Plans All Payors / Plans 3.51 other 3.51 3.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN 81 MG TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 51079-024-01 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN 81 MG TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 51079-801-20 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN 81 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 51079-171-03 NDC GY 1 UN outpatient 0.88 0.86 All Payors / Plans All Payors / Plans 0.88 other 0.88 0.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN 81 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 60687-413-11 NDC GY 1 UN outpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ASPIRIN-DIPYRIDAMOLE 25-200 MG CAPSULE, ER MULTIPHASE 12 HR" ERX-637000000 CDM A9270 CPT 637 RC 55111-469-01 NDC GY 1 UN outpatient 3.54 3.47 All Payors / Plans All Payors / Plans 3.54 other 3.54 3.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATENOLOL 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6322-06 NDC GY 0.5 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATENOLOL 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6322-61 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATENOLOL 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-169-01 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATOMOXETINE 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 51079-169-20 NDC GY 1 UN outpatient 7.05 6.91 All Payors / Plans All Payors / Plans 7.05 other 7.05 7.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATOMOXETINE 40 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 60687-390-11 NDC GY 1 UN outpatient 9.55 9.36 All Payors / Plans All Payors / Plans 9.55 other 9.55 9.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATORVASTATIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6323-61 NDC GY 1 UN outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATORVASTATIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-541-11 NDC GY 1 UN outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATORVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-402-11 NDC GY 1 UN outpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATORVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62584-267-11 NDC GY 1 UN outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATORVASTATIN 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72888-006-01 NDC GY 1 UN outpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0378-0018-01 NDC GY 1 UN outpatient 9.82 9.62 All Payors / Plans All Payors / Plans 9.82 other 9.82 9.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-255-01 NDC GY 1 UN outpatient 2.57 2.52 All Payors / Plans All Payors / Plans 2.57 other 2.57 2.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-255-20 NDC GY 1 UN outpatient 2.66 2.61 All Payors / Plans All Payors / Plans 2.66 other 2.66 2.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 57237-100-99 NDC GY 1 UN outpatient 2.76 2.7 All Payors / Plans All Payors / Plans 2.76 other 2.76 2.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BACITRACIN 500 UNIT/GRAM PACKET ERX-637000000 CDM A9270 CPT 637 RC 62584-266-01 NDC GY 1 UN outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BACITRACIN ZINC 500 UNIT/GRAM OINTMENT IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 62584-266-11 NDC GY 1 UN outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BACLOFEN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7156-61 NDC GY 1 UN outpatient 1.89 1.85 All Payors / Plans All Payors / Plans 1.89 other 1.89 1.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BACLOFEN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50111-334-01 NDC GY 1 UN outpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BACLOFEN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-550-11 NDC GY 1 UN outpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZOCAINE-MENTHOL 15-2.6 MG LOZENGE ERX-637000000 CDM A9270 CPT 637 RC 0093-8739-01 NDC GY 1 UN outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZOCAINE-MENTHOL 15-3.6 MG LOZENGE ERX-637000000 CDM A9270 CPT 637 RC 62559-820-01 NDC GY 1 UN outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZONATATE 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50742-240-01 NDC GY 1 UN outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZONATATE 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 65197-103-05 NDC GY 1 UN outpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZTROPINE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51672-2035-6 NDC GY 1 UN outpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZTROPINE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68094-764-59 NDC GY 1 UN outpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZTROPINE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68094-764-62 NDC GY 0.5 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZTROPINE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6817-61 NDC GY 0.5 UN outpatient 1.98 1.94 All Payors / Plans All Payors / Plans 1.98 other 1.98 1.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BICTEGRAVIR-EMTRICITABINE-TENOFOVIR ALAFENAMIDE 50-200-25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0245-0212-89 NDC GY 1 UN outpatient 132.15 129.51 All Payors / Plans All Payors / Plans 132.15 other 132.15 132.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BISACODYL 10 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 0904-6818-61 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BISACODYL 5 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 49884-257-01 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BISOPROLOL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-204-11 NDC GY 0.5 UN outpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BISOPROLOL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6519-61 NDC GY 1 UN outpatient 4.19 4.11 All Payors / Plans All Payors / Plans 4.19 other 4.19 4.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BROMOCRIPTINE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-086-01 NDC GY 1 UN outpatient 3.33 3.26 All Payors / Plans All Payors / Plans 3.33 other 3.33 3.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUDESONIDE EC 3 MG CAPSULE,DELAYED,EXTEND.RELEASE" ERX-637000000 CDM A9270 CPT 637 RC 51079-087-01 NDC GY 1 UN outpatient 2.55 2.5 All Payors / Plans All Payors / Plans 2.55 other 2.55 2.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUMETANIDE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-735-01 NDC GY 1 UN outpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUMETANIDE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59762-5008-2 NDC GY 1 UN outpatient 5.04 4.94 All Payors / Plans All Payors / Plans 5.04 other 5.04 5.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPRENORPHINE 2 MG TABLET, SUBLINGUAL" ERX-637000000 CDM A9270 CPT 637 RC 60687-746-01 NDC GY 2 UN outpatient 3.72 3.65 All Payors / Plans All Payors / Plans 3.72 other 3.72 3.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPRENORPHINE-NALOXONE 8-2 MG TABLET, SUBLINGUAL" ERX-637000000 CDM A9270 CPT 637 RC 60687-746-11 NDC GY 1 UN outpatient 9.97 9.77 All Payors / Plans All Payors / Plans 9.97 other 9.97 9.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPRENORPHINE-NALOXONE 8-2 MG TABLET, SUBLINGUAL" ERX-637000000 CDM A9270 CPT 637 RC 70954-444-10 NDC GY 1 UN outpatient 9.98 9.78 All Payors / Plans All Payors / Plans 9.98 other 9.98 9.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPROPION 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 43386-160-12 NDC GY 1 UN outpatient 5.02 4.92 All Payors / Plans All Payors / Plans 5.02 other 5.02 5.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPROPION 75 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-621-11 NDC GY 1 UN outpatient 3.32 3.25 All Payors / Plans All Payors / Plans 3.32 other 3.32 3.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPROPION SR 100 MG TABLET SUSTAINED-RELEASE 12 HR ERX-637000000 CDM A9270 CPT 637 RC 0904-6808-06 NDC GY 1 UN outpatient 2.64 2.59 All Payors / Plans All Payors / Plans 2.64 other 2.64 2.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPROPION SR 150 MG TABLET SUSTAINED-RELEASE 12 HR ERX-637000000 CDM A9270 CPT 637 RC 0904-6808-61 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPROPION SR 150 MG TABLET SUSTAINED-RELEASE 12 HR ERX-637000000 CDM A9270 CPT 637 RC 29300-220-19 NDC GY 1 UN outpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPROPION XL 150 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 50268-574-11 NDC GY 1 UN outpatient 3.49 3.42 All Payors / Plans All Payors / Plans 3.49 other 3.49 3.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPROPION XL 150 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 68094-045-01 NDC GY 2 UN outpatient 2.3 2.25 All Payors / Plans All Payors / Plans 2.3 other 2.3 2.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUSPIRONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0121-0904-05 NDC GY 1 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUSPIRONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-8315-01 NDC GY 1 UN outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUSPIRONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-8315-23 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-8330-01 NDC GY 1 UN outpatient 3.41 3.34 All Payors / Plans All Payors / Plans 3.41 other 3.41 3.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-8330-23 NDC GY 1 UN outpatient 4.12 4.04 All Payors / Plans All Payors / Plans 4.12 other 4.12 4.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0054-0235-24 NDC GY 1 UN outpatient 4.12 4.04 All Payors / Plans All Payors / Plans 4.12 other 4.12 4.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60505-0582-4 NDC GY 1 UN outpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAFFEINE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68180-422-01 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCITRIOL 0.25 MCG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0536466110 NDC GY 1 UN outpatient 2.74 2.69 All Payors / Plans All Payors / Plans 2.74 other 2.74 2.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCITRIOL 0.25 MCG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904549261 NDC GY 1 UN outpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM ACETATE 667 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 7733386125 NDC GY 1 UN outpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM ACETATE(PHOSPHAT BIND) 667 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 7985440050 NDC GY 1 UN outpatient 4.92 4.82 All Payors / Plans All Payors / Plans 4.92 other 4.92 4.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CALCIUM CARBONATE 200 MG CALCIUM (500 MG) TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 0093-1010-42 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CALCIUM CARBONATE 200 MG CALCIUM (500 MG) TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 45802-112-22 NDC GY 1 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CALCIUM CARBONATE 500 MG CALCIUM (1,250 MG) TABLET" ERX-637000000 CDM A9270 CPT 637 RC 51672-1312-0 NDC GY 1 UN outpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAPTOPRIL 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-180-22 NDC GY 1 UN outpatient 4.21 4.13 All Payors / Plans All Payors / Plans 4.21 other 4.21 4.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBAMAZEPINE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69623-802-76 NDC GY 1 UN outpatient 2.01 1.97 All Payors / Plans All Payors / Plans 2.01 other 2.01 2.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBAMAZEPINE XR 100 MG TABLET EXTENDED RELEASE 12 HR ERX-637000000 CDM A9270 CPT 637 RC 50228-465-01 NDC GY 1 UN outpatient 1.08 1.06 All Payors / Plans All Payors / Plans 1.08 other 1.08 1.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBAMAZEPINE XR 400 MG TABLET EXTENDED RELEASE 12 HR ERX-637000000 CDM A9270 CPT 637 RC 60687-630-11 NDC GY 1 UN outpatient 5.05 4.95 All Payors / Plans All Payors / Plans 5.05 other 5.05 5.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBAMAZEPINE XR 400 MG TABLET EXTENDED RELEASE 12 HR ERX-637000000 CDM A9270 CPT 637 RC 50228-466-01 NDC GY 1 UN outpatient 11.33 11.1 All Payors / Plans All Payors / Plans 11.33 other 11.33 11.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 10-100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7070-07 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 25-100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 82625-8802-1 NDC GY 2 UN outpatient 3.68 3.61 All Payors / Plans All Payors / Plans 3.68 other 3.68 3.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 25-100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-1170-03 NDC GY 2 UN outpatient 2.11 2.07 All Payors / Plans All Payors / Plans 2.11 other 2.11 2.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 25-100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7036-04 NDC GY 1 UN outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 25-100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-291-11 NDC GY 1 UN outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 25-100 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 68094-853-62 NDC GY 1 UN outpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 25-100 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 0065-0085-15 NDC GY 1 UN outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 25-250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-594-11 NDC GY 1 UN outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBIDOPA-LEVODOPA 25-250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65162-188-10 NDC GY 1 UN outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 12.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-595-11 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 12.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-403-10 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-190-01 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7190-04 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 31722-587-30 NDC GY 1 UN outpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 3.125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7189-04 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 3.125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0093-1177-01 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 3.125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0713-0268-31 NDC GY 1 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 6.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 61314-631-36 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 6.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 61314-630-06 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 6.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 24208-635-62 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 6.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 61314-641-75 NDC GY 1 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARVEDILOL 6.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-057-24 NDC GY 1 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFDINIR 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 8068105700 NDC GY 1 UN outpatient 10.45 10.24 All Payors / Plans All Payors / Plans 10.45 other 10.45 10.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFDINIR 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50268-584-11 NDC GY 1 UN outpatient 8.92 8.74 All Payors / Plans All Payors / Plans 8.92 other 8.92 8.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFDINIR 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 43598-447-71 NDC GY 1 UN outpatient 2.74 2.69 All Payors / Plans All Payors / Plans 2.74 other 2.74 2.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFUROXIME 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 43598-447-74 NDC GY 1 UN outpatient 9.56 9.37 All Payors / Plans All Payors / Plans 9.56 other 9.56 9.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFUROXIME 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60505-708-90 NDC GY 1 UN outpatient 9.56 9.37 All Payors / Plans All Payors / Plans 9.56 other 9.56 9.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFUROXIME 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0135-0466-02 NDC GY 1 UN outpatient 3.45 3.38 All Payors / Plans All Payors / Plans 3.45 other 3.45 3.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CELECOXIB 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0536-1362-06 NDC GY 1 UN outpatient 3.42 3.35 All Payors / Plans All Payors / Plans 3.42 other 3.42 3.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CELECOXIB 200 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0766785840 NDC GY 1 UN outpatient 4.28 4.19 All Payors / Plans All Payors / Plans 4.28 other 4.28 4.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CELECOXIB 200 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 49348-573-08 NDC GY 1 UN outpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEPHALEXIN 250 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 60505-7063-0 NDC GY 2 UN outpatient 2.25 2.21 All Payors / Plans All Payors / Plans 2.25 other 2.25 2.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEPHALEXIN 250 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 43598-446-71 NDC GY 1 UN outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEPHALEXIN 500 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904-7229-61 NDC GY 1 UN outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEPHALEXIN 500 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904-7208-06 NDC GY 1 UN outpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEPHALEXIN 500 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50268-597-11 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CETIRIZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-597-15 NDC GY 1 UN outpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CETIRIZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-597-11 NDC GY 1 UN outpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CETIRIZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-598-15 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CETIRIZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-598-11 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CETIRIZINE-PSEUDOEPHEDRINE 5-120 MG TABLET EXTENDED RELEASE 12 HR ERX-637000000 CDM A9270 CPT 637 RC 50268-599-11 NDC GY 1 UN outpatient 2.54 2.49 All Payors / Plans All Payors / Plans 2.54 other 2.54 2.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORDIAZEPOXIDE 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50268-599-15 NDC GY 1 UN outpatient 2.04 2 All Payors / Plans All Payors / Plans 2.04 other 2.04 2.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORDIAZEPOXIDE 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 23155-512-11 NDC GY 1 UN outpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORDIAZEPOXIDE 5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 24338-260-10 NDC GY 1 UN outpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORDIAZEPOXIDE 5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50268-624-11 NDC GY 1 UN outpatient 2.63 2.58 All Payors / Plans All Payors / Plans 2.63 other 2.63 2.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORPROMAZINE PER 10 MG ERX-637000000 CDM A9270 CPT 637 RC 0904-7026-61 NDC GY 1 UN outpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORPROMAZINE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 50268-623-11 NDC GY 1 UN outpatient 9.42 9.23 All Payors / Plans All Payors / Plans 9.42 other 9.42 9.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORPROMAZINE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 60687-472-11 NDC GY 1 UN outpatient 4.16 4.08 All Payors / Plans All Payors / Plans 4.16 other 4.16 4.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORTHALIDONE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70756-411-11 NDC GY 1 UN outpatient 6.84 6.7 All Payors / Plans All Payors / Plans 6.84 other 6.84 6.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORTHALIDONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0378-9102-16 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHOLECALCIFEROL 10 MCG (400 UNIT) TABLET ERX-637000000 CDM A9270 CPT 637 RC 43598-436-11 NDC GY 1 UN outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CHOLECALCIFEROL 25 MCG (1,000 UNIT) TABLET" ERX-637000000 CDM A9270 CPT 637 RC 59762-3304-3 NDC GY 1 UN outpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CHOLECALCIFEROL 25 MCG (1,000 UNIT) TABLET" ERX-637000000 CDM A9270 CPT 637 RC 68462-639-25 NDC GY 1 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHOLESTYRAMINE 4 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 0378-9112-16 NDC GY 1 UN outpatient 3.33 3.26 All Payors / Plans All Payors / Plans 3.33 other 3.33 3.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHOLESTYRAMINE 4 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 0378-9116-16 NDC GY 1 UN outpatient 8.62 8.45 All Payors / Plans All Payors / Plans 8.62 other 8.62 8.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHOLESTYRAMINE 4 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 0281-0326-08 NDC GY 1 UN outpatient 3.52 3.45 All Payors / Plans All Payors / Plans 3.52 other 3.52 3.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CILOSTAZOL 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 45802-210-02 NDC GY 2 UN outpatient 5.52 5.41 All Payors / Plans All Payors / Plans 5.52 other 5.52 5.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CINACALCET 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-304-50 NDC GY 1 UN outpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CINACALCET 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0555-9049-58 NDC GY 1 UN outpatient 23.45 22.98 All Payors / Plans All Payors / Plans 23.45 other 23.45 23.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0555-9049-79 NDC GY 2 UN outpatient 2.01 1.97 All Payors / Plans All Payors / Plans 2.01 other 2.01 2.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0093-0810-01 NDC GY 2 UN outpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-281-11 NDC GY 0.5 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0093-0811-05 NDC GY 1 UN outpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CITALOPRAM 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-604-11 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CITALOPRAM 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 45802-059-11 NDC GY 0.5 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CITALOPRAM 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 45802-048-35 NDC GY 0.5 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CITALOPRAM 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0574-2008-15 NDC GY 1 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLARITHROMYCIN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0832-0465-15 NDC GY 1 UN outpatient 8.87 8.69 All Payors / Plans All Payors / Plans 8.87 other 8.87 8.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN 150 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 68308-152-15 NDC GY 2 UN outpatient 2.02 1.98 All Payors / Plans All Payors / Plans 2.02 other 2.02 2.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN 150 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0121-0868-05 NDC GY 2 UN outpatient 2.1 2.06 All Payors / Plans All Payors / Plans 2.1 other 2.1 2.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CLONAZEPAM 0.25 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 0121-1045-16 NDC GY 2 UN outpatient 5.12 5.02 All Payors / Plans All Payors / Plans 5.12 other 5.12 5.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CLONAZEPAM 0.25 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 0904-7276-41 NDC GY 1 UN outpatient 3.42 3.35 All Payors / Plans All Payors / Plans 3.42 other 3.42 3.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONAZEPAM 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 17856-1045-1 NDC GY 1 UN outpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONAZEPAM 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 24208-434-05 NDC GY 1 UN outpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONAZEPAM 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60505-3113-0 NDC GY 1 UN outpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONAZEPAM 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-740-11 NDC GY 1 UN outpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONAZEPAM 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60505-3110-0 NDC GY 2 UN outpatient 3.76 3.68 All Payors / Plans All Payors / Plans 3.76 other 3.76 3.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONAZEPAM 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-723-01 NDC GY 1 UN outpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-723-11 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 43598-165-30 NDC GY 1 UN outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69543-382-90 NDC GY 1 UN outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.1 MG/24 HR PATCH WEEKLY ERX-637000000 CDM A9270 CPT 637 RC 60505-3276-3 NDC GY 1 UN outpatient 22.12 21.68 All Payors / Plans All Payors / Plans 22.12 other 22.12 22.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 49884-320-55 NDC GY 1 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55111-262-79 NDC GY 1 UN outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55111-262-81 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.2 MG/24 HR PATCH WEEKLY ERX-637000000 CDM A9270 CPT 637 RC 60505-3275-0 NDC GY 1 UN outpatient 28.96 28.38 All Payors / Plans All Payors / Plans 28.96 other 28.96 28.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.3 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-390-10 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.3 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-157-13 NDC GY 1 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.3 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0054-0064-47 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.3 MG/24 HR PATCH WEEKLY ERX-637000000 CDM A9270 CPT 637 RC 16714-671-02 NDC GY 1 UN outpatient 34.4 33.71 All Payors / Plans All Payors / Plans 34.4 other 34.4 34.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLONIDINE 0.3 MG/24 HR PATCH WEEKLY ERX-637000000 CDM A9270 CPT 637 RC 57237-077-10 NDC GY 1 UN outpatient 36.46 35.73 All Payors / Plans All Payors / Plans 36.46 other 36.46 36.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOPIDOGREL 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65162-691-79 NDC GY 1 UN outpatient 14.11 13.83 All Payors / Plans All Payors / Plans 14.11 other 14.11 14.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOPIDOGREL 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-157-40 NDC GY 1 UN outpatient 14.11 13.83 All Payors / Plans All Payors / Plans 14.11 other 14.11 14.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOPIDOGREL 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 64380-797-01 NDC GY 1 UN outpatient 16.56 16.23 All Payors / Plans All Payors / Plans 16.56 other 16.56 16.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOPIDOGREL 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72205-042-11 NDC GY 1 UN outpatient 18.02 17.66 All Payors / Plans All Payors / Plans 18.02 other 18.02 18.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOPIDOGREL 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68180-678-01 NDC GY 1 UN outpatient 16.46 16.13 All Payors / Plans All Payors / Plans 16.46 other 16.46 16.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLOPIDOGREL 75 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72205-044-11 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COLCHICINE 0.6 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0228-2067-10 NDC GY 1 UN outpatient 9.49 9.3 All Payors / Plans All Payors / Plans 9.49 other 9.49 9.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COLCHICINE 0.6 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62584-812-11 NDC GY 1 UN outpatient 9.66 9.47 All Payors / Plans All Payors / Plans 9.66 other 9.66 9.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CYANOCOBALAMIN 1,000 MCG TABLET" ERX-637000000 CDM A9270 CPT 637 RC 62584-813-11 NDC GY 0.5 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CYANOCOBALAMIN 1,000 MCG TABLET" ERX-637000000 CDM A9270 CPT 637 RC 65162-649-78 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CYANOCOBALAMIN 1,000 MCG TABLET" ERX-637000000 CDM A9270 CPT 637 RC 0904-7262-61 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CYANOCOBALAMIN 1,000 MCG TABLET" ERX-637000000 CDM A9270 CPT 637 RC 0904-7263-61 NDC GY 0.5 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYANOCOBALAMIN 100 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51991-293-01 NDC GY 1 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOBENZAPRINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-138-01 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOBENZAPRINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0832-0038-89 NDC GY 0.5 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOBENZAPRINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7027-61 NDC GY 0.5 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOBENZAPRINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-670-11 NDC GY 1 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOSPORINE 0.05 % DROPPERETTE ERX-637000000 CDM A9270 CPT 637 RC 0406-8515-23 NDC GY 1 UN outpatient 19.31 18.92 All Payors / Plans All Payors / Plans 19.31 other 19.31 19.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOSPORINE 0.05 % DROPPERETTE ERX-637000000 CDM A9270 CPT 637 RC 0406-8530-23 NDC GY 1 UN outpatient 9.4 9.21 All Payors / Plans All Payors / Plans 9.4 other 9.4 9.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYPROHEPTADINE 4 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-0552-23 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DABIGATRAN ETEXILATE 150 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904-6966-61 NDC GY 1 UN outpatient 9.53 9.34 All Payors / Plans All Payors / Plans 9.53 other 9.53 9.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DAPAGLIFLOZIN PROPANEDIOL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 42858-001-10 NDC GY 2 UN outpatient 42.21 41.37 All Payors / Plans All Payors / Plans 42.21 other 42.21 42.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DAPAGLIFLOZIN PROPANEDIOL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-354-11 NDC GY 2 UN outpatient 42.29 41.44 All Payors / Plans All Payors / Plans 42.29 other 42.29 42.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DARUNAVIR 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6828-05 NDC GY 1 UN outpatient 14.21 13.93 All Payors / Plans All Payors / Plans 14.21 other 14.21 14.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DESMOPRESSIN 0.1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59011-410-10 NDC GY 1 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DESVENLAFAXINE 50 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 59011-410-20 NDC GY 1 UN outpatient 2.54 2.49 All Payors / Plans All Payors / Plans 2.54 other 2.54 2.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-0512-23 NDC GY 1 UN outpatient 2.01 1.97 All Payors / Plans All Payors / Plans 2.01 other 2.01 2.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0406-0512-62 NDC GY 1 UN outpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DEXMETHYLPHENIDATE XR 10 MG CAPSULE,ER BIPHASIC 50-50" ERX-637000000 CDM A9270 CPT 637 RC 0904-6761-30 NDC GY 1 UN outpatient 9.03 8.85 All Payors / Plans All Payors / Plans 9.03 other 9.03 9.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DEXMETHYLPHENIDATE XR 5 MG CAPSULE,ER BIPHASIC 50-50" ERX-637000000 CDM A9270 CPT 637 RC 0904-7427-30 NDC GY 1 UN outpatient 11.18 10.96 All Payors / Plans All Payors / Plans 11.18 other 11.18 11.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DEXMETHYLPHENIDATE XR 5 MG CAPSULE,ER BIPHASIC 50-50" ERX-637000000 CDM A9270 CPT 637 RC 45802-410-59 NDC GY 1 UN outpatient 4.25 4.17 All Payors / Plans All Payors / Plans 4.25 other 4.25 4.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70677-1037-1 NDC GY 1 UN outpatient 3.42 3.35 All Payors / Plans All Payors / Plans 3.42 other 3.42 3.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65162-280-03 NDC GY 2 UN outpatient 3.64 3.57 All Payors / Plans All Payors / Plans 3.64 other 3.64 3.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIAZEPAM 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50458-550-01 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIAZEPAM 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6936-61 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIAZEPAM 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0032-0047-70 NDC GY 1 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIAZEPAM 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0032-0046-70 NDC GY 1 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICLOFENAC EPOLAMINE 1.3 % PATCH 12 HOUR ERX-637000000 CDM A9270 CPT 637 RC 50268-585-11 NDC GY 1 UN outpatient 36.36 35.63 All Payors / Plans All Payors / Plans 36.36 other 36.36 36.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904-6474-61 NDC GY 1 UN outpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 51079-051-01 NDC GY 1 UN outpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE PER 20 MG ERX-637000000 CDM A9270 CPT 637 RC 63739-564-10 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE PER 20 MG ERX-637000000 CDM A9270 CPT 637 RC 0904-5676-61 NDC GY 0.5 UN outpatient 1.89 1.85 All Payors / Plans All Payors / Plans 1.89 other 1.89 1.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIGOXIN 125 MCG (0.125 MG) TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-888-10 NDC GY 1 UN outpatient 2.74 2.69 All Payors / Plans All Payors / Plans 2.74 other 2.74 2.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIGOXIN 125 MCG (0.125 MG) TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-963-10 NDC GY 1 UN outpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIGOXIN 125 MCG (0.125 MG) TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-045-11 NDC GY 1 UN outpatient 2.77 2.71 All Payors / Plans All Payors / Plans 2.77 other 2.77 2.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIGOXIN 250 MCG (0.25 MG) TABLET ERX-637000000 CDM A9270 CPT 637 RC 0087040501 NDC GY 1 UN outpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILTIAZEM 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7985408009 NDC GY 1 UN outpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILTIAZEM 60 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0093-1172-01 NDC GY 1 UN outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DILTIAZEM CD 120 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 16714-234-01 NDC GY 1 UN outpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DILTIAZEM CD 120 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 0093-4127-73 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DILTIAZEM CD 180 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 6373612002 NDC GY 1 UN outpatient 1.92 1.88 All Payors / Plans All Payors / Plans 1.92 other 1.92 1.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DILTIAZEM CD 180 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 0904-6599-61 NDC GY 1 UN outpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DILTIAZEM CD 240 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 68084-607-11 NDC GY 1 UN outpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DILTIAZEM CD 240 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 65162-681-10 NDC GY 1 UN outpatient 2.02 1.98 All Payors / Plans All Payors / Plans 2.02 other 2.02 2.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DILTIAZEM CD 240 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 65162-682-10 NDC GY 1 UN outpatient 1.82 1.78 All Payors / Plans All Payors / Plans 1.82 other 1.82 1.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DILTIAZEM SR 60 MG CAPSULE,EXTENDED RELEASE 12 HR" ERX-637000000 CDM A9270 CPT 637 RC 0143-1458-01 NDC GY 1 UN outpatient 9.67 9.48 All Payors / Plans All Payors / Plans 9.67 other 9.67 9.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE PER 50 MG ERX-637000000 CDM A9270 CPT 637 RC 0143-1495-01 NDC GY 1 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE PER 50 MG ERX-637000000 CDM A9270 CPT 637 RC 16571-672-01 NDC GY 1 UN outpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 75826-138-10 NDC GY 1 UN outpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DISULFIRAM 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7811201104 NDC GY 1.5 UN outpatient 13.6 13.33 All Payors / Plans All Payors / Plans 13.6 other 13.6 13.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX 125 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 0573-2871-93 NDC GY 1 UN outpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIVALPROEX 250 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 70756-629-25 NDC GY 1 UN outpatient 3.4 3.33 All Payors / Plans All Payors / Plans 3.4 other 3.4 3.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIVALPROEX 250 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0071-0369-40 NDC GY 1 UN outpatient 3.41 3.34 All Payors / Plans All Payors / Plans 3.41 other 3.41 3.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX 250 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 0904-6187-61 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX 250 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 65862-692-01 NDC GY 2 UN outpatient 1.92 1.88 All Payors / Plans All Payors / Plans 1.92 other 1.92 1.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX 250 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 60687-156-95 NDC GY 1 UN outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIVALPROEX 500 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 69097-999-02 NDC GY 1 UN outpatient 4.06 3.98 All Payors / Plans All Payors / Plans 4.06 other 4.06 4.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIVALPROEX 500 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 68084-928-95 NDC GY 1 UN outpatient 3.41 3.34 All Payors / Plans All Payors / Plans 3.41 other 3.41 3.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIVALPROEX 500 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0378-0127-01 NDC GY 1 UN outpatient 4.21 4.13 All Payors / Plans All Payors / Plans 4.21 other 4.21 4.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX 500 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 0904-7096-61 NDC GY 1 UN outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX 500 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 0904-6931-81 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX 500 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 0904-6931-86 NDC GY 0.5 UN outpatient 0.55 0.54 All Payors / Plans All Payors / Plans 0.55 other 0.55 0.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX 500 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 62559-157-17 NDC GY 2 UN outpatient 2.19 2.15 All Payors / Plans All Payors / Plans 2.19 other 2.19 2.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX SPRINKLE 125 MG CAPSULE, DELAYED REL SPRINKLE" ERX-637000000 CDM A9270 CPT 637 RC 10572-100-01 NDC GY 1 UN outpatient 2.76 2.7 All Payors / Plans All Payors / Plans 2.76 other 2.76 2.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DIVALPROEX SPRINKLE 125 MG CAPSULE, DELAYED REL SPRINKLE" ERX-637000000 CDM A9270 CPT 637 RC 52268-100-01 NDC GY 1 UN outpatient 2.76 2.7 All Payors / Plans All Payors / Plans 2.76 other 2.76 2.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOCUSATE SODIUM 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 51801-013-30 NDC GY 1 UN outpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOCUSATE SODIUM 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 51801-011-30 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOCUSATE SODIUM 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 51801-012-30 NDC GY 1 UN outpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOFETILIDE 125 MCG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0245-5317-01 NDC GY 1 UN outpatient 19.85 19.45 All Payors / Plans All Payors / Plans 19.85 other 19.85 19.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOFETILIDE 125 MCG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0245-5317-89 NDC GY 1 UN outpatient 2.78 2.72 All Payors / Plans All Payors / Plans 2.78 other 2.78 2.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOFETILIDE 250 MCG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0245-5319-89 NDC GY 2 UN outpatient 3.68 3.61 All Payors / Plans All Payors / Plans 3.68 other 3.68 3.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOLUTEGRAVIR 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-973-10 NDC GY 1 UN outpatient 78.77 77.19 All Payors / Plans All Payors / Plans 78.77 other 78.77 78.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DONEPEZIL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-472-01 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXAZOSIN 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0121-0948-16 NDC GY 1 UN outpatient 2.55 2.5 All Payors / Plans All Payors / Plans 2.55 other 2.55 2.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXAZOSIN 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-850-33 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXAZOSIN 8 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 75834-280-30 NDC GY 1 UN outpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXEPIN 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 6025800601 NDC GY 1 UN outpatient 2.68 2.63 All Payors / Plans All Payors / Plans 2.68 other 2.68 2.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXEPIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 7135101012 NDC GY 3 UN outpatient 5.58 5.47 All Payors / Plans All Payors / Plans 5.58 other 5.58 5.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXYCYCLINE 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 7135101099 NDC GY 1 UN outpatient 4.9 4.8 All Payors / Plans All Payors / Plans 4.9 other 4.9 4.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXYCYCLINE 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0536-1271-80 NDC GY 1 UN outpatient 4.84 4.74 All Payors / Plans All Payors / Plans 4.84 other 4.84 4.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXYCYCLINE 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 52380-0126-2 NDC GY 1 UN outpatient 4.1 4.02 All Payors / Plans All Payors / Plans 4.1 other 4.1 4.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRONABINOL PER 2.5 MG ERX-637000000 CDM A9270 CPT 637 RC 68462-330-90 NDC GY 1 UN outpatient 10.87 10.65 All Payors / Plans All Payors / Plans 10.87 other 10.87 10.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRONABINOL PER 2.5 MG ERX-637000000 CDM A9270 CPT 637 RC 60687-581-11 NDC GY 2 UN outpatient 21.73 21.3 All Payors / Plans All Payors / Plans 21.73 other 21.73 21.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DULOXETINE 20 MG CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 49348-610-36 NDC GY 1 UN outpatient 2.78 2.72 All Payors / Plans All Payors / Plans 2.78 other 2.78 2.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DULOXETINE 20 MG CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 65862-830-30 NDC GY 2 UN outpatient 6.63 6.5 All Payors / Plans All Payors / Plans 6.63 other 6.63 6.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DULOXETINE 20 MG CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 60687-178-11 NDC GY 1 UN outpatient 3.32 3.25 All Payors / Plans All Payors / Plans 3.32 other 3.32 3.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DULOXETINE 30 MG CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 51079-630-01 NDC GY 1 UN outpatient 2.72 2.67 All Payors / Plans All Payors / Plans 2.72 other 2.72 2.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DULOXETINE 60 MG CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 59762-5310-1 NDC GY 1 UN outpatient 2.68 2.63 All Payors / Plans All Payors / Plans 2.68 other 2.68 2.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DULOXETINE 60 MG CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 68084-996-11 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DULOXETINE 60 MG CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 51079-631-01 NDC GY 1 UN outpatient 2.71 2.66 All Payors / Plans All Payors / Plans 2.71 other 2.71 2.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "DULOXETINE 60 MG CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 51079-631-20 NDC GY 1 UN outpatient 2.77 2.71 All Payors / Plans All Payors / Plans 2.77 other 2.77 2.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DUTASTERIDE 0.5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 51079-632-01 NDC GY 1 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EMPAGLIFLOZIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 17856-0759-5 NDC GY 1 UN outpatient 21.36 20.93 All Payors / Plans All Payors / Plans 21.36 other 21.36 21.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EMPAGLIFLOZIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60758-119-05 NDC GY 1 UN outpatient 21.21 20.79 All Payors / Plans All Payors / Plans 21.21 other 21.21 21.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EMPAGLIFLOZIN 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7001-61 NDC GY 0.5 UN outpatient 10.68 10.47 All Payors / Plans All Payors / Plans 10.68 other 10.68 10.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-506-01 NDC GY 1 UN outpatient 3.49 3.42 All Payors / Plans All Payors / Plans 3.49 other 3.49 3.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENALAPRIL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-506-11 NDC GY 1 UN outpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENALAPRIL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-473-11 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENALAPRIL 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6992-61 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENALAPRIL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-484-01 NDC GY 2 UN outpatient 1.85 1.81 All Payors / Plans All Payors / Plans 1.85 other 1.85 1.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPLERENONE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-484-11 NDC GY 2 UN outpatient 9.72 9.53 All Payors / Plans All Payors / Plans 9.72 other 9.72 9.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPLERENONE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7000-61 NDC GY 1 UN outpatient 2.21 2.17 All Payors / Plans All Payors / Plans 2.21 other 2.21 2.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPLERENONE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-495-01 NDC GY 2 UN outpatient 20.61 20.2 All Payors / Plans All Payors / Plans 20.61 other 20.61 20.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ERGOCALCIFEROL 1,250 MCG (50,000 UNIT) CAPSULE" ERX-637000000 CDM A9270 CPT 637 RC 60687-495-11 NDC GY 1 UN outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ERGOCALCIFEROL 1,250 MCG (50,000 UNIT) CAPSULE" ERX-637000000 CDM A9270 CPT 637 RC 4329255515 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERYTHROMYCIN BASE 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7733371510 NDC GY 1 UN outpatient 14.37 14.08 All Payors / Plans All Payors / Plans 14.37 other 14.37 14.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ESCITALOPRAM 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7733371525 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ESTRADIOL 0.1 MG/24 HR PATCH WEEKLY ERX-637000000 CDM A9270 CPT 637 RC 68084-202-11 NDC GY 1 UN outpatient 65.37 64.06 All Payors / Plans All Payors / Plans 65.37 other 65.37 65.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ESTRADIOL 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-685-11 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ESTRADIOL 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59746-115-06 NDC GY 1 UN outpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETHAMBUTOL 400 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-684-11 NDC GY 3 UN outpatient 8.23 8.07 All Payors / Plans All Payors / Plans 8.23 other 8.23 8.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EZETIMIBE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6461-61 NDC GY 1 UN outpatient 10.76 10.54 All Payors / Plans All Payors / Plans 10.76 other 10.76 10.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EZETIMIBE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0713-0526-06 NDC GY 1 UN outpatient 10.08 9.88 All Payors / Plans All Payors / Plans 10.08 other 10.08 10.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EZETIMIBE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 45802-759-00 NDC GY 1 UN outpatient 10.83 10.61 All Payors / Plans All Payors / Plans 10.83 other 10.83 10.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EZETIMIBE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7304-61 NDC GY 1 UN outpatient 10.83 10.61 All Payors / Plans All Payors / Plans 10.83 other 10.83 10.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FAMOTIDINE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70436-155-41 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FAMOTIDINE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-709-11 NDC GY 1 UN outpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FAMOTIDINE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0998-0016-15 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FAMOTIDINE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 24208-730-06 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENOFIBRATE 145 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-662-11 NDC GY 1 UN outpatient 9.03 8.85 All Payors / Plans All Payors / Plans 9.03 other 9.03 9.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENOFIBRATE 145 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-662-15 NDC GY 1 UN outpatient 3.5 3.43 All Payors / Plans All Payors / Plans 3.5 other 3.5 3.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENOFIBRATE 48 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-587-11 NDC GY 1 UN outpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENOFIBRATE 48 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0378-0183-01 NDC GY 1 UN outpatient 3.46 3.39 All Payors / Plans All Payors / Plans 3.46 other 3.46 3.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL 12 MCG/HR PATCH 72 HOUR ERX-637000000 CDM A9270 CPT 637 RC 0603-5484-21 NDC GY 1 UN outpatient 62.08 60.84 All Payors / Plans All Payors / Plans 62.08 other 62.08 62.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL 25 MCG/HR PATCH 72 HOUR ERX-637000000 CDM A9270 CPT 637 RC 0591-5557-01 NDC GY 1 UN outpatient 25.67 25.16 All Payors / Plans All Payors / Plans 25.67 other 25.67 25.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL 75 MCG/HR PATCH 72 HOUR ERX-637000000 CDM A9270 CPT 637 RC 60687-215-11 NDC GY 1 UN outpatient 49.61 48.62 All Payors / Plans All Payors / Plans 49.61 other 49.61 49.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FERROUS GLUCONATE 324 MG (38 MG IRON) TABLET ERX-637000000 CDM A9270 CPT 637 RC 0527-4117-37 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FERROUS SULFATE 325 MG (65 MG IRON) TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-226-11 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FERROUS SULFATE 325 MG (65 MG IRON) TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-5053-59 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "FIBRINOGEN-THROMBIN 4.8 X 4.8 CM ADHESIVE PATCH,MEDICATED" ERX-637000000 CDM A9270 CPT 637 RC 0904-6990-61 NDC GY 1 UN outpatient 789.82 774.02 All Payors / Plans All Payors / Plans 789.82 other 789.82 789.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FIDAXOMICIN 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70954-484-10 NDC GY 1 UN outpatient 240.21 235.41 All Payors / Plans All Payors / Plans 240.21 other 240.21 240.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FINASTERIDE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6622-61 NDC GY 1 UN outpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FINASTERIDE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-494-11 NDC GY 1 UN outpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FINASTERIDE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 5026885911 NDC GY 1 UN outpatient 1.92 1.88 All Payors / Plans All Payors / Plans 1.92 other 1.92 1.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLECAINIDE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 5026885811 NDC GY 1 UN outpatient 3.49 3.42 All Payors / Plans All Payors / Plans 3.49 other 3.49 3.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLECAINIDE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-632-11 NDC GY 1 UN outpatient 2.02 1.98 All Payors / Plans All Payors / Plans 2.02 other 2.02 2.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUCONAZOLE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-633-11 NDC GY 1 UN outpatient 4.15 4.07 All Payors / Plans All Payors / Plans 4.15 other 4.15 4.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUCONAZOLE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6638-61 NDC GY 1 UN outpatient 6.67 6.54 All Payors / Plans All Payors / Plans 6.67 other 6.67 6.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUCONAZOLE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-630-11 NDC GY 1 UN outpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUCONAZOLE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-327-01 NDC GY 1 UN outpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUDROCORTISONE 0.1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-327-11 NDC GY 1 UN outpatient 2.54 2.49 All Payors / Plans All Payors / Plans 2.54 other 2.54 2.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUDROCORTISONE 0.1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6803-61 NDC GY 0.5 UN outpatient 2.72 2.67 All Payors / Plans All Payors / Plans 2.72 other 2.72 2.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUORESCEIN 1 MG STRIP ERX-637000000 CDM A9270 CPT 637 RC 0904-6804-61 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUORESCEIN 1 MG STRIP ERX-637000000 CDM A9270 CPT 637 RC 0904-6801-61 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOXETINE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 43598-505-30 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOXETINE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 60687-266-11 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOXETINE 20 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0006-0227-61 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOXETINE 20 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 68382-144-06 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOXETINE 20 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 65862-475-01 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOXETINE 20 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 68382-146-01 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOXETINE 20 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 60687-549-11 NDC GY 1 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUPHENAZINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-560-11 NDC GY 1 UN outpatient 9.51 9.32 All Payors / Plans All Payors / Plans 9.51 other 9.51 9.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUPHENAZINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0013-5301-17 NDC GY 1 UN outpatient 9.52 9.33 All Payors / Plans All Payors / Plans 9.52 other 9.52 9.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUVOXAMINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-586-11 NDC GY 2 UN outpatient 3.72 3.65 All Payors / Plans All Payors / Plans 3.72 other 3.72 3.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLIC ACID 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65649-303-03 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLIC ACID 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-271-11 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLIC ACID 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 49884-311-52 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7362-61 NDC GY 1 UN outpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 49884-315-52 NDC GY 0.5 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59746-020-22 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE 80 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6360-61 NDC GY 1 UN outpatient 1.94 1.9 All Payors / Plans All Payors / Plans 1.94 other 1.94 1.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904-7363-61 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904-6361-61 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0904-7364-61 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50458-580-01 NDC GY 1 UN outpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50458-578-01 NDC GY 1 UN outpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50458-578-10 NDC GY 1 UN outpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GABAPENTIN 400 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 50458-578-30 NDC GY 1 UN outpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GEMFIBROZIL 600 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50458-577-01 NDC GY 1 UN outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GEMFIBROZIL 600 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50458-579-10 NDC GY 1 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIMEPIRIDE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6373-61 NDC GY 1 UN outpatient 1.84 1.8 All Payors / Plans All Payors / Plans 1.84 other 1.84 1.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIMEPIRIDE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-741-11 NDC GY 1 UN outpatient 1.94 1.9 All Payors / Plans All Payors / Plans 1.94 other 1.94 1.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIMEPIRIDE 4 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6374-61 NDC GY 1 UN outpatient 2.59 2.54 All Payors / Plans All Payors / Plans 2.59 other 2.59 2.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIPIZIDE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-743-11 NDC GY 0.5 UN outpatient 1.94 1.9 All Payors / Plans All Payors / Plans 1.94 other 1.94 1.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIPIZIDE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6779-61 NDC GY 0.5 UN outpatient 1.96 1.92 All Payors / Plans All Payors / Plans 1.96 other 1.96 1.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIPIZIDE 10 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 60687-245-01 NDC GY 2 UN outpatient 1.96 1.92 All Payors / Plans All Payors / Plans 1.96 other 1.96 1.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIPIZIDE 2.5 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 60687-245-11 NDC GY 1 UN outpatient 3.51 3.44 All Payors / Plans All Payors / Plans 3.51 other 3.51 3.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIPIZIDE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-710-11 NDC GY 1 UN outpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "GLYCERIN-WITCH HAZEL 12.5-50 % PADS, MEDICATED 40 EACH BOX" ERX-637000000 CDM A9270 CPT 637 RC 60687-256-01 NDC GY 40 UN outpatient 11.34 11.11 All Payors / Plans All Payors / Plans 11.34 other 11.34 11.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLYCOPYRROLATE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-256-11 NDC GY 1 UN outpatient 3.33 3.26 All Payors / Plans All Payors / Plans 3.33 other 3.33 3.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUAIFENESIN 600 MG TABLET EXTENDED RELEASE 12HR ERX-637000000 CDM A9270 CPT 637 RC 0904-6781-61 NDC GY 1 UN outpatient 2.56 2.51 All Payors / Plans All Payors / Plans 2.56 other 2.56 2.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUAIFENESIN 600 MG TABLET EXTENDED RELEASE 12HR ERX-637000000 CDM A9270 CPT 637 RC 50268-711-11 NDC GY 1 UN outpatient 2.65 2.6 All Payors / Plans All Payors / Plans 2.65 other 2.65 2.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUAIFENESIN 600 MG TABLET EXTENDED RELEASE 12HR ERX-637000000 CDM A9270 CPT 637 RC 70377-009-11 NDC GY 1 UN outpatient 2.65 2.6 All Payors / Plans All Payors / Plans 2.65 other 2.65 2.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUANFACINE 1 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0904-6778-61 NDC GY 1 UN outpatient 1.93 1.89 All Payors / Plans All Payors / Plans 1.93 other 1.93 1.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUANFACINE 2 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 16714-988-01 NDC GY 0.5 UN outpatient 0.48 0.47 All Payors / Plans All Payors / Plans 0.48 other 0.48 0.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUAR GUM PACKET ERX-637000000 CDM A9270 CPT 637 RC 0078-0659-20 NDC GY 1 UN outpatient 32.47 31.82 All Payors / Plans All Payors / Plans 32.47 other 32.47 32.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HALOPERIDOL 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0078-0777-20 NDC GY 1 UN outpatient 1.96 1.92 All Payors / Plans All Payors / Plans 1.96 other 1.96 1.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HALOPERIDOL 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0078-0696-20 NDC GY 1 UN outpatient 2.66 2.61 All Payors / Plans All Payors / Plans 2.66 other 2.66 2.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HALOPERIDOL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 4858200155 NDC GY 1 UN outpatient 1.82 1.78 All Payors / Plans All Payors / Plans 1.82 other 1.82 1.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0591-2258-54 NDC GY 1 UN outpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 45802-580-01 NDC GY 1 UN outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50742-505-04 NDC GY 1 UN outpatient 8.94 8.76 All Payors / Plans All Payors / Plans 8.94 other 8.94 8.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60505-3438-3 NDC GY 1 UN outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72319-006-02 NDC GY 1 UN outpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6522-61 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-7252-61 NDC GY 1 UN outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 48433-219-05 NDC GY 1 UN outpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 57896-303-01 NDC GY 2 UN outpatient 2.2 2.16 All Payors / Plans All Payors / Plans 2.2 other 2.2 2.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-622-01 NDC GY 2 UN outpatient 2.13 2.09 All Payors / Plans All Payors / Plans 2.13 other 2.13 2.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-622-11 NDC GY 2 UN outpatient 2.46 2.41 All Payors / Plans All Payors / Plans 2.46 other 2.46 2.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-432-02 NDC GY 1 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6924-61 NDC GY 1 UN outpatient 1.85 1.81 All Payors / Plans All Payors / Plans 1.85 other 1.85 1.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 16714-611-04 NDC GY 1 UN outpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCHLOROTHIAZIDE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-231-11 NDC GY 0.5 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCHLOROTHIAZIDE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-242-01 NDC GY 0.5 UN outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCHLOROTHIAZIDE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-242-11 NDC GY 0.5 UN outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6707-06 NDC GY 1 UN outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6707-82 NDC GY 1 UN outpatient 1.93 1.89 All Payors / Plans All Payors / Plans 1.93 other 1.93 1.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-720-11 NDC GY 1 UN outpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-328-33 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-930-08 NDC GY 1 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-717-11 NDC GY 0.5 UN outpatient 4.93 4.83 All Payors / Plans All Payors / Plans 4.93 other 4.93 4.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 12870-0001-1 NDC GY 0.5 UN outpatient 4.93 4.83 All Payors / Plans All Payors / Plans 4.93 other 4.93 4.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 25 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 43598-210-55 NDC GY 1 UN outpatient 20.37 19.96 All Payors / Plans All Payors / Plans 20.37 other 20.37 20.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69618-033-01 NDC GY 1 UN outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 77333-812-25 NDC GY 0.5 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0395266116 NDC GY 1 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-571-10 NDC GY 1 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-511-11 NDC GY 0.5 UN outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-572-10 NDC GY 1 UN outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYCHLOROQUINE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-512-01 NDC GY 1 UN outpatient 4.14 4.06 All Payors / Plans All Payors / Plans 4.14 other 4.14 4.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYUREA 500 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 68084-512-11 NDC GY 1 UN outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYUREA 500 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63739-573-10 NDC GY 2 UN outpatient 5.42 5.31 All Payors / Plans All Payors / Plans 5.42 other 5.42 5.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0006-0277-01 NDC GY 1 UN outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE PAMOATE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 0006-0221-01 NDC GY 1 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE PAMOATE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 0486112501 NDC GY 1 UN outpatient 1.82 1.78 All Payors / Plans All Payors / Plans 1.82 other 1.82 1.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE PAMOATE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 0904-7261-61 NDC GY 1 UN outpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE PAMOATE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 63629-8775-1 NDC GY 1 UN outpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE PAMOATE PER 50 MG ERX-637000000 CDM A9270 CPT 637 RC 66553-008-01 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE PAMOATE PER 50 MG ERX-637000000 CDM A9270 CPT 637 RC 77333-827-25 NDC GY 1 UN outpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 400 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 6936722001 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 400 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7733383525 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 600 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 77333-844-25 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0121119030 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 3932806412 NDC GY 1 UN outpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IBUPROFEN 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0436-0936-16 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMIPRAMINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 39328-063-25 NDC GY 1 UN outpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMIPRAMINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0536-7415-51 NDC GY 1 UN outpatient 1.85 1.81 All Payors / Plans All Payors / Plans 1.85 other 1.85 1.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDAPAMIDE 1.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0132020220 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDAPAMIDE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0132-0202-20 NDC GY 1 UN outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDOMETHACIN 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0310-1110-01 NDC GY 1 UN outpatient 1.82 1.78 All Payors / Plans All Payors / Plans 1.82 other 1.82 1.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDOMETHACIN 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0310-1110-30 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDOMETHACIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0310-1105-01 NDC GY 1 UN outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INDOMETHACIN 50 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 68084-654-11 NDC GY 1 UN outpatient 206.11 201.99 All Payors / Plans All Payors / Plans 206.11 other 206.11 206.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRBESARTAN 150 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69584-841-10 NDC GY 1 UN outpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRBESARTAN 75 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-487-11 NDC GY 1 UN outpatient 1.89 1.85 All Payors / Plans All Payors / Plans 1.89 other 1.89 1.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISONIAZID 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6927-61 NDC GY 1 UN outpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOSORBIDE DINITRATE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-103-01 NDC GY 1 UN outpatient 2.63 2.58 All Payors / Plans All Payors / Plans 2.63 other 2.63 2.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOSORBIDE DINITRATE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 53489-143-05 NDC GY 1 UN outpatient 3.51 3.44 All Payors / Plans All Payors / Plans 3.51 other 3.51 3.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOSORBIDE DINITRATE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-544-10 NDC GY 1 UN outpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOSORBIDE DINITRATE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-753-01 NDC GY 1 UN outpatient 2.58 2.53 All Payors / Plans All Payors / Plans 2.58 other 2.58 2.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOSORBIDE DINITRATE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62135-436-90 NDC GY 1 UN outpatient 2.63 2.58 All Payors / Plans All Payors / Plans 2.63 other 2.63 2.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOSORBIDE MONONITRATE 30 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0121-0974-10 NDC GY 0.5 UN outpatient 0.54 0.53 All Payors / Plans All Payors / Plans 0.54 other 0.54 0.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOSORBIDE MONONITRATE 30 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0121-0974-94 NDC GY 0.5 UN outpatient 0.47 0.46 All Payors / Plans All Payors / Plans 0.47 other 0.47 0.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ISOSORBIDE MONONITRATE 60 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 60687-738-42 NDC GY 1 UN outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IVABRADINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68094-043-59 NDC GY 1 UN outpatient 18.51 18.14 All Payors / Plans All Payors / Plans 18.51 other 18.51 18.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IVABRADINE 7.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0121-0747-10 NDC GY 1 UN outpatient 18.51 18.14 All Payors / Plans All Payors / Plans 18.51 other 18.51 18.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 61314-701-01 NDC GY 1 UN outpatient 6.59 6.46 All Payors / Plans All Payors / Plans 6.59 other 6.59 6.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 24208-670-04 NDC GY 0.5 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0121-0853-20 NDC GY 1 UN outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-496-47 NDC GY 1 UN outpatient 1.93 1.89 All Payors / Plans All Payors / Plans 1.93 other 1.93 1.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-419-01 NDC GY 1 UN outpatient 1.85 1.81 All Payors / Plans All Payors / Plans 1.85 other 1.85 1.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-2725-61 NDC GY 1 UN outpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-420-01 NDC GY 1 UN outpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59762-5000-5 NDC GY 1 UN outpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-146-36 NDC GY 1 UN outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACOSAMIDE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69452-344-60 NDC GY 1 UN outpatient 4.83 4.73 All Payors / Plans All Payors / Plans 4.83 other 4.83 4.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACOSAMIDE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59651-299-60 NDC GY 1 UN outpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACOSAMIDE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-567-10 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACTOBACILLUS RHAMNOSUS GG 10 BILLION CELL CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 68084-299-11 NDC GY 1 UN outpatient 3.55 3.48 All Payors / Plans All Payors / Plans 3.55 other 3.55 3.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LAMOTRIGINE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0228-2076-10 NDC GY 1 UN outpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LAMOTRIGINE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-549-11 NDC GY 1 UN outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LAMOTRIGINE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-764-11 NDC GY 1 UN outpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LAMOTRIGINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-764-15 NDC GY 1 UN outpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LANSOPRAZOLE 30 MG TABLET,DISINTEGRAT, DELAY REL" ERX-637000000 CDM A9270 CPT 637 RC 50268-766-11 NDC GY 1 UN outpatient 21.73 21.3 All Payors / Plans All Payors / Plans 21.73 other 21.73 21.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LANSOPRAZOLE 30 MG TABLET,DISINTEGRAT, DELAY REL" ERX-637000000 CDM A9270 CPT 637 RC 0065-0741-14 NDC GY 1 UN outpatient 14.33 14.04 All Payors / Plans All Payors / Plans 14.33 other 14.33 14.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEFLUNOMIDE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0536-1217-94 NDC GY 1 UN outpatient 55.15 54.05 All Payors / Plans All Payors / Plans 55.15 other 55.15 55.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEFLUNOMIDE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7733393410 NDC GY 1 UN outpatient 6.98 6.84 All Payors / Plans All Payors / Plans 6.98 other 6.98 6.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEFLUNOMIDE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7733393425 NDC GY 1 UN outpatient 4.1 4.02 All Payors / Plans All Payors / Plans 4.1 other 4.1 4.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEFLUNOMIDE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60219-1676-1 NDC GY 1 UN outpatient 2.04 2 All Payors / Plans All Payors / Plans 2.04 other 2.04 2.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LETROZOLE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0456-0458-01 NDC GY 1 UN outpatient 2.59 2.54 All Payors / Plans All Payors / Plans 2.59 other 2.59 2.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LETROZOLE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 42192-330-01 NDC GY 1 UN outpatient 1.84 1.8 All Payors / Plans All Payors / Plans 1.84 other 1.84 1.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETIRACETAM 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 64980-514-05 NDC GY 1 UN outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETIRACETAM 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6418-61 NDC GY 1 UN outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETIRACETAM 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-645-11 NDC GY 1 UN outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETIRACETAM 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 17478-290-10 NDC GY 1 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETIRACETAM 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 61314-647-10 NDC GY 1 UN outpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOFLOXACIN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 33342-098-09 NDC GY 1 UN outpatient 1.08 1.06 All Payors / Plans All Payors / Plans 1.08 other 1.08 1.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOFLOXACIN 750 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-344-11 NDC GY 1 UN outpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 100 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6928-61 NDC GY 1 UN outpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 112 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-342-11 NDC GY 1 UN outpatient 2.65 2.6 All Payors / Plans All Payors / Plans 2.65 other 2.65 2.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 112 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69097-122-03 NDC GY 1 UN outpatient 2.01 1.97 All Payors / Plans All Payors / Plans 2.01 other 2.01 2.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 125 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69097-122-15 NDC GY 1 UN outpatient 2.72 2.67 All Payors / Plans All Payors / Plans 2.72 other 2.72 2.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 137 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-755-11 NDC GY 1 UN outpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 137 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50268-757-11 NDC GY 0.0876 UN outpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 150 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-539-01 NDC GY 1 UN outpatient 2 1.96 All Payors / Plans All Payors / Plans 2 other 2 2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 150 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-539-11 NDC GY 1 UN outpatient 2.74 2.69 All Payors / Plans All Payors / Plans 2.74 other 2.74 2.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 150 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 57664-377-08 NDC GY 1 UN outpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 175 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-795-01 NDC GY 1 UN outpatient 2.63 2.58 All Payors / Plans All Payors / Plans 2.63 other 2.63 2.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 175 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-795-11 NDC GY 1 UN outpatient 2.62 2.57 All Payors / Plans All Payors / Plans 2.62 other 2.62 2.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 200 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-808-11 NDC GY 1 UN outpatient 3.49 3.42 All Payors / Plans All Payors / Plans 3.49 other 3.49 3.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 25 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6869-61 NDC GY 1 UN outpatient 2 1.96 All Payors / Plans All Payors / Plans 2 other 2 2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 25 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-454-11 NDC GY 1 UN outpatient 2 1.96 All Payors / Plans All Payors / Plans 2 other 2 2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 25 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6868-61 NDC GY 1 UN outpatient 1.84 1.8 All Payors / Plans All Payors / Plans 1.84 other 1.84 1.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 50 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-443-11 NDC GY 1 UN outpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 50 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68382-805-01 NDC GY 1 UN outpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 50 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51672-1394-0 NDC GY 1 UN outpatient 1.87 1.83 All Payors / Plans All Payors / Plans 1.87 other 1.87 1.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 75 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0168-0004-15 NDC GY 1 UN outpatient 2.61 2.56 All Payors / Plans All Payors / Plans 2.61 other 2.61 2.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 75 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0168-0004-80 NDC GY 2 UN outpatient 5.21 5.11 All Payors / Plans All Payors / Plans 5.21 other 5.21 5.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 88 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0168-0002-15 NDC GY 1 UN outpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 88 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-750-95 NDC GY 1 UN outpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 88 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0591-0348-01 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-MENTHOL 4-1 % ADHESIVE PATCH,MEDICATED" ERX-637000000 CDM A9270 CPT 637 RC 24208-590-64 NDC GY 1 UN outpatient 10.52 10.31 All Payors / Plans All Payors / Plans 10.52 other 10.52 10.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "LIDOCAINE-MENTHOL 4-1 % ADHESIVE PATCH,MEDICATED" ERX-637000000 CDM A9270 CPT 637 RC 61314-355-02 NDC GY 1 UN outpatient 10.52 10.31 All Payors / Plans All Payors / Plans 10.52 other 10.52 10.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINEZOLID 600 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70069-121-01 NDC GY 1 UN outpatient 11.26 11.03 All Payors / Plans All Payors / Plans 11.26 other 11.26 11.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINEZOLID 600 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 73302-456-01 NDC GY 1 UN outpatient 6.74 6.61 All Payors / Plans All Payors / Plans 6.74 other 6.74 6.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIOTHYRONINE 25 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-100-11 NDC GY 1 UN outpatient 2.04 2 All Payors / Plans All Payors / Plans 2.04 other 2.04 2.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIOTHYRONINE 5 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51079-093-01 NDC GY 1 UN outpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISDEXAMFETAMINE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0121-0675-85 NDC GY 1 UN outpatient 20.88 20.46 All Payors / Plans All Payors / Plans 20.88 other 20.88 20.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISDEXAMFETAMINE 30 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0591-4012-01 NDC GY 1 UN outpatient 20.88 20.46 All Payors / Plans All Payors / Plans 20.88 other 20.88 20.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISINOPRIL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0121-4675-05 NDC GY 1 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISINOPRIL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60687-634-11 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISINOPRIL 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 31722-154-90 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISINOPRIL 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62332-047-90 NDC GY 1 UN outpatient 2.59 2.54 All Payors / Plans All Payors / Plans 2.59 other 2.59 2.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISINOPRIL 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0378-5807-93 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISINOPRIL 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 33342-062-07 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISINOPRIL 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0378-5813-77 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LISINOPRIL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 23155-858-78 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LITHIUM CARBONATE 150 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 62559-390-20 NDC GY 1 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LITHIUM CARBONATE 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 68180-166-11 NDC GY 1 UN outpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LITHIUM CARBONATE 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-6510-01 NDC GY 1 UN outpatient 1.08 1.06 All Payors / Plans All Payors / Plans 1.08 other 1.08 1.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LITHIUM CARBONATE 450 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 65628-206-05 NDC GY 1 UN outpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOPERAMIDE 2 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 49884-155-76 NDC GY 1 UN outpatient 2.71 2.66 All Payors / Plans All Payors / Plans 2.71 other 2.71 2.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-896-95 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-844-11 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-856-11 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-713-11 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-527-90 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-698-11 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-709-11 NDC GY 1 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOSARTAN 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0591-0345-01 NDC GY 1 UN outpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOSARTAN 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 23155-059-01 NDC GY 1 UN outpatient 1.13 1.11 All Payors / Plans All Payors / Plans 1.13 other 1.13 1.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOSARTAN 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 23155-026-01 NDC GY 0.5 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-292-01 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-293-01 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOXAPINE 5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 68462-260-01 NDC GY 1 UN outpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LURASIDONE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 6025816101 NDC GY 1 UN outpatient 9.04 8.86 All Payors / Plans All Payors / Plans 9.04 other 9.04 9.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LURASIDONE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 4110081163 NDC GY 1 UN outpatient 51.48 50.45 All Payors / Plans All Payors / Plans 51.48 other 51.48 51.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LURASIDONE 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7733395125 NDC GY 1 UN outpatient 2.69 2.64 All Payors / Plans All Payors / Plans 2.69 other 2.69 2.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LURASIDONE 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 27241-063-03 NDC GY 1 UN outpatient 51.48 50.45 All Payors / Plans All Payors / Plans 51.48 other 51.48 51.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LURASIDONE 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-572-30 NDC GY 1 UN outpatient 1.85 1.81 All Payors / Plans All Payors / Plans 1.85 other 1.85 1.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MAGNESIUM CHLORIDE 64 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 64764-730-30 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET ERX-637000000 CDM A9270 CPT 637 RC 64764-720-30 NDC GY 1 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MECLIZINE 12.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0832-1211-89 NDC GY 2 UN outpatient 3.92 3.84 All Payors / Plans All Payors / Plans 3.92 other 3.92 3.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MECLIZINE 12.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 51672-4035-1 NDC GY 2 UN outpatient 3.76 3.68 All Payors / Plans All Payors / Plans 3.76 other 3.76 3.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MECLIZINE 12.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0832-1212-89 NDC GY 1 UN outpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MECLIZINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0832-1213-89 NDC GY 1 UN outpatient 4.26 4.17 All Payors / Plans All Payors / Plans 4.26 other 4.26 4.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MECLIZINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0832-1216-89 NDC GY 1 UN outpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MECLIZINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62584-994-11 NDC GY 1 UN outpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEDROXYPROGESTERONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0832-1218-89 NDC GY 1 UN outpatient 1.08 1.06 All Payors / Plans All Payors / Plans 1.08 other 1.08 1.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEDROXYPROGESTERONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7214003711 NDC GY 1 UN outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEDROXYPROGESTERONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0065-0518-01 NDC GY 1 UN outpatient 4.26 4.17 All Payors / Plans All Payors / Plans 4.26 other 4.26 4.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEDROXYPROGESTERONE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 8068115500 NDC GY 2 UN outpatient 1.93 1.89 All Payors / Plans All Payors / Plans 1.93 other 1.93 1.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEGESTROL 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65862-048-24 NDC GY 1 UN outpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEMANTINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69968-0061-1 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEMANTINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 7430000070 NDC GY 1 UN outpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MESALAMINE 1,000 MG SUPPOSITORY" ERX-637000000 CDM A9270 CPT 637 RC 7733398325 NDC GY 1 UN outpatient 6.87 6.73 All Payors / Plans All Payors / Plans 6.87 other 6.87 6.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESALAMINE 400 MG CAPSULE (WITH DEL REL TABLETS) ERX-637000000 CDM A9270 CPT 637 RC 0904-6269-08 NDC GY 2 UN outpatient 20.75 20.34 All Payors / Plans All Payors / Plans 20.75 other 20.75 20.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MESALAMINE 800 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 63739-988-32 NDC GY 2 UN outpatient 30.4 29.79 All Payors / Plans All Payors / Plans 30.4 other 30.4 30.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METFORMIN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-104-09 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METFORMIN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68084-104-11 NDC GY 1 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METFORMIN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 16714-622-01 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METFORMIN 850 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0904-6082-61 NDC GY 1 UN outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHADONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 16714-621-01 NDC GY 1 UN outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHADONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 83257-005-41 NDC GY 1 UN outpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHADONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60793-701-02 NDC GY 1 UN outpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHADONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 60793-702-04 NDC GY 1 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHAZOLAMIDE 1 (ONE) 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55513-223-01 NDC GY 1 UN outpatient 5.02 4.92 All Payors / Plans All Payors / Plans 5.02 other 5.02 5.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHAZOLAMIDE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50242-037-06 NDC GY 1 UN outpatient 9.48 9.29 All Payors / Plans All Payors / Plans 9.48 other 9.48 9.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHIMAZOLE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50242-120-47 NDC GY 1 UN outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHIMAZOLE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55513-132-01 NDC GY 1 UN outpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHIMAZOLE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0069-0305-01 NDC GY 0.0996 UN outpatient 0.1 0.1 All Payors / Plans All Payors / Plans 0.1 other 0.1 0.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLERGONOVINE 0.2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0069-0306-01 NDC GY 1 UN outpatient 24.85 24.35 All Payors / Plans All Payors / Plans 24.85 other 24.85 24.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPHENIDATE HCL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0264-4100-90 NDC GY 1 UN outpatient 4.83 4.73 All Payors / Plans All Payors / Plans 4.83 other 4.83 4.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPHENIDATE HCL 18 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 63323-325-03 NDC GY 1 UN outpatient 9.95 9.75 All Payors / Plans All Payors / Plans 9.95 other 9.95 9.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPHENIDATE HCL 27 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 63323-325-09 NDC GY 1 UN outpatient 8.72 8.55 All Payors / Plans All Payors / Plans 8.72 other 8.72 8.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPHENIDATE HCL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72485-201-01 NDC GY 1 UN outpatient 6.85 6.71 All Payors / Plans All Payors / Plans 6.85 other 6.85 6.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44567-530-01 NDC GY 1 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 39822-0255-1 NDC GY 1 UN outpatient 2 1.96 All Payors / Plans All Payors / Plans 2 other 2 2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOLAZONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 67457-316-25 NDC GY 2 UN outpatient 5.53 5.42 All Payors / Plans All Payors / Plans 5.53 other 5.53 5.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOLAZONE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-883-30 NDC GY 2 UN outpatient 6.78 6.64 All Payors / Plans All Payors / Plans 6.78 other 6.78 6.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOLAZONE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-6102-20 NDC GY 1 UN outpatient 9.14 8.96 All Payors / Plans All Payors / Plans 9.14 other 9.14 9.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOLAZONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-631-50 NDC GY 1 UN outpatient 9.49 9.3 All Payors / Plans All Payors / Plans 9.49 other 9.49 9.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL 12.5 MG ERX-637000000 CDM A9270 CPT 637 RC 63323-710-50 NDC GY 1 UN outpatient 0.88 0.86 All Payors / Plans All Payors / Plans 0.88 other 0.88 0.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 100 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 25021-191-10 NDC GY 1 UN outpatient 4.82 4.72 All Payors / Plans All Payors / Plans 4.82 other 4.82 4.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 100 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0143-9279-01 NDC GY 1 UN outpatient 3.39 3.32 All Payors / Plans All Payors / Plans 3.39 other 3.39 3.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 200 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 60505-6132-6 NDC GY 1 UN outpatient 2.62 2.57 All Payors / Plans All Payors / Plans 2.62 other 2.62 2.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 25 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 60505-6132-7 NDC GY 2 UN outpatient 2.22 2.18 All Payors / Plans All Payors / Plans 2.22 other 2.22 2.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 25 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 68817-134-50 NDC GY 0.5 UN outpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 25 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 70114-101-01 NDC GY 0.5 UN outpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 25 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 71288-166-10 NDC GY 0.5 UN outpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 25 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0409-0302-01 NDC GY 1 UN outpatient 2 1.96 All Payors / Plans All Payors / Plans 2 other 2 2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 50 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0069-0249-01 NDC GY 1 UN outpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 50 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 55513-221-01 NDC GY 0.5 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL SUCCINATE XL 50 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 55513-222-01 NDC GY 0.5 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL TARTRATE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-310-25 NDC GY 1 UN outpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL TARTRATE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-310-50 NDC GY 1 UN outpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL TARTRATE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-310-90 NDC GY 1 UN outpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL TARTRATE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-310-91 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL TARTRATE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-3613-01 NDC GY 0.5 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL TARTRATE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-360-01 NDC GY 1 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL TARTRATE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-360-03 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOPROLOL TARTRATE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-360-19 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METRONIDAZOLE 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 58160-821-43 NDC GY 2 UN outpatient 2.17 2.13 All Payors / Plans All Payors / Plans 2.17 other 2.17 2.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METRONIDAZOLE 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-495-07 NDC GY 1 UN outpatient 2 1.96 All Payors / Plans All Payors / Plans 2 other 2 2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METRONIDAZOLE 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-495-27 NDC GY 1 UN outpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEXILETINE 150 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63323-496-03 NDC GY 1 UN outpatient 4.1 4.02 All Payors / Plans All Payors / Plans 4.1 other 4.1 4.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEXILETINE 150 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 61958-2901-2 NDC GY 1 UN outpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEXILETINE 200 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 69374-920-05 NDC GY 1 UN outpatient 2.04 2 All Payors / Plans All Payors / Plans 2.04 other 2.04 2.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDODRINE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 42023-219-01 NDC GY 1 UN outpatient 2.54 2.49 All Payors / Plans All Payors / Plans 2.54 other 2.54 2.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDODRINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 42023-219-10 NDC GY 1 UN outpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDODRINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59676-340-00 NDC GY 1 UN outpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MINOXIDIL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0069-1309-01 NDC GY 1 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MINOXIDIL 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 39822-0190-1 NDC GY 1 UN outpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIRTAZAPINE 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72611-860-01 NDC GY 0.5 UN outpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIRTAZAPINE 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 17478-542-02 NDC GY 1 UN outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIRTAZAPINE 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 67457-855-00 NDC GY 1 UN outpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MISOPROSTOL 100 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 67457-855-02 NDC GY 10 UN outpatient 86.71 84.98 All Payors / Plans All Payors / Plans 86.71 other 86.71 86.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MISOPROSTOL 1000 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 58468-0040-1 NDC GY 1 UN outpatient 2.77 2.71 All Payors / Plans All Payors / Plans 2.77 other 2.77 2.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MISOPROSTOL 200 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 58468-0041-1 NDC GY 5 UN outpatient 33.43 32.76 All Payors / Plans All Payors / Plans 33.43 other 33.43 33.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MISOPROSTOL 200 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-251-05 NDC GY 1 UN outpatient 6.69 6.56 All Payors / Plans All Payors / Plans 6.69 other 6.69 6.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MISOPROSTOL 200 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-251-10 NDC GY 1 UN outpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MISOPROSTOL 25 MCG ERX-637000000 CDM A9270 CPT 637 RC 44206-251-90 NDC GY 1 UN outpatient 1.84 1.8 All Payors / Plans All Payors / Plans 1.84 other 1.84 1.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MODAFINIL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-251-91 NDC GY 2 UN outpatient 22.83 22.37 All Payors / Plans All Payors / Plans 22.83 other 22.83 22.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MONTELUKAST 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 50242-041-64 NDC GY 1 UN outpatient 1.26 1.23 All Payors / Plans All Payors / Plans 1.26 other 1.26 1.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MONTELUKAST 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-5922-16 NDC GY 1 UN outpatient 1.82 1.78 All Payors / Plans All Payors / Plans 1.82 other 1.82 1.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MONTELUKAST 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-5921-16 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MONTELUKAST 5 MG TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 43066-150-10 NDC GY 1 UN outpatient 2.66 2.61 All Payors / Plans All Payors / Plans 2.66 other 2.66 2.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 10 MG/0.5 ML SYRINGE ERX-637000000 CDM A9270 CPT 637 RC 43066-360-20 NDC GY 0.5 UN outpatient 4.41 4.32 All Payors / Plans All Payors / Plans 4.41 other 4.41 4.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 15 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 0781-3402-78 NDC GY 1 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 15 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 0781-3402-95 NDC GY 1 UN outpatient 1.97 1.93 All Payors / Plans All Payors / Plans 1.97 other 1.97 1.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 30 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 0781-3407-78 NDC GY 1 UN outpatient 1.83 1.79 All Payors / Plans All Payors / Plans 1.83 other 1.83 1.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 30 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 0781-3408-80 NDC GY 1 UN outpatient 3.53 3.46 All Payors / Plans All Payors / Plans 3.53 other 3.53 3.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE IMMEDIATE RELEASE 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44567-101-10 NDC GY 0.5 UN outpatient 1.38 1.35 All Payors / Plans All Payors / Plans 1.38 other 1.38 1.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MULTIVIT-IRON-FA-CALCIUM-MINS 9 MG IRON-400 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55150-114-20 NDC GY 1 UN outpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MULTIVIT-IRON-FA-CALCIUM-MINS 9 MG IRON-400 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72485-422-10 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MULTIVIT-IRON-FA-CALCIUM-MINS 9 MG IRON-400 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6116-01 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MULTIVIT-MINERALS-IRON-FOLIC ACID 7.5 MG IRON-400 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6117-01 NDC GY 1 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NABUMETONE 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6117-10 NDC GY 2 UN outpatient 1.96 1.92 All Payors / Plans All Payors / Plans 1.96 other 1.96 1.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NABUMETONE 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55150-116-20 NDC GY 2 UN outpatient 6.84 6.7 All Payors / Plans All Payors / Plans 6.84 other 6.84 6.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NABUMETONE 750 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55150-117-20 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NADOLOL 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 67457-349-10 NDC GY 1 UN outpatient 6.79 6.65 All Payors / Plans All Payors / Plans 6.79 other 6.79 6.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALOXEGOL 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68982-182-02 NDC GY 0.5 UN outpatient 10.87 10.65 All Payors / Plans All Payors / Plans 10.87 other 10.87 10.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALTREXONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68982-182-01 NDC GY 1 UN outpatient 4.05 3.97 All Payors / Plans All Payors / Plans 4.05 other 4.05 4.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALTREXONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 47426-201-01 NDC GY 1 UN outpatient 3.53 3.46 All Payors / Plans All Payors / Plans 3.53 other 3.53 3.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALTREXONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-1001-25 NDC GY 1 UN outpatient 7.02 6.88 All Payors / Plans All Payors / Plans 7.02 other 7.02 7.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALTREXONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1630-10 NDC GY 1 UN outpatient 6.83 6.69 All Payors / Plans All Payors / Plans 6.83 other 6.83 6.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAPROXEN 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1630-15 NDC GY 0.5 UN outpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAPROXEN 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-1004-01 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAPROXEN 375 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-1004-25 NDC GY 1 UN outpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAPROXEN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 64253-400-30 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAPROXEN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-0144-11 NDC GY 1 UN outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEBIVOLOL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-0144-21 NDC GY 0.5 UN outpatient 8.62 8.45 All Payors / Plans All Payors / Plans 8.62 other 8.62 8.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEBIVOLOL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-398-01 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEBIVOLOL 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-398-10 NDC GY 0.5 UN outpatient 6.87 6.73 All Payors / Plans All Payors / Plans 6.87 other 6.87 6.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEOMYCIN 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-0829-11 NDC GY 2 UN outpatient 7.03 6.89 All Payors / Plans All Payors / Plans 7.03 other 7.03 7.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIACIN 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0003-2570-16 NDC GY 5 UN outpatient 4.41 4.32 All Payors / Plans All Payors / Plans 4.41 other 4.41 4.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIACIN 500 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 0409-0830-01 NDC GY 1 UN outpatient 4.11 4.03 All Payors / Plans All Payors / Plans 4.11 other 4.11 4.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 14 MG/24 HR PATCH 24 HOUR ERX-637000000 CDM A9270 CPT 637 RC 0409-0830-11 NDC GY 1 UN outpatient 4.2 4.12 All Payors / Plans All Payors / Plans 4.2 other 4.2 4.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 14 MG/24 HR PATCH 24 HOUR ERX-637000000 CDM A9270 CPT 637 RC 0143-9729-01 NDC GY 1 UN outpatient 4.23 4.15 All Payors / Plans All Payors / Plans 4.23 other 4.23 4.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 14 MG/24 HR PATCH 24 HOUR ERX-637000000 CDM A9270 CPT 637 RC 68382-860-02 NDC GY 1 UN outpatient 4.89 4.79 All Payors / Plans All Payors / Plans 4.89 other 4.89 4.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 2 MG GUM ERX-637000000 CDM A9270 CPT 637 RC 55513-207-01 NDC GY 1 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 2 MG GUM ERX-637000000 CDM A9270 CPT 637 RC 55513-206-01 NDC GY 1 UN outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 2 MG GUM ERX-637000000 CDM A9270 CPT 637 RC 0069-0342-01 NDC GY 1 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 2 MG GUM ERX-637000000 CDM A9270 CPT 637 RC 0069-0315-01 NDC GY 1 UN outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 21 MG/24 HR PATCH 24 HOUR ERX-637000000 CDM A9270 CPT 637 RC 70121-1755-1 NDC GY 1 UN outpatient 6.93 6.79 All Payors / Plans All Payors / Plans 6.93 other 6.93 6.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICOTINE 7 MG/24 HR PATCH 24 HOUR ERX-637000000 CDM A9270 CPT 637 RC 70121-1754-1 NDC GY 1 UN outpatient 10.73 10.52 All Payors / Plans All Payors / Plans 10.73 other 10.73 10.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-1412-04 NDC GY 1 UN outpatient 3.32 3.25 All Payors / Plans All Payors / Plans 3.32 other 3.32 3.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE XL 30 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 0641-6008-01 NDC GY 1 UN outpatient 2.71 2.66 All Payors / Plans All Payors / Plans 2.71 other 2.71 2.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE XL 30 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 70860-405-41 NDC GY 1 UN outpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE XL 30 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 72205-101-01 NDC GY 1 UN outpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE XL 30 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 0409-1159-02 NDC GY 1 UN outpatient 4.25 4.17 All Payors / Plans All Payors / Plans 4.25 other 4.25 4.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE XL 60 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 0409-1159-09 NDC GY 0.5 UN outpatient 2.49 2.44 All Payors / Plans All Payors / Plans 2.49 other 2.49 2.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE XL 60 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 55150-167-10 NDC GY 1 UN outpatient 7.07 6.93 All Payors / Plans All Payors / Plans 7.07 other 7.07 7.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE XL 90 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 63323-464-17 NDC GY 1 UN outpatient 4.89 4.79 All Payors / Plans All Payors / Plans 4.89 other 4.89 4.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIFEDIPINE XL 90 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 0409-1162-01 NDC GY 1 UN outpatient 4.89 4.79 All Payors / Plans All Payors / Plans 4.89 other 4.89 4.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NIMODIPINE 30 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-1162-02 NDC GY 2 UN outpatient 8.26 8.09 All Payors / Plans All Payors / Plans 8.26 other 8.26 8.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROFURANTOIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-1162-18 NDC GY 1 UN outpatient 8.85 8.67 All Payors / Plans All Payors / Plans 8.85 other 8.85 8.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROFURANTOIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-1162-19 NDC GY 1 UN outpatient 4.96 4.86 All Payors / Plans All Payors / Plans 4.96 other 4.96 4.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROFURANTOIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63323-466-01 NDC GY 1 UN outpatient 4.19 4.11 All Payors / Plans All Payors / Plans 4.19 other 4.19 4.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROFURANTOIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-1165-01 NDC GY 1 UN outpatient 4.92 4.82 All Payors / Plans All Payors / Plans 4.92 other 4.92 4.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROFURANTOIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 55150-171-10 NDC GY 2 UN outpatient 3.93 3.85 All Payors / Plans All Payors / Plans 3.93 other 3.93 3.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROGLYCERIN 0.1 MG/HR PATCH 24 HOUR ERX-637000000 CDM A9270 CPT 637 RC 10122-620-10 NDC GY 1 UN outpatient 0.64 0.63 All Payors / Plans All Payors / Plans 0.64 other 0.64 0.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NITROGLYCERIN 0.4 MG TABLET, SUBLINGUAL" ERX-637000000 CDM A9270 CPT 637 RC 10122-620-01 NDC GY 1 UN outpatient 0.29 0.28 All Payors / Plans All Payors / Plans 0.29 other 0.29 0.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NITROGLYCERIN 0.4 MG TABLET, SUBLINGUAL" ERX-637000000 CDM A9270 CPT 637 RC 60505-6231-0 NDC GY 1 UN outpatient 0.5 0.49 All Payors / Plans All Payors / Plans 0.5 other 0.5 0.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "NITROGLYCERIN 0.4 MG TABLET, SUBLINGUAL" ERX-637000000 CDM A9270 CPT 637 RC 60505-6231-5 NDC GY 1 UN outpatient 0.29 0.28 All Payors / Plans All Payors / Plans 0.29 other 0.29 0.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROGLYCERIN 0.4 MG/HR PATCH 24 HOUR ERX-637000000 CDM A9270 CPT 637 RC 0143-9140-01 NDC GY 1 UN outpatient 0.87 0.85 All Payors / Plans All Payors / Plans 0.87 other 0.87 0.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROGLYCERIN 0.6 MG/HR PATCH 24 HOUR ERX-637000000 CDM A9270 CPT 637 RC 0143-9140-25 NDC GY 1 UN outpatient 2.75 2.7 All Payors / Plans All Payors / Plans 2.75 other 2.75 2.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORETHINDRONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0143-9923-90 NDC GY 4 UN outpatient 13.87 13.59 All Payors / Plans All Payors / Plans 13.87 other 13.87 13.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORGESTREL-ETHINYL ESTRADIOL 0.3-30 MG-MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0781-3451-70 NDC GY 1 UN outpatient 1.94 1.9 All Payors / Plans All Payors / Plans 1.94 other 1.94 1.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORGESTREL-ETHINYL ESTRADIOL 0.3-30 MG-MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44567-707-25 NDC GY 1 UN outpatient 1.94 1.9 All Payors / Plans All Payors / Plans 1.94 other 1.94 1.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORTRIPTYLINE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 60505-6142-0 NDC GY 4 UN outpatient 4.26 4.17 All Payors / Plans All Payors / Plans 4.26 other 4.26 4.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORTRIPTYLINE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-9566-01 NDC GY 2 UN outpatient 3.73 3.66 All Payors / Plans All Payors / Plans 3.73 other 3.73 3.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORTRIPTYLINE 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-9735-01 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NORTRIPTYLINE 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-9735-10 NDC GY 1 UN outpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLANZAPINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 25021-121-20 NDC GY 1 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLANZAPINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44567-241-10 NDC GY 1 UN outpatient 3.33 3.26 All Payors / Plans All Payors / Plans 3.33 other 3.33 3.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLANZAPINE 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59630-266-01 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLANZAPINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 25021-109-10 NDC GY 1 UN outpatient 2.07 2.03 All Payors / Plans All Payors / Plans 2.07 other 2.07 2.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLANZAPINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-342-41 NDC GY 1 UN outpatient 2.04 2 All Payors / Plans All Payors / Plans 2.04 other 2.04 2.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLANZAPINE 7.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 25021-127-20 NDC GY 1 UN outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLANZAPINE 7.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 25021-128-50 NDC GY 1 UN outpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OLANZAPINE ODT 10 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 44567-235-25 NDC GY 1 UN outpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OLANZAPINE ZYDIS 5 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 0143-9857-01 NDC GY 2 UN outpatient 3.8 3.72 All Payors / Plans All Payors / Plans 3.8 other 3.8 3.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OLANZAPINE ZYDIS 5 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 0143-9858-01 NDC GY 1 UN outpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OLANZAPINE ZYDIS 5 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 0143-9858-25 NDC GY 1 UN outpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OLANZAPINE ZYDIS 5 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 0264-3153-11 NDC GY 1 UN outpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON 4 (FOUR) 4 MG TABLETS ERX-637000000 CDM A9270 CPT 637 RC 0264-3155-11 NDC GY 4 UN outpatient 3.88 3.8 All Payors / Plans All Payors / Plans 3.88 other 3.88 3.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON 4 (FOUR) 4 MG TABLETS ERX-637000000 CDM A9270 CPT 637 RC 60505-6151-1 NDC GY 4 UN outpatient 4.19 4.11 All Payors / Plans All Payors / Plans 4.19 other 4.19 4.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 8 MG ERX-637000000 CDM A9270 CPT 637 RC 0143-9977-90 NDC GY 0.5 UN outpatient 0.52 0.51 All Payors / Plans All Payors / Plans 0.52 other 0.52 0.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 8 MG ERX-637000000 CDM A9270 CPT 637 RC 0143-9979-22 NDC GY 1 UN outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OSELTAMIVIR 30 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0143-9979-90 NDC GY 1 UN outpatient 4.24 4.16 All Payors / Plans All Payors / Plans 4.24 other 4.24 4.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OSELTAMIVIR 30 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 25021-119-20 NDC GY 1 UN outpatient 2.75 2.7 All Payors / Plans All Payors / Plans 2.75 other 2.75 2.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OSELTAMIVIR 75 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 66733-958-23 NDC GY 1 UN outpatient 2.78 2.72 All Payors / Plans All Payors / Plans 2.78 other 2.78 2.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXAZEPAM 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63323-478-27 NDC GY 1 UN outpatient 2.76 2.7 All Payors / Plans All Payors / Plans 2.76 other 2.76 2.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXAZEPAM 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0641-1398-31 NDC GY 1 UN outpatient 7.01 6.87 All Payors / Plans All Payors / Plans 7.01 other 7.01 7.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXAZEPAM 15 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-3300-01 NDC GY 1 UN outpatient 9.18 9 All Payors / Plans All Payors / Plans 9.18 other 9.18 9.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXCARBAZEPINE 150 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-3300-24 NDC GY 1 UN outpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXCARBAZEPINE 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-4777-23 NDC GY 1 UN outpatient 2.61 2.56 All Payors / Plans All Payors / Plans 2.61 other 2.61 2.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXCARBAZEPINE 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-9549-50 NDC GY 1 UN outpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXCARBAZEPINE 300 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-9549-60 NDC GY 2 UN outpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYBUTYNIN 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-3410-24 NDC GY 1 UN outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYBUTYNIN 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-3410-50 NDC GY 1 UN outpatient 1.87 1.83 All Payors / Plans All Payors / Plans 1.87 other 1.87 1.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYBUTYNIN 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-3612-50 NDC GY 1 UN outpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-3814-50 NDC GY 1 UN outpatient 2.02 1.98 All Payors / Plans All Payors / Plans 2.02 other 2.02 2.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0781-3289-91 NDC GY 1 UN outpatient 3.39 3.32 All Payors / Plans All Payors / Plans 3.39 other 3.39 3.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0781-3290-91 NDC GY 1 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 71104-922-01 NDC GY 1 UN outpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 71104-911-01 NDC GY 1 UN outpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0548-5900-00 NDC GY 1 UN outpatient 1.85 1.81 All Payors / Plans All Payors / Plans 1.85 other 1.85 1.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OXYCODONE ER 10 MG TABLET,ORAL ONLY,EXT.REL.12 HR" ERX-637000000 CDM A9270 CPT 637 RC 0517-0031-01 NDC GY 1 UN outpatient 10.49 10.28 All Payors / Plans All Payors / Plans 10.49 other 10.49 10.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OXYCODONE ER 10 MG TABLET,ORAL ONLY,EXT.REL.12 HR" ERX-637000000 CDM A9270 CPT 637 RC 0517-0031-25 NDC GY 1 UN outpatient 10.59 10.38 All Payors / Plans All Payors / Plans 10.59 other 10.59 10.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 16714-857-01 NDC GY 1 UN outpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 16714-859-01 NDC GY 1 UN outpatient 1.83 1.79 All Payors / Plans All Payors / Plans 1.83 other 1.83 1.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PALIPERIDONE 1.5 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 0338-0089-03 NDC GY 2 UN outpatient 17.24 16.9 All Payors / Plans All Payors / Plans 17.24 other 17.24 17.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PALIPERIDONE 3 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 0409-7941-03 NDC GY 1 UN outpatient 20.77 20.35 All Payors / Plans All Payors / Plans 20.77 other 20.77 20.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PALIPERIDONE 6 MG TABLET EXTENDED RELEASE 24HR ERX-637000000 CDM A9270 CPT 637 RC 63323-870-74 NDC GY 1 UN outpatient 17.26 16.91 All Payors / Plans All Payors / Plans 17.26 other 17.26 17.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PANCRELIPASE (LIP-PROT-AMYL) 12,000-38,000 -60,000 UNIT CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 43598-413-11 NDC GY 1 UN outpatient 10.64 10.43 All Payors / Plans All Payors / Plans 10.64 other 10.64 10.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PANCRELIPASE (LIP-PROT-AMYL) 6,000-19,000 -30,000 UNIT CAPSULE,DELAYED RELEASE(DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 60505-6229-4 NDC GY 1 UN outpatient 8.63 8.46 All Payors / Plans All Payors / Plans 8.63 other 8.63 8.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PANTOPRAZOLE 20 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 70594-034-01 NDC GY 1 UN outpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 55513-032-01 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 55513-025-01 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-637000000 CDM A9270 CPT 637 RC 55513-028-01 NDC GY 1 UN outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAROXETINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55513-057-01 NDC GY 1 UN outpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAROXETINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55513-111-01 NDC GY 2 UN outpatient 5.25 5.15 All Payors / Plans All Payors / Plans 5.25 other 5.25 5.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAROXETINE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55513-021-01 NDC GY 1 UN outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAROXETINE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55513-023-01 NDC GY 1 UN outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PENICILLIN V POTASSIUM 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55513-730-01 NDC GY 1 UN outpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PENICILLIN V POTASSIUM 250 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55513-710-01 NDC GY 2 UN outpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PERPHENAZINE PER 4 MG ERX-637000000 CDM A9270 CPT 637 RC 55513-710-21 NDC GY 1 UN outpatient 2.65 2.6 All Payors / Plans All Payors / Plans 2.65 other 2.65 2.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PERPHENAZINE PER 8 MG ERX-637000000 CDM A9270 CPT 637 RC 43598-931-11 NDC GY 1 UN outpatient 4.22 4.14 All Payors / Plans All Payors / Plans 4.22 other 4.22 4.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENAZOPYRIDINE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0054-4184-25 NDC GY 1 UN outpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENAZOPYRIDINE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0054-8175-25 NDC GY 1 UN outpatient 2.01 1.97 All Payors / Plans All Payors / Plans 2.01 other 2.01 2.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENOBARBITAL 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6145-01 NDC GY 1 UN outpatient 2.65 2.6 All Payors / Plans All Payors / Plans 2.65 other 2.65 2.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENOBARBITAL 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6145-25 NDC GY 0.5 UN outpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENOBARBITAL 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-165-01 NDC GY 2 UN outpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENOBARBITAL 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 67457-423-00 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYTOIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0338-0089-04 NDC GY 2 UN outpatient 13.59 13.32 All Payors / Plans All Payors / Plans 13.59 other 13.59 13.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYTOIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63323-624-04 NDC GY 2 UN outpatient 3.82 3.74 All Payors / Plans All Payors / Plans 3.82 other 3.82 3.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYTOIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63323-624-06 NDC GY 2 UN outpatient 3.71 3.64 All Payors / Plans All Payors / Plans 3.71 other 3.71 3.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PHENYTOIN 50 MG TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 0409-1273-03 NDC GY 2 UN outpatient 6.92 6.78 All Payors / Plans All Payors / Plans 6.92 other 6.92 6.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHYTONADIONE (VITAMIN K1) 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1273-32 NDC GY 0.5 UN outpatient 29.78 29.18 All Payors / Plans All Payors / Plans 29.78 other 29.78 29.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PILOCARPINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6244-01 NDC GY 1 UN outpatient 8.89 8.71 All Payors / Plans All Payors / Plans 8.89 other 8.89 8.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PINDOLOL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 76045-204-00 NDC GY 1 UN outpatient 4.05 3.97 All Payors / Plans All Payors / Plans 4.05 other 4.05 4.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIOGLITAZONE 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-1980-01 NDC GY 1 UN outpatient 5.02 4.92 All Payors / Plans All Payors / Plans 5.02 other 5.02 5.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POLYETHYLENE GLYCOL 17 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 0641-6173-01 NDC GY 0.235294118 UN outpatient 0.8 0.78 All Payors / Plans All Payors / Plans 0.8 other 0.8 0.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POLYETHYLENE GLYCOL 17 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 0641-6173-10 NDC GY 1 UN outpatient 3.48 3.41 All Payors / Plans All Payors / Plans 3.48 other 3.48 3.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POLYETHYLENE GLYCOL 17 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 72266-127-01 NDC GY 0.5 UN outpatient 1.66 1.63 All Payors / Plans All Payors / Plans 1.66 other 1.66 1.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POLYETHYLENE GLYCOL 236-22.74-6.74 -5.86 GRAM RECON SOLN ERX-637000000 CDM A9270 CPT 637 RC 0904-2056-61 NDC GY 0.0625 UN outpatient 10.31 10.1 All Payors / Plans All Payors / Plans 10.31 other 10.31 10.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM BICARB-CITRIC ACID 10 MEQ TABLET, EFFERVESCENT" ERX-637000000 CDM A9270 CPT 637 RC 63323-664-01 NDC GY 4 UN outpatient 7.94 7.78 All Payors / Plans All Payors / Plans 7.94 other 7.94 7.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM BICARB-CITRIC ACID 20 MEQ TABLET, EFFERVESCENT" ERX-637000000 CDM A9270 CPT 637 RC 72485-101-25 NDC GY 0.5 UN outpatient 1.28 1.25 All Payors / Plans All Payors / Plans 1.28 other 1.28 1.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM BICARB-CITRIC ACID 20 MEQ TABLET, EFFERVESCENT" ERX-637000000 CDM A9270 CPT 637 RC 58160-842-43 NDC GY 1 UN outpatient 2.55 2.5 All Payors / Plans All Payors / Plans 2.55 other 2.55 2.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM CHLORIDE 10 MEQ TABLET,ER PARTICLES/CRYSTALS" ERX-637000000 CDM A9270 CPT 637 RC 58160-842-52 NDC GY 1 UN outpatient 1.08 1.06 All Payors / Plans All Payors / Plans 1.08 other 1.08 1.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM CHLORIDE 10 MEQ TABLET,ER PARTICLES/CRYSTALS" ERX-637000000 CDM A9270 CPT 637 RC 63323-883-05 NDC GY 1 UN outpatient 1.08 1.06 All Payors / Plans All Payors / Plans 1.08 other 1.08 1.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM CHLORIDE 20 MEQ TABLET,ER PARTICLES/CRYSTALS" ERX-637000000 CDM A9270 CPT 637 RC 0069-3032-20 NDC GY 1 UN outpatient 1.83 1.79 All Payors / Plans All Payors / Plans 1.83 other 1.83 1.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM CHLORIDE 20 MEQ TABLET,ER PARTICLES/CRYSTALS" ERX-637000000 CDM A9270 CPT 637 RC 47335-049-40 NDC GY 0.5 UN outpatient 0.56 0.55 All Payors / Plans All Payors / Plans 0.56 other 0.56 0.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM CHLORIDE 20 MEQ TABLET,ER PARTICLES/CRYSTALS" ERX-637000000 CDM A9270 CPT 637 RC 47335-050-40 NDC GY 2 UN outpatient 2.28 2.23 All Payors / Plans All Payors / Plans 2.28 other 2.28 2.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM CITRATE 10 MEQ (1,080 MG) TABLET EXTENDED RELEASE" ERX-637000000 CDM A9270 CPT 637 RC 70710-1531-1 NDC GY 1 UN outpatient 6.99 6.85 All Payors / Plans All Payors / Plans 6.99 other 6.99 6.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM, SODIUM PHOSPHATES 280-160-250 MG POWDER IN PACKET" ERX-637000000 CDM A9270 CPT 637 RC 0517-9702-01 NDC GY 1 UN outpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM, SODIUM PHOSPHATES 280-160-250 MG POWDER IN PACKET" ERX-637000000 CDM A9270 CPT 637 RC 0517-9702-25 NDC GY 1 UN outpatient 4.21 4.13 All Payors / Plans All Payors / Plans 4.21 other 4.21 4.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "POTASSIUM, SODIUM PHOSPHATES 280-160-250 MG POWDER IN PACKET" ERX-637000000 CDM A9270 CPT 637 RC 58160-811-43 NDC GY 1 UN outpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAMIPEXOLE 0.125 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0075-0621-60 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAMIPEXOLE 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0075-2915-00 NDC GY 1 UN outpatient 3.39 3.32 All Payors / Plans All Payors / Plans 3.39 other 3.39 3.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRASUGREL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0075-8025-10 NDC GY 1 UN outpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0548-5602-00 NDC GY 1 UN outpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAZOSIN 1 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0548-5604-00 NDC GY 1 UN outpatient 4.96 4.86 All Payors / Plans All Payors / Plans 4.96 other 4.96 4.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAZOSIN 1 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-006-01 NDC GY 1 UN outpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAZOSIN 1 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-006-10 NDC GY 1 UN outpatient 4.24 4.16 All Payors / Plans All Payors / Plans 4.24 other 4.24 4.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAZOSIN 2 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-016-01 NDC GY 1 UN outpatient 6.85 6.71 All Payors / Plans All Payors / Plans 6.85 other 6.85 6.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAZOSIN 2 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-026-01 NDC GY 1 UN outpatient 6.85 6.71 All Payors / Plans All Payors / Plans 6.85 other 6.85 6.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRAZOSIN 5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-036-01 NDC GY 1 UN outpatient 9.93 9.73 All Payors / Plans All Payors / Plans 9.93 other 9.93 9.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-046-01 NDC GY 2 UN outpatient 5.19 5.09 All Payors / Plans All Payors / Plans 5.19 other 5.19 5.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-056-01 NDC GY 1 UN outpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 100 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-056-10 NDC GY 1 UN outpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 16714-066-01 NDC GY 1 UN outpatient 1.93 1.89 All Payors / Plans All Payors / Plans 1.93 other 1.93 1.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 71839-110-10 NDC GY 1 UN outpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 76329-3318-1 NDC GY 1 UN outpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 50 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 49502-101-01 NDC GY 1 UN outpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 75 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0115-1694-30 NDC GY 1 UN outpatient 2.05 2.01 All Payors / Plans All Payors / Plans 2.05 other 2.05 2.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 75 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0115-1694-49 NDC GY 2 UN outpatient 3.81 3.73 All Payors / Plans All Payors / Plans 3.81 other 3.81 3.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREGABALIN 75 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 42023-159-25 NDC GY 1 UN outpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRENATAL VITAMIN WITH IRON AND FOLIC ACID 27 MG IRON- 800 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 54288-103-10 NDC GY 1 UN outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRENATAL VITAMIN WITH IRON AND FOLIC ACID 27 MG IRON- 800 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59676-310-00 NDC GY 1 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRENATAL VITAMIN WITH IRON AND FOLIC ACID 27 MG IRON- 800 MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0143-9398-01 NDC GY 1 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRIMIDONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0143-9398-10 NDC GY 1 UN outpatient 2.63 2.58 All Payors / Plans All Payors / Plans 2.63 other 2.63 2.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROCHLORPERAZINE MALEATE PER 10 MG ERX-637000000 CDM A9270 CPT 637 RC 60505-6196-0 NDC GY 0.5 UN outpatient 1.71 1.68 All Payors / Plans All Payors / Plans 1.71 other 1.71 1.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROCHLORPERAZINE MALEATE PER 10 MG ERX-637000000 CDM A9270 CPT 637 RC 55150-194-10 NDC GY 1 UN outpatient 2.56 2.51 All Payors / Plans All Payors / Plans 2.56 other 2.56 2.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROCHLORPERAZINE MALEATE PER 5 MG ERX-637000000 CDM A9270 CPT 637 RC 67457-182-10 NDC GY 1 UN outpatient 3.35 3.28 All Payors / Plans All Payors / Plans 3.35 other 3.35 3.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROMETHAZINE 2 (TWO) 25 MG TABLETS ERX-637000000 CDM A9270 CPT 637 RC 63323-739-11 NDC GY 2 UN outpatient 1.93 1.89 All Payors / Plans All Payors / Plans 1.93 other 1.93 1.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROMETHAZINE 25 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 63323-739-12 NDC GY 1 UN outpatient 18.62 18.25 All Payors / Plans All Payors / Plans 18.62 other 18.62 18.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROMETHAZINE 25 MG SUPPOSITORY ERX-637000000 CDM A9270 CPT 637 RC 0338-5197-41 NDC GY 0.5 UN outpatient 5.69 5.58 All Payors / Plans All Payors / Plans 5.69 other 5.69 5.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROMETHAZINE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 0409-9094-22 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPAFENONE 150 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-9094-25 NDC GY 1 UN outpatient 2.59 2.54 All Payors / Plans All Payors / Plans 2.59 other 2.59 2.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPRANOLOL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6027-01 NDC GY 1 UN outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPRANOLOL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6028-01 NDC GY 1 UN outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPRANOLOL 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6247-01 NDC GY 1 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPRANOLOL 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-806-11 NDC GY 1 UN outpatient 1.87 1.83 All Payors / Plans All Payors / Plans 1.87 other 1.87 1.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPRANOLOL 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-806-12 NDC GY 1 UN outpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPRANOLOL 80 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-0650-01 NDC GY 1 UN outpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PROPRANOLOL LA 60 MG CAPSULE,EXTENDED RELEASE 24 HR" ERX-637000000 CDM A9270 CPT 637 RC 61314-318-01 NDC GY 1 UN outpatient 7.02 6.88 All Payors / Plans All Payors / Plans 7.02 other 7.02 7.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PROPRANOLOL LA 80 MG CAPSULE,EXTENDED RELEASE 24 HR" ERX-637000000 CDM A9270 CPT 637 RC 61314-326-01 NDC GY 1 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PROPRANOLOL LA 80 MG CAPSULE,EXTENDED RELEASE 24 HR" ERX-637000000 CDM A9270 CPT 637 RC 0338-6045-37 NDC GY 1 UN outpatient 8.63 8.46 All Payors / Plans All Payors / Plans 8.63 other 8.63 8.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PSEUDOEPHEDRINE 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-117-00 NDC GY 1 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PSEUDOEPHEDRINE 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-117-20 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PYRAZINAMIDE 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0069-6001-10 NDC GY 3 UN outpatient 30.79 30.17 All Payors / Plans All Payors / Plans 30.79 other 30.79 30.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PYRIDOSTIGMINE 60 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0143-9022-02 NDC GY 1 UN outpatient 3.31 3.24 All Payors / Plans All Payors / Plans 3.31 other 3.31 3.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PYRIDOSTIGMINE 60 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 43598-262-02 NDC GY 1 UN outpatient 2.74 2.69 All Payors / Plans All Payors / Plans 2.74 other 2.74 2.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PYRIDOXINE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 43598-262-11 NDC GY 1 UN outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PYRIDOXINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70121-1463-2 NDC GY 1 UN outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-6102-18 NDC GY 1 UN outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-6102-19 NDC GY 1 UN outpatient 2.76 2.7 All Payors / Plans All Payors / Plans 2.76 other 2.76 2.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 16729-500-08 NDC GY 1 UN outpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 16729-500-30 NDC GY 1 UN outpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 23155-473-31 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 23155-473-33 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE XR 200 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 25021-311-10 NDC GY 1 UN outpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE XR 300 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 36000-282-25 NDC GY 1 UN outpatient 2.74 2.69 All Payors / Plans All Payors / Plans 2.74 other 2.74 2.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUETIAPINE XR 50 MG TABLET EXTENDED RELEASE 24 HR ERX-637000000 CDM A9270 CPT 637 RC 36000-283-25 NDC GY 1 UN outpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RALOXIFENE 60 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-280-03 NDC GY 1 UN outpatient 2.77 2.71 All Payors / Plans All Payors / Plans 2.77 other 2.77 2.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RALOXIFENE 60 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-280-04 NDC GY 1 UN outpatient 14.13 13.85 All Payors / Plans All Payors / Plans 14.13 other 14.13 14.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RALTEGRAVIR 400 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72603-133-01 NDC GY 1 UN outpatient 39.79 38.99 All Payors / Plans All Payors / Plans 39.79 other 39.79 39.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RAMIPRIL 1.25 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 72603-133-25 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RAMIPRIL 2.5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 72603-251-01 NDC GY 1 UN outpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RAMIPRIL 5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 72603-474-01 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RANOLAZINE 500 MG TABLET EXTENDED RELEASE 12 HR ERX-637000000 CDM A9270 CPT 637 RC 72603-474-25 NDC GY 1 UN outpatient 4.19 4.11 All Payors / Plans All Payors / Plans 4.19 other 4.19 4.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility REPAGLINIDE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-0181-01 NDC GY 1 UN outpatient 8.99 8.81 All Payors / Plans All Payors / Plans 8.99 other 8.99 8.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIFABUTIN 150 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-0183-01 NDC GY 2 UN outpatient 32.92 32.26 All Payors / Plans All Payors / Plans 32.92 other 32.92 32.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIFAMPIN 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0338-0511-41 NDC GY 1 UN outpatient 6.93 6.79 All Payors / Plans All Payors / Plans 6.93 other 6.93 6.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIFAXIMIN 550 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1207-03 NDC GY 1 UN outpatient 59.46 58.27 All Payors / Plans All Payors / Plans 59.46 other 59.46 59.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RISPERIDONE 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1207-13 NDC GY 0.5 UN outpatient 1.08 1.06 All Payors / Plans All Payors / Plans 1.08 other 1.08 1.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "RISPERIDONE 0.5 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 63323-010-02 NDC GY 1 UN outpatient 4.2 4.12 All Payors / Plans All Payors / Plans 4.2 other 4.2 4.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RISPERIDONE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0548-5850-00 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "RISPERIDONE 1 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 63323-593-03 NDC GY 1 UN outpatient 2.66 2.61 All Payors / Plans All Payors / Plans 2.66 other 2.66 2.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "RISPERIDONE 1 MG TABLET,DISINTEGRATING" ERX-637000000 CDM A9270 CPT 637 RC 63323-596-03 NDC GY 1 UN outpatient 4.24 4.16 All Payors / Plans All Payors / Plans 4.24 other 4.24 4.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RISPERIDONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0143-9682-01 NDC GY 1 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RISPERIDONE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70720-951-30 NDC GY 1 UN outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RISPERIDONE 3 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70720-950-36 NDC GY 0.5 UN outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RISPERIDONE 3 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 49281-547-58 NDC GY 0.5 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIVAROXABAN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 67457-426-00 NDC GY 1 UN outpatient 22.69 22.24 All Payors / Plans All Payors / Plans 22.69 other 22.69 22.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIVAROXABAN 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-2723-01 NDC GY 1 UN outpatient 22.69 22.24 All Payors / Plans All Payors / Plans 22.69 other 22.69 22.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIVAROXABAN 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-2723-30 NDC GY 1 UN outpatient 22.69 22.24 All Payors / Plans All Payors / Plans 22.69 other 22.69 22.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIVAROXABAN 15 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-0391-12 NDC GY 1 UN outpatient 22.69 22.24 All Payors / Plans All Payors / Plans 22.69 other 22.69 22.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIVAROXABAN 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 25021-402-01 NDC GY 1 UN outpatient 15.78 15.46 All Payors / Plans All Payors / Plans 15.78 other 15.78 15.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIVAROXABAN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-519-01 NDC GY 1 UN outpatient 22.23 21.79 All Payors / Plans All Payors / Plans 22.23 other 22.23 22.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPINIROLE 0.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-523-01 NDC GY 1 UN outpatient 1.84 1.8 All Payors / Plans All Payors / Plans 1.84 other 1.84 1.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPINIROLE 0.25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-953-11 NDC GY 1 UN outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPINIROLE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63739-953-25 NDC GY 1 UN outpatient 1.89 1.85 All Payors / Plans All Payors / Plans 1.89 other 1.89 1.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPINIROLE 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 71288-403-01 NDC GY 1 UN outpatient 1.83 1.79 All Payors / Plans All Payors / Plans 1.83 other 1.83 1.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 71288-422-95 NDC GY 1 UN outpatient 3.45 3.38 All Payors / Plans All Payors / Plans 3.45 other 3.45 3.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 25021-400-01 NDC GY 1 UN outpatient 3.45 3.38 All Payors / Plans All Payors / Plans 3.45 other 3.45 3.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 6380750055 NDC GY 1 UN outpatient 3.45 3.38 All Payors / Plans All Payors / Plans 3.45 other 3.45 3.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 6425322233 NDC GY 1 UN outpatient 2.02 1.98 All Payors / Plans All Payors / Plans 2.02 other 2.02 2.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 6425322235 NDC GY 2 UN outpatient 8.49 8.32 All Payors / Plans All Payors / Plans 8.49 other 8.49 8.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 8290306413 NDC GY 1 UN outpatient 4.25 4.17 All Payors / Plans All Payors / Plans 4.25 other 4.25 4.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 6425333335 NDC GY 1 UN outpatient 4.24 4.16 All Payors / Plans All Payors / Plans 4.24 other 4.24 4.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 58160-820-43 NDC GY 1 UN outpatient 2.54 2.49 All Payors / Plans All Payors / Plans 2.54 other 2.54 2.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 58160-820-52 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63833-387-02 NDC GY 1 UN outpatient 2.68 2.63 All Payors / Plans All Payors / Plans 2.68 other 2.68 2.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROSUVASTATIN 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63833-397-01 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SACUBITRIL-VALSARTAN 24-26 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63833-386-02 NDC GY 1 UN outpatient 19.42 19.03 All Payors / Plans All Payors / Plans 19.42 other 19.42 19.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SACUBITRIL-VALSARTAN 49-51 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63833-396-01 NDC GY 1 UN outpatient 19.42 19.03 All Payors / Plans All Payors / Plans 19.42 other 19.42 19.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SACUBITRIL-VALSARTAN 97-103 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 18657-117-01 NDC GY 1 UN outpatient 19.42 19.03 All Payors / Plans All Payors / Plans 19.42 other 19.42 19.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCOPOLAMINE BASE 1 MG OVER 3 DAYS PATCH 3 DAY ERX-637000000 CDM A9270 CPT 637 RC 0517-0901-01 NDC GY 1 UN outpatient 14.01 13.73 All Payors / Plans All Payors / Plans 14.01 other 14.01 14.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCOPOLAMINE BASE 1 MG OVER 3 DAYS PATCH 3 DAY ERX-637000000 CDM A9270 CPT 637 RC 0641-6231-01 NDC GY 1 UN outpatient 28.04 27.48 All Payors / Plans All Payors / Plans 28.04 other 28.04 28.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCOPOLAMINE BASE 1 MG OVER 3 DAYS PATCH 3 DAY ERX-637000000 CDM A9270 CPT 637 RC 0641-6231-25 NDC GY 1 UN outpatient 14.03 13.75 All Payors / Plans All Payors / Plans 14.03 other 14.03 14.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SELEGILINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55150-400-01 NDC GY 1 UN outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SELEGILINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-614-01 NDC GY 1 UN outpatient 6.65 6.52 All Payors / Plans All Payors / Plans 6.65 other 6.65 6.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SENNA 8.6 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0009-0011-03 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SENNA 8.6 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0009-0011-04 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0009-0016-12 NDC GY 2 UN outpatient 1.78 1.74 All Payors / Plans All Payors / Plans 1.78 other 1.78 1.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1312-30 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1283-31 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-5601-25 NDC GY 1 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SERTRALINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44567-705-01 NDC GY 1 UN outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SERTRALINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44567-705-10 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SERTRALINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-322-01 NDC GY 1 UN outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SERTRALINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-437-10 NDC GY 1 UN outpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SERTRALINE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-437-91 NDC GY 1 UN outpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEVELAMER 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-438-20 NDC GY 1 UN outpatient 2.72 2.67 All Payors / Plans All Payors / Plans 2.72 other 2.72 2.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEVELAMER 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-438-92 NDC GY 1 UN outpatient 9.12 8.94 All Payors / Plans All Payors / Plans 9.12 other 9.12 9.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEVELAMER 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-439-40 NDC GY 1 UN outpatient 2.77 2.71 All Payors / Plans All Payors / Plans 2.77 other 2.77 2.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEVELAMER 800 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44206-439-93 NDC GY 1 UN outpatient 9.3 9.11 All Payors / Plans All Payors / Plans 9.3 other 9.3 9.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEVELAMER CARBONATE 0.8 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 49281-423-88 NDC GY 1 UN outpatient 4.18 4.1 All Payors / Plans All Payors / Plans 4.18 other 4.18 4.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SILDENAFIL (PULM.HYPERTENSION) 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 49281-424-88 NDC GY 1 UN outpatient 2.59 2.54 All Payors / Plans All Payors / Plans 2.59 other 2.59 2.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SILVER NITRATE 75-25 % STICK ERX-637000000 CDM A9270 CPT 637 RC 60505-6128-0 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SIMETHICONE 80 MG TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 60505-6128-1 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SIMETHICONE 80 MG TABLET,CHEWABLE" ERX-637000000 CDM A9270 CPT 637 RC 0517-2310-05 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIMVASTATIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-2340-01 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIMVASTATIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-2340-10 NDC GY 0.5 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIMVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-0069-10 NDC GY 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIMVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-0072-25 NDC GY 2 UN outpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIMVASTATIN 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-3793-19 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIMVASTATIN 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-3795-19 NDC GY 1 UN outpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SITAGLIPTIN PHOSPHATE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 25021-700-01 NDC GY 1 UN outpatient 26.62 26.09 All Payors / Plans All Payors / Plans 26.62 other 26.62 26.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SITAGLIPTIN PHOSPHATE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-161-00 NDC GY 1 UN outpatient 26.62 26.09 All Payors / Plans All Payors / Plans 26.62 other 26.62 26.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SOD PHOS DI, MONO-K PHOS MONO 250 MG TABLET" ERX-637000000 CDM A9270 CPT 637 RC 68462-756-01 NDC GY 1 UN outpatient 2.72 2.67 All Payors / Plans All Payors / Plans 2.72 other 2.72 2.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 650 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68462-756-25 NDC GY 1 UN outpatient 0.97 0.95 All Payors / Plans All Payors / Plans 0.97 other 0.97 0.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 650 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72266-118-01 NDC GY 1 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 650 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72266-118-25 NDC GY 1 UN outpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM BICARBONATE 650 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 72266-119-01 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SODIUM CHLORIDE 1,000 MG TABLET,SOLUBLE" ERX-637000000 CDM A9270 CPT 637 RC 72266-119-25 NDC GY 1 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SODIUM CHLORIDE 1,000 MG TABLET,SOLUBLE" ERX-637000000 CDM A9270 CPT 637 RC 72266-234-01 NDC GY 2 UN outpatient 2.14 2.1 All Payors / Plans All Payors / Plans 2.14 other 2.14 2.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SODIUM CHLORIDE 1,000 MG TABLET,SOLUBLE" ERX-637000000 CDM A9270 CPT 637 RC 72266-234-25 NDC GY 1 UN outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 72611-722-25 NDC GY 1 UN outpatient 10.88 10.66 All Payors / Plans All Payors / Plans 10.88 other 10.88 10.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 36000-320-01 NDC GY 1 UN outpatient 10.93 10.71 All Payors / Plans All Payors / Plans 10.93 other 10.93 10.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM ZIRCONIUM CYCLOSILICATE 5 GRAM POWDER IN PACKET ERX-637000000 CDM A9270 CPT 637 RC 25021-791-20 NDC GY 1 UN outpatient 10.93 10.71 All Payors / Plans All Payors / Plans 10.93 other 10.93 10.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOTALOL 80 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69543-455-20 NDC GY 0.5 UN outpatient 3.53 3.46 All Payors / Plans All Payors / Plans 3.53 other 3.53 3.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOTALOL 80 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-0117-03 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPIRONOLACTONE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0338-0117-04 NDC GY 1 UN outpatient 2.56 2.51 All Payors / Plans All Payors / Plans 2.56 other 2.56 2.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPIRONOLACTONE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 65219-479-05 NDC GY 0.5 UN outpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPIRONOLACTONE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 15054-1120-4 NDC GY 2 UN outpatient 2.12 2.08 All Payors / Plans All Payors / Plans 2.12 other 2.12 2.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPIRONOLACTONE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 58468-0070-1 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPIRONOLACTONE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-711-00 NDC GY 1 UN outpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCRALFATE 1 GRAM TABLET ERX-637000000 CDM A9270 CPT 637 RC 67457-528-10 NDC GY 1 UN outpatient 1.83 1.79 All Payors / Plans All Payors / Plans 1.83 other 1.83 1.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCRALFATE 1 GRAM TABLET ERX-637000000 CDM A9270 CPT 637 RC 62935-227-10 NDC GY 1 UN outpatient 10.33 10.12 All Payors / Plans All Payors / Plans 10.33 other 10.33 10.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62935-306-40 NDC GY 1 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 62935-756-80 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0074-3663-03 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SULFASALAZINE 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0074-3641-03 NDC GY 1 UN outpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUMATRIPTAN 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1886-02 NDC GY 1 UN outpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUMATRIPTAN 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1886-22 NDC GY 1 UN outpatient 1.85 1.81 All Payors / Plans All Payors / Plans 1.85 other 1.85 1.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAMOXIFEN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-885-10 NDC GY 2 UN outpatient 2.07 2.03 All Payors / Plans All Payors / Plans 2.07 other 2.07 2.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAMSULOSIN 0.4 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63323-890-10 NDC GY 1 UN outpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAMSULOSIN 0.4 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-4279-02 NDC GY 1 UN outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TEMAZEPAM 15 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-4713-02 NDC GY 2 UN outpatient 1.92 1.88 All Payors / Plans All Payors / Plans 1.92 other 1.92 1.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TEMAZEPAM 7.5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-4713-12 NDC GY 1 UN outpatient 8.74 8.57 All Payors / Plans All Payors / Plans 8.74 other 8.74 8.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TERAZOSIN 1 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 55150-161-02 NDC GY 1 UN outpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TERAZOSIN 1 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 55150-162-05 NDC GY 1 UN outpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TERAZOSIN 5 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63323-492-04 NDC GY 1 UN outpatient 2.63 2.58 All Payors / Plans All Payors / Plans 2.63 other 2.63 2.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THIAMINE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-492-07 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-492-09 NDC GY 0.5 UN outpatient 0.51 0.5 All Payors / Plans All Payors / Plans 0.51 other 0.51 0.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THIOTHIXENE 10 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 63323-492-27 NDC GY 1 UN outpatient 6.92 6.78 All Payors / Plans All Payors / Plans 6.92 other 6.92 6.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THYROID (PORK) 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-492-41 NDC GY 1 UN outpatient 3.49 3.42 All Payors / Plans All Payors / Plans 3.49 other 3.49 3.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THYROID (PORK) 60 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-492-57 NDC GY 1 UN outpatient 3.32 3.25 All Payors / Plans All Payors / Plans 3.32 other 3.32 3.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIZANIDINE 4 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 69623-191-37 NDC GY 0.5 UN outpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIZANIDINE 4 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 83090-003-10 NDC GY 1 UN outpatient 1.91 1.87 All Payors / Plans All Payors / Plans 1.91 other 1.91 1.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOLTERODINE 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55150-242-51 NDC GY 1 UN outpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOPIRAMATE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1985-03 NDC GY 1 UN outpatient 1.93 1.89 All Payors / Plans All Payors / Plans 1.93 other 1.93 1.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOPIRAMATE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 0641-6001-01 NDC GY 1 UN outpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOPIRAMATE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 0641-6044-01 NDC GY 1 UN outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOPIRAMATE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 0641-6044-25 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOPIRAMATE PER 25 MG ERX-637000000 CDM A9270 CPT 637 RC 0641-6207-01 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TORSEMIDE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-108-01 NDC GY 1 UN outpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TORSEMIDE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-106-01 NDC GY 1 UN outpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TORSEMIDE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-2168-17 NDC GY 2 UN outpatient 2.24 2.2 All Payors / Plans All Payors / Plans 2.24 other 2.24 2.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TORSEMIDE 20 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-064-01 NDC GY 1 UN outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAMADOL 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-064-03 NDC GY 1 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAMADOL 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-064-04 NDC GY 0.5 UN outpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAMADOL 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-642-01 NDC GY 1 UN outpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAMADOL 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-4031-01 NDC GY 1 UN outpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAZODONE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-4031-16 NDC GY 1 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAZODONE 100 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0006-4681-01 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAZODONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0009-0746-30 NDC GY 1 UN outpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAZODONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55150-329-01 NDC GY 1 UN outpatient 0.98 0.96 All Payors / Plans All Payors / Plans 0.98 other 0.98 0.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAZODONE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 67457-887-00 NDC GY 1 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 58160-976-02 NDC GY 1 UN outpatient 3.35 3.28 All Payors / Plans All Payors / Plans 3.35 other 3.35 3.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRIAMTERENE-HYDROCHLOROTHIAZIDE 75-50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6052-01 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ULIPRISTAL 30 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 47335-235-83 NDC GY 1 UN outpatient 44.86 43.96 All Payors / Plans All Payors / Plans 44.86 other 44.86 44.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility URSODIOL 300 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0143-9519-01 NDC GY 1 UN outpatient 10.07 9.87 All Payors / Plans All Payors / Plans 10.07 other 10.07 10.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALACYCLOVIR 500 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0517-0740-01 NDC GY 1 UN outpatient 8.95 8.77 All Payors / Plans All Payors / Plans 8.95 other 8.95 8.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALPROIC ACID 250 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0517-0740-20 NDC GY 2 UN outpatient 2.03 1.99 All Payors / Plans All Payors / Plans 2.03 other 2.03 2.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALSARTAN 160 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 59746-001-06 NDC GY 1 UN outpatient 4.08 4 All Payors / Plans All Payors / Plans 4.08 other 4.08 4.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALSARTAN 320 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 68382-916-01 NDC GY 1 UN outpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALSARTAN 320 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70121-1573-1 NDC GY 1 UN outpatient 2.56 2.51 All Payors / Plans All Payors / Plans 2.56 other 2.56 2.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALSARTAN 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70121-1573-5 NDC GY 1 UN outpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALSARTAN 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0009-0018-20 NDC GY 1 UN outpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALSARTAN 80 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0009-0047-22 NDC GY 1 UN outpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 125 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0009-0047-25 NDC GY 1 UN outpatient 9.11 8.93 All Payors / Plans All Payors / Plans 9.11 other 9.11 9.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 125 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0009-0039-28 NDC GY 1 UN outpatient 8.9 8.72 All Payors / Plans All Payors / Plans 8.9 other 8.9 8.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 125 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0009-0039-30 NDC GY 1 UN outpatient 4.07 3.99 All Payors / Plans All Payors / Plans 4.07 other 4.07 4.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VARENICLINE 0.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-3414-01 NDC GY 1 UN outpatient 3.55 3.48 All Payors / Plans All Payors / Plans 3.55 other 3.55 3.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VENLAFAXINE 25 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-3414-11 NDC GY 1 UN outpatient 3.45 3.38 All Payors / Plans All Payors / Plans 3.45 other 3.45 3.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VENLAFAXINE 37.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-3414-18 NDC GY 1 UN outpatient 2 1.96 All Payors / Plans All Payors / Plans 2 other 2 2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VENLAFAXINE 75 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-3414-21 NDC GY 1 UN outpatient 2.71 2.66 All Payors / Plans All Payors / Plans 2.71 other 2.71 2.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "VENLAFAXINE XR 150 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 0703-4502-01 NDC GY 0.75 UN outpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "VENLAFAXINE XR 37.5 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 23155-240-31 NDC GY 1 UN outpatient 0.96 0.94 All Payors / Plans All Payors / Plans 0.96 other 0.96 0.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "VENLAFAXINE XR 37.5 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 23155-240-41 NDC GY 1 UN outpatient 1.95 1.91 All Payors / Plans All Payors / Plans 1.95 other 1.95 1.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "VENLAFAXINE XR 75 MG CAPSULE,EXTENDED RELEASE 24HR" ERX-637000000 CDM A9270 CPT 637 RC 0338-1055-48 NDC GY 1 UN outpatient 1.98 1.94 All Payors / Plans All Payors / Plans 1.98 other 1.98 1.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERAPAMIL 120 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-0152-01 NDC GY 1 UN outpatient 0.94 0.92 All Payors / Plans All Payors / Plans 0.94 other 0.94 0.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERAPAMIL 40 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 47335-993-01 NDC GY 1 UN outpatient 1.02 1 All Payors / Plans All Payors / Plans 1.02 other 1.02 1.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERAPAMIL 80 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0143-9362-01 NDC GY 1 UN outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERAPAMIL SR 120 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 63323-729-01 NDC GY 1 UN outpatient 1.92 1.88 All Payors / Plans All Payors / Plans 1.92 other 1.92 1.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERAPAMIL SR 180 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 0469-3250-10 NDC GY 1 UN outpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERAPAMIL SR 240 MG TABLET EXTENDED RELEASE ERX-637000000 CDM A9270 CPT 637 RC 25021-190-10 NDC GY 1 UN outpatient 1.83 1.79 All Payors / Plans All Payors / Plans 1.83 other 1.83 1.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VIT B COMP NO.3-FOLIC-C-BIOTIN 1-60-300 MG-MG-MCG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-2305-04 NDC GY 1 UN outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VITAMIN E 180 MG (400 UNIT) CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-2305-05 NDC GY 1 UN outpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VORICONAZOLE 200 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-2305-16 NDC GY 1 UN outpatient 16.37 16.04 All Payors / Plans All Payors / Plans 16.37 other 16.37 16.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VORICONAZOLE 50 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-2305-17 NDC GY 6 UN outpatient 25.14 24.64 All Payors / Plans All Payors / Plans 25.14 other 25.14 25.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VORTIOXETINE 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 70069-816-01 NDC GY 1 UN outpatient 24.04 23.56 All Payors / Plans All Payors / Plans 24.04 other 24.04 24.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VORTIOXETINE 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44567-611-01 NDC GY 1 UN outpatient 24.04 23.56 All Payors / Plans All Payors / Plans 24.04 other 24.04 24.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WARFARIN 1 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 44567-611-10 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WARFARIN 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-2308-01 NDC GY 1 UN outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WARFARIN 2 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-2308-21 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WARFARIN 2.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55150-288-01 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WARFARIN 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 55150-288-10 NDC GY 1 UN outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WARFARIN 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1893-03 NDC GY 1 UN outpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WARFARIN 7.5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0409-1890-03 NDC GY 1 UN outpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 76329-1912-1 NDC GY 1 UN outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZIPRASIDONE 20 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-1891-01 NDC GY 1 UN outpatient 9.31 9.12 All Payors / Plans All Payors / Plans 9.31 other 9.31 9.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZIPRASIDONE 20 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-1891-03 NDC GY 1 UN outpatient 7.05 6.91 All Payors / Plans All Payors / Plans 7.05 other 7.05 7.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZIPRASIDONE 40 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0409-3815-12 NDC GY 1 UN outpatient 6.81 6.67 All Payors / Plans All Payors / Plans 6.81 other 6.81 6.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZIPRASIDONE 40 MG CAPSULE ERX-637000000 CDM A9270 CPT 637 RC 0641-6127-01 NDC GY 1 UN outpatient 6.81 6.67 All Payors / Plans All Payors / Plans 6.81 other 6.81 6.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZOLPIDEM 10 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0641-6127-25 NDC GY 1 UN outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZOLPIDEM 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 63323-451-00 NDC GY 1 UN outpatient 0.93 0.91 All Payors / Plans All Payors / Plans 0.93 other 0.93 0.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZOLPIDEM 5 MG TABLET ERX-637000000 CDM A9270 CPT 637 RC 0143-9570-01 NDC GY 2 UN outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACOSAMIDE 200 MG/20 ML SOLUTION ERX-636000000 CDM C9254 HCPCS 636 RC 0904-6830-61 NDC JZ 5 ML outpatient 25.58 25.07 All Payors / Plans All Payors / Plans 25.58 other 25.58 25.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACOSAMIDE 200 MG/20 ML SOLUTION ERX-636000000 CDM C9254 HCPCS 636 RC 60687-428-11 NDC JZ 20 ML outpatient 145.47 142.56 All Payors / Plans All Payors / Plans 145.47 other 145.47 145.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANGRELOR 50 MG RECON SOLN ERX-636000000 CDM C9460 HCPCS 636 RC 0206-8862-01 NDC JZ 0.02994 UN outpatient 46.99 46.05 All Payors / Plans All Payors / Plans 46.99 other 46.99 46.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANGRELOR 50 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM C9460 HCPCS 636 RC 0781-3113-90 NDC JZ 1 UN outpatient 1569.18 1537.8 All Payors / Plans All Payors / Plans 1569.18 other 1569.18 1569.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) SOLUTION" ERX-636000000 CDM J0131 HCPCS 636 RC 0264-7510-10 NDC 100 ML outpatient 35.45 34.74 All Payors / Plans All Payors / Plans 35.45 other 35.45 35.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) SOLUTION" ERX-636000000 CDM J0131 HCPCS 636 RC 0264-7510-20 NDC 100 ML outpatient 35.92 35.2 All Payors / Plans All Payors / Plans 35.92 other 35.92 35.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETYLCYSTEINE PER 100 MG ERX-636000000 CDM J0132 HCPCS 636 RC 0904-7243-61 NDC JZ 25 ML outpatient 118.81 116.43 All Payors / Plans All Payors / Plans 118.81 other 118.81 118.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACYCLOVIR PER 5 MG ERX-636000000 CDM J0133 HCPCS 636 RC 60687-807-11 NDC JW 1 ML outpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACYCLOVIR PER 5 MG ERX-636000000 CDM J0133 HCPCS 636 RC 0555-0158-02 NDC JW 4 ML outpatient 5.1 5 All Payors / Plans All Payors / Plans 5.1 other 5.1 5.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) SOLUTION" ERX-636000000 CDM J0136 HCPCS 636 RC 51079-141-01 NDC JW 7 ML outpatient 2.18 2.14 All Payors / Plans All Payors / Plans 2.18 other 2.18 2.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) SOLUTION" ERX-636000000 CDM J0137 HCPCS 636 RC 0409-7929-03 NDC 100 ML outpatient 62.8 61.54 All Payors / Plans All Payors / Plans 62.8 other 62.8 62.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADENOSINE PER 6 MG ERX-636000000 CDM J0153 HCPCS 636 RC 43598-326-75 NDC JZ 6 ML outpatient 0.13 0.13 All Payors / Plans All Payors / Plans 0.13 other 0.13 0.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADENOSINE PER 6 MG ERX-636000000 CDM J0153 HCPCS 636 RC 53746-831-53 NDC JZ 2 ML outpatient 30.93 30.31 All Payors / Plans All Payors / Plans 30.93 other 30.93 30.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADENOSINE PER 6 MG ERX-636000000 CDM J0153 HCPCS 636 RC 0904-6084-61 NDC JZ 0.6 ML outpatient 9.28 9.09 All Payors / Plans All Payors / Plans 9.28 other 9.28 9.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE 1 MG/ML SOLUTION ERX-636000000 CDM J0171 HCPCS 636 RC 25021-132-82 NDC 1 ML outpatient 25.77 25.25 All Payors / Plans All Payors / Plans 25.77 other 25.77 25.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE HCL IN 5% DEXTROSE 4 MG/250 ML (16 MCG/ML) SOLUTION ERX-636000000 CDM J0171 HCPCS 636 RC 0338-0409-03 NDC 2 ML outpatient 0.66 0.65 All Payors / Plans All Payors / Plans 0.66 other 0.66 0.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE HCL IN 5% DEXTROSE 4 MG/250 ML (16 MCG/ML) SOLUTION ERX-636000000 CDM J0171 HCPCS 636 RC 57664-683-31 NDC 254 ML outpatient 185.9 182.18 All Payors / Plans All Payors / Plans 185.9 other 185.9 185.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE 0.1 MG/ML SYRINGE ERX-636000000 CDM J0171 HCPCS 636 RC 69339-152-01 NDC JZ 10 ML outpatient 50.17 49.17 All Payors / Plans All Payors / Plans 50.17 other 50.17 50.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE PER 0.1 MG ERX-636000000 CDM J0171 HCPCS 636 RC 71399-0125-8 NDC JZ 0.1 ML outpatient 6.18 6.06 All Payors / Plans All Payors / Plans 6.18 other 6.18 6.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE PER 0.1 MG ERX-636000000 CDM J0171 HCPCS 636 RC 0121-0978-10 NDC JZ 0.3 ML outpatient 13.39 13.12 All Payors / Plans All Payors / Plans 13.39 other 13.39 13.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE 0.15 MG/0.3 ML AUTO-INJECTOR ERX-636000000 CDM J0171 HCPCS 636 RC 63323-269-50 NDC JZ 1 UN outpatient 347.2 340.26 All Payors / Plans All Payors / Plans 347.2 other 347.2 347.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE 0.3 MG/0.3 ML AUTO-INJECTOR ERX-636000000 CDM J0171 HCPCS 636 RC 63323-269-94 NDC JZ 1 UN outpatient 322.38 315.93 All Payors / Plans All Payors / Plans 322.38 other 322.38 322.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPINEPHRINE 0.3 MG/0.3 ML AUTO-INJECTOR ERX-636000000 CDM J0171 HCPCS 636 RC 63323-229-01 NDC JZ 1 UN outpatient 307.17 301.03 All Payors / Plans All Payors / Plans 307.17 other 307.17 307.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AGALSIDASE BETA PER 1 MG ERX-636000000 CDM J0180 HCPCS 636 RC 0078-0825-81 NDC JZ 1 UN outpatient 8139.19 7976.41 All Payors / Plans All Payors / Plans 8139.19 other 8139.19 8139.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AGALSIDASE BETA PER 1 MG ERX-636000000 CDM J0180 HCPCS 636 RC 55150-308-01 NDC JZ 5 UN outpatient 8746.2 8571.28 All Payors / Plans All Payors / Plans 8746.2 other 8746.2 8746.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APREPITANT 130 MG/18 ML (7.2 MG/ML) EMULSION ERX-636000000 CDM J0185 HCPCS 636 RC 0009-0760-04 NDC JZ 18 ML outpatient 629.64 617.05 All Payors / Plans All Payors / Plans 629.64 other 629.64 629.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility REMDESIVIR 100 MG RECON SOLN 1 EACH VIAL ERX-250000000 CDM J0248 HCPCS 250 RC 63323-377-01 NDC JZ 1 UN outpatient 1283.94 1258.26 All Payors / Plans All Payors / Plans 1283.94 other 1283.94 1283.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMINOPHYLLINE 500 MG/20 ML SOLUTION ERX-636000000 CDM J0280 HCPCS 636 RC 0904-5959-61 NDC JZ 3 ML outpatient 7.46 7.31 All Payors / Plans All Payors / Plans 7.46 other 7.46 7.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMINOPHYLLINE PER 250 MG ERX-636000000 CDM J0280 HCPCS 636 RC 65862-185-01 NDC JZ 3 ML outpatient 19.56 19.17 All Payors / Plans All Payors / Plans 19.56 other 19.56 19.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMIODARONE IN DEXTROSE,ISO-OSM 150 MG/100 ML (1.5 MG/ML) SOLUTION" ERX-636000000 CDM J0283 HCPCS 636 RC 0168-0277-40 NDC JZ 100 ML outpatient 104.65 102.56 All Payors / Plans All Payors / Plans 104.65 other 104.65 104.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "AMIODARONE IN DEXTROSE,ISO-OSM 360 MG/200 ML (1.8 MG/ML) SOLUTION" ERX-636000000 CDM J0283 HCPCS 636 RC 63629-2391-1 NDC JZ 200 ML outpatient 102.76 100.7 All Payors / Plans All Payors / Plans 102.76 other 102.76 102.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 60687-486-11 NDC 0.5 UN outpatient 5.2 5.1 All Payors / Plans All Payors / Plans 5.2 other 5.2 5.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 68180-968-01 NDC 1 UN outpatient 25.76 25.24 All Payors / Plans All Payors / Plans 25.76 other 25.76 25.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 23155-547-42 NDC JZ 0.29 UN outpatient 0.24 0.24 All Payors / Plans All Payors / Plans 0.24 other 0.24 0.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 60505-6130-0 NDC JZ 0.29 UN outpatient 0.24 0.24 All Payors / Plans All Payors / Plans 0.24 other 0.24 0.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 60505-6130-5 NDC JZ 0.54 UN outpatient 3.19 3.13 All Payors / Plans All Payors / Plans 3.19 other 3.19 3.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 71288-101-10 NDC JZ 1 UN outpatient 15.45 15.14 All Payors / Plans All Payors / Plans 15.45 other 15.45 15.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 42023-116-25 NDC JZ 0.57 UN outpatient 5.79 5.67 All Payors / Plans All Payors / Plans 5.79 other 5.79 5.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 55111-694-07 NDC JZ 1 UN outpatient 15.48 15.17 All Payors / Plans All Payors / Plans 15.48 other 15.48 15.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN PER 500 MG ERX-636000000 CDM J0290 HCPCS 636 RC 61703-325-18 NDC JZ 1 UN outpatient 10.99 10.77 All Payors / Plans All Payors / Plans 10.99 other 10.99 10.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN-SULBACTAM PER 1.5 G ERX-636000000 CDM J0295 HCPCS 636 RC 67457-430-10 NDC JZ 1 UN outpatient 11.09 10.87 All Payors / Plans All Payors / Plans 11.09 other 11.09 11.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN-SULBACTAM PER 1.5 G ERX-636000000 CDM J0295 HCPCS 636 RC 14789-121-05 NDC JZ 1 UN outpatient 20.4 19.99 All Payors / Plans All Payors / Plans 20.4 other 20.4 20.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN-SULBACTAM PER 1.5 G ERX-636000000 CDM J0295 HCPCS 636 RC 55513-190-01 NDC JZ 1 UN outpatient 20.4 19.99 All Payors / Plans All Payors / Plans 20.4 other 20.4 20.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN-SULBACTAM PER 1.5 G ERX-636000000 CDM J0295 HCPCS 636 RC 70114-130-01 NDC JZ 1 UN outpatient 10.53 10.32 All Payors / Plans All Payors / Plans 10.53 other 10.53 10.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN-SULBACTAM PER 1.5 G ERX-636000000 CDM J0295 HCPCS 636 RC 43598-387-11 NDC JZ 1 UN outpatient 15.88 15.56 All Payors / Plans All Payors / Plans 15.88 other 15.88 15.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AMPICILLIN-SULBACTAM PER 1.5 G ERX-636000000 CDM J0295 HCPCS 636 RC 0781-6135-94 NDC JZ 1 UN outpatient 20.87 20.45 All Payors / Plans All Payors / Plans 20.87 other 20.87 20.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCCINYLCHOLINE CHLORIDE 100 MG/5 ML (20 MG/ML) SYRINGE ERX-250000000 CDM J0330 HCPCS 250 RC 60687-525-11 NDC JZ 0.5 ML outpatient 6.32 6.19 All Payors / Plans All Payors / Plans 6.32 other 6.32 6.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUCCINYLCHOLINE PER 20 MG ERX-636000000 CDM J0330 HCPCS 636 RC 25021-826-82 NDC 7.5 ML outpatient 69 67.62 All Payors / Plans All Payors / Plans 69 other 69 69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE PER 20 MG ERX-636000000 CDM J0360 HCPCS 636 RC 6936728302 NDC JZ 0.5 ML outpatient 17.78 17.42 All Payors / Plans All Payors / Plans 17.78 other 17.78 17.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE PER 20 MG ERX-636000000 CDM J0360 HCPCS 636 RC 90000-002-51 NDC JZ 0.25 ML outpatient 7.75 7.6 All Payors / Plans All Payors / Plans 7.75 other 7.75 7.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE PER 20 MG ERX-636000000 CDM J0360 HCPCS 636 RC 0574-4024-11 NDC JZ 0.5 ML outpatient 15.49 15.18 All Payors / Plans All Payors / Plans 15.49 other 15.49 15.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE PER 20 MG ERX-636000000 CDM J0360 HCPCS 636 RC 48102-057-11 NDC JZ 0.5 ML outpatient 8.03 7.87 All Payors / Plans All Payors / Plans 8.03 other 8.03 8.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDRALAZINE PER 20 MG ERX-636000000 CDM J0360 HCPCS 636 RC 72485-670-31 NDC JZ 0.2 ML outpatient 3.21 3.15 All Payors / Plans All Payors / Plans 3.21 other 3.21 3.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN PER 500 MG ERX-636000000 CDM J0456 HCPCS 636 RC 76329-3015-5 NDC 0.264 UN outpatient 2.89 2.83 All Payors / Plans All Payors / Plans 2.89 other 2.89 2.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN PER 500 MG ERX-636000000 CDM J0456 HCPCS 636 RC 42494-416-01 NDC JZ 1 UN outpatient 45.23 44.33 All Payors / Plans All Payors / Plans 45.23 other 45.23 45.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN PER 500 MG ERX-636000000 CDM J0456 HCPCS 636 RC 0143-9564-01 NDC JZ 0.5 UN outpatient 22.62 22.17 All Payors / Plans All Payors / Plans 22.62 other 22.62 22.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN PER 500 MG ERX-636000000 CDM J0456 HCPCS 636 RC 70004-810-11 NDC JZ 0.5 UN outpatient 5.37 5.26 All Payors / Plans All Payors / Plans 5.37 other 5.37 5.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZITHROMYCIN PER 500 MG ERX-636000000 CDM J0456 HCPCS 636 RC 0641-0493-21 NDC JZ 1 UN outpatient 10.73 10.52 All Payors / Plans All Payors / Plans 10.73 other 10.73 10.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZTREONAM 1 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J0457 HCPCS 636 RC 0641-2555-41 NDC JZ 1 UN outpatient 103.42 101.35 All Payors / Plans All Payors / Plans 103.42 other 103.42 103.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZTREONAM 2 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J0457 HCPCS 636 RC 42192-614-05 NDC JZ 1 UN outpatient 187.05 183.31 All Payors / Plans All Payors / Plans 187.05 other 187.05 187.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZTREONAM 2 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J0457 HCPCS 636 RC 76329-1240-1 NDC JZ 1 UN outpatient 151.99 148.95 All Payors / Plans All Payors / Plans 151.99 other 151.99 151.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZTREONAM 2 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J0457 HCPCS 636 RC 43598-405-11 NDC JZ 1 UN outpatient 151.99 148.95 All Payors / Plans All Payors / Plans 151.99 other 151.99 151.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE 1 MG/ML SOLUTION ERX-636000000 CDM J0461 HCPCS 636 RC 49884-307-02 NDC JZ 1 ML outpatient 36.36 35.63 All Payors / Plans All Payors / Plans 36.36 other 36.36 36.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE PER 0.01 MG ERX-636000000 CDM J0461 HCPCS 636 RC 62332-365-06 NDC JZ 5 ML outpatient 22.53 22.08 All Payors / Plans All Payors / Plans 22.53 other 22.53 22.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE PER 0.01 MG ERX-636000000 CDM J0461 HCPCS 636 RC 0904-7227-61 NDC JZ 5 ML outpatient 22.53 22.08 All Payors / Plans All Payors / Plans 22.53 other 22.53 22.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE PER 0.01 MG ERX-636000000 CDM J0461 HCPCS 636 RC 16729-136-00 NDC JZ 1 ML outpatient 25.66 25.15 All Payors / Plans All Payors / Plans 25.66 other 25.66 25.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE PER 0.01 MG ERX-636000000 CDM J0461 HCPCS 636 RC 16729-136-16 NDC JZ 7.5 ML outpatient 192.39 188.54 All Payors / Plans All Payors / Plans 192.39 other 192.39 192.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ATROPINE PER 0.01 MG ERX-636000000 CDM J0461 HCPCS 636 RC 60687-544-11 NDC JZ 10 ML outpatient 40.42 39.61 All Payors / Plans All Payors / Plans 40.42 other 40.42 40.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE PER 20 MG ERX-636000000 CDM J0500 HCPCS 636 RC 0574007015 NDC JZ 2 ML outpatient 65.16 63.86 All Payors / Plans All Payors / Plans 65.16 other 65.16 65.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE PER 20 MG ERX-636000000 CDM J0500 HCPCS 636 RC 51079-284-01 NDC JZ 2 ML outpatient 81.39 79.76 All Payors / Plans All Payors / Plans 81.39 other 81.39 81.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE PER 20 MG ERX-636000000 CDM J0500 HCPCS 636 RC 51079-284-20 NDC JZ 1 ML outpatient 40.7 39.89 All Payors / Plans All Payors / Plans 40.7 other 40.7 40.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DICYCLOMINE PER 20 MG ERX-636000000 CDM J0500 HCPCS 636 RC 51079-285-01 NDC JZ 1 ML outpatient 30.46 29.85 All Payors / Plans All Payors / Plans 30.46 other 30.46 30.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZTROPINE MESYLATE PER 1 MG ERX-636000000 CDM J0515 HCPCS 636 RC 0904-7728-61 NDC JZ 1 ML outpatient 66.12 64.8 All Payors / Plans All Payors / Plans 66.12 other 66.12 66.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BENZTROPINE MESYLATE PER 1 MG ERX-636000000 CDM J0515 HCPCS 636 RC 60687-555-11 NDC JZ 2 ML outpatient 104.39 102.3 All Payors / Plans All Payors / Plans 104.39 other 104.39 104.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PENICILLIN G BENZATHINE PER 1200000 UNITS ERX-636000000 CDM J0561 HCPCS 636 RC 68094-004-59 NDC JG 0.23 ML outpatient 76.89 75.35 All Payors / Plans All Payors / Plans 76.89 other 76.89 76.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PENICILLIN G BENZATHINE PER 2400000 UNITS ERX-636000000 CDM J0561 HCPCS 636 RC 45802-147-53 NDC JG 4 ML outpatient 1209.8 1185.6 All Payors / Plans All Payors / Plans 1209.8 other 1209.8 1209.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM GLUCONATE PER 10 MG ERX-250000000 CDM J0612 HCPCS 250 RC 65219-184-20 NDC 10 ML outpatient 39.85 39.05 All Payors / Plans All Payors / Plans 39.85 other 39.85 39.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM GLUCONATE PER 10 MG ERX-250000000 CDM J0612 HCPCS 250 RC 2055503300 NDC JZ 2.4 ML outpatient 9.58 9.39 All Payors / Plans All Payors / Plans 9.58 other 9.58 9.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM GLUCONATE PER 10 MG ERX-250000000 CDM J0612 HCPCS 250 RC 8068116801 NDC JZ 23 ML outpatient 38.55 37.78 All Payors / Plans All Payors / Plans 38.55 other 38.55 38.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM GLUCONATE PER 10 MG ERX-250000000 CDM J0612 HCPCS 250 RC 42806-266-98 NDC JZ 10 ML outpatient 39.89 39.09 All Payors / Plans All Payors / Plans 39.89 other 39.89 39.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM GLUCONATE IN NACL 1 GRAM/50 ML SOLUTION ERX-250000000 CDM J0613 HCPCS 250 RC 0054-0046-41 NDC 50 ML outpatient 40.4 39.59 All Payors / Plans All Payors / Plans 40.4 other 40.4 40.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM GLUCONATE IN NACL 2 GRAM/100 ML SOLUTION ERX-250000000 CDM J0613 HCPCS 250 RC 16714-527-01 NDC 100 ML outpatient 82.67 81.02 All Payors / Plans All Payors / Plans 82.67 other 82.67 82.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CALCIUM GLUCONATE IN NACL 2 GRAM/100 ML SOLUTION ERX-250000000 CDM J0613 HCPCS 250 RC 14789-015-05 NDC 100 ML outpatient 82.67 81.02 All Payors / Plans All Payors / Plans 82.67 other 82.67 82.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUCOVORIN CALCIUM PER 50 MG ERX-636000000 CDM J0640 HCPCS 636 RC 63739-052-74 NDC JW 5 ML outpatient 6.51 6.38 All Payors / Plans All Payors / Plans 6.51 other 6.51 6.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUCOVORIN CALCIUM PER 50 MG ERX-636000000 CDM J0640 HCPCS 636 RC 0338-1047-02 NDC JW 0.3 UN outpatient 6.43 6.3 All Payors / Plans All Payors / Plans 6.43 other 6.43 6.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUCOVORIN CALCIUM PER 50 MG ERX-636000000 CDM J0640 HCPCS 636 RC 0338-0049-10 NDC JZ 0.92 UN outpatient 151.67 148.64 All Payors / Plans All Payors / Plans 151.67 other 151.67 151.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUCOVORIN CALCIUM PER 50 MG ERX-636000000 CDM J0640 HCPCS 636 RC 0338-0049-11 NDC JZ 0.3 UN outpatient 1.51 1.48 All Payors / Plans All Payors / Plans 1.51 other 1.51 1.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 20 MCG/ML SOLUTION ERX-636000000 CDM J0651 HCPCS 636 RC 68462-101-30 NDC JZ 1.9 ML outpatient 75.29 73.78 All Payors / Plans All Payors / Plans 75.29 other 75.29 75.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOTHYROXINE 40 MCG/ML SOLUTION ERX-636000000 CDM J0651 HCPCS 636 RC 50268-330-11 NDC JZ 3.75 ML outpatient 267.24 261.9 All Payors / Plans All Payors / Plans 267.24 other 267.24 267.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPIVACAINE 0.125% 0.125 % (1,250 MCG/ML) SOLUTION" ERX-250000000 CDM J0665 HCPCS 250 RC 63323-424-05 NDC 100 ML outpatient 50.56 49.55 All Payors / Plans All Payors / Plans 50.56 other 50.56 50.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BUPIVACAINE 0.125% 0.125 % (1,250 MCG/ML) SOLUTION" ERX-250000000 CDM J0665 HCPCS 250 RC 63323-184-10 NDC 100 ML outpatient 30.6 29.99 All Payors / Plans All Payors / Plans 30.6 other 30.6 30.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) SOLUTION ERX-250000000 CDM J0665 HCPCS 250 RC 5483800650 NDC JZ 1.4 ML outpatient 15.67 15.36 All Payors / Plans All Payors / Plans 15.67 other 15.67 15.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE HCL 0.25 % (2.5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 0338-0017-04 NDC 2 ML outpatient 61.45 60.22 All Payors / Plans All Payors / Plans 61.45 other 61.45 61.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE HCL 0.5 % (5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 0338-0017-11 NDC 10 ML outpatient 21.01 20.59 All Payors / Plans All Payors / Plans 21.01 other 21.01 21.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE 0.25 % (2.5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 62332-056-31 NDC JZ 30 ML outpatient 10.86 10.64 All Payors / Plans All Payors / Plans 10.86 other 10.86 10.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE 0.25 % (2.5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 0378-0873-16 NDC JZ 30 ML outpatient 10.73 10.52 All Payors / Plans All Payors / Plans 10.73 other 10.73 10.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE 0.25 % (2.5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 0591-3510-54 NDC JZ 4 ML outpatient 15.31 15 All Payors / Plans All Payors / Plans 15.31 other 15.31 15.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE 0.25 % (2.5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 50268-184-11 NDC JZ 7 ML outpatient 10.4 10.19 All Payors / Plans All Payors / Plans 10.4 other 10.4 10.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE PF 0.5 % (5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 50268-184-12 NDC JZ 10 ML outpatient 11.1 10.88 All Payors / Plans All Payors / Plans 11.1 other 11.1 11.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE PF 0.5 % (5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 55111-671-06 NDC JZ 10 ML outpatient 11.04 10.82 All Payors / Plans All Payors / Plans 11.04 other 11.04 11.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE PF 0.5 % (5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 68084-752-25 NDC JZ 5 ML outpatient 11.1 10.88 All Payors / Plans All Payors / Plans 11.1 other 11.1 11.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE PF 0.5 % (5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 68084-752-95 NDC JZ 25 ML outpatient 9.2 9.02 All Payors / Plans All Payors / Plans 9.2 other 9.2 9.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE PF 0.5 % (5 MG/ML) SOLUTION ERX-636000000 CDM J0665 HCPCS 636 RC 0904-6294-61 NDC JZ 25 ML outpatient 9.16 8.98 All Payors / Plans All Payors / Plans 9.16 other 9.16 9.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE PF 0.75 % (7.5 MG/ML) SOLUTION 10 ML VIAL ERX-636000000 CDM J0665 HCPCS 636 RC 0536-1272-22 NDC JZ 5 ML outpatient 11.11 10.89 All Payors / Plans All Payors / Plans 11.11 other 11.11 11.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUPIVACAINE PF 0.75 % (7.5 MG/ML) SOLUTION 10 ML VIAL ERX-636000000 CDM J0665 HCPCS 636 RC 51672-2002-2 NDC JZ 5 ML outpatient 15.93 15.61 All Payors / Plans All Payors / Plans 15.93 other 15.93 15.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN 3 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J0688 HCPCS 636 RC 60505-6156-4 NDC JZ 1 UN outpatient 26.07 25.55 All Payors / Plans All Payors / Plans 26.07 other 26.07 26.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0689 HCPCS 636 RC 0338-0017-48 NDC 50 ML outpatient 30.95 30.33 All Payors / Plans All Payors / Plans 30.95 other 30.95 30.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0689 HCPCS 636 RC 0409-7922-09 NDC 50 ML outpatient 24.91 24.41 All Payors / Plans All Payors / Plans 24.91 other 24.91 24.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0690 HCPCS 636 RC 0338-0017-38 NDC 100 ML outpatient 15.96 15.64 All Payors / Plans All Payors / Plans 15.96 other 15.96 15.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0690 HCPCS 636 RC 0338-0017-41 NDC 50 ML outpatient 62.23 60.99 All Payors / Plans All Payors / Plans 62.23 other 62.23 62.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0690 HCPCS 636 RC 0121-0903-15 NDC 1 UN outpatient 63.67 62.4 All Payors / Plans All Payors / Plans 63.67 other 63.67 63.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN 2 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J0690 HCPCS 636 RC 55150-119-30 NDC JZ 1 UN outpatient 25.61 25.1 All Payors / Plans All Payors / Plans 25.61 other 25.61 25.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN 2 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J0690 HCPCS 636 RC 55150-120-30 NDC JZ 1 UN outpatient 25.61 25.1 All Payors / Plans All Payors / Plans 25.61 other 25.61 25.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN 3 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J0690 HCPCS 636 RC 60505-6156-0 NDC JZ 1 UN outpatient 26.07 25.55 All Payors / Plans All Payors / Plans 26.07 other 26.07 26.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0690 HCPCS 636 RC 60505-6157-0 NDC JZ 1 UN outpatient 10.81 10.59 All Payors / Plans All Payors / Plans 10.81 other 10.81 10.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0690 HCPCS 636 RC 60505-6157-4 NDC JZ 1 UN outpatient 10.53 10.32 All Payors / Plans All Payors / Plans 10.53 other 10.53 10.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0690 HCPCS 636 RC 60505-6159-0 NDC JZ 0.5 UN outpatient 5.33 5.22 All Payors / Plans All Payors / Plans 5.33 other 5.33 5.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFAZOLIN PER 500 MG ERX-636000000 CDM J0690 HCPCS 636 RC 60505-6159-4 NDC JZ 1 UN outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFEPIME PER 500 MG ERX-636000000 CDM J0692 HCPCS 636 RC 64679-056-02 NDC JZ 0.5 UN outpatient 10.25 10.05 All Payors / Plans All Payors / Plans 10.25 other 10.25 10.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFEPIME PER 500 MG ERX-636000000 CDM J0692 HCPCS 636 RC 68001-507-53 NDC JZ 1 UN outpatient 31.11 30.49 All Payors / Plans All Payors / Plans 31.11 other 31.11 31.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFEPIME PER 500 MG ERX-636000000 CDM J0692 HCPCS 636 RC 72485-403-01 NDC JZ 1 UN outpatient 31.11 30.49 All Payors / Plans All Payors / Plans 31.11 other 31.11 31.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFEPIME PER 500 MG ERX-636000000 CDM J0692 HCPCS 636 RC 0005-2000-01 NDC JZ 0.5 UN outpatient 12.68 12.43 All Payors / Plans All Payors / Plans 12.68 other 12.68 12.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFEPIME PER 500 MG ERX-636000000 CDM J0692 HCPCS 636 RC 0338-0683-04 NDC JZ 1 UN outpatient 39.87 39.07 All Payors / Plans All Payors / Plans 39.87 other 39.87 39.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFOXITIN PER 1 G ERX-636000000 CDM J0694 HCPCS 636 RC 14789-107-05 NDC JZ 1 UN outpatient 20.45 20.04 All Payors / Plans All Payors / Plans 20.45 other 20.45 20.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFOXITIN PER 1 G ERX-636000000 CDM J0694 HCPCS 636 RC 0409-6653-18 NDC JZ 1 UN outpatient 30.75 30.14 All Payors / Plans All Payors / Plans 30.75 other 30.75 30.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTRIAXONE PER 250 MG ERX-636000000 CDM J0696 HCPCS 636 RC 0990-7922-55 NDC 10 ML outpatient 25.75 25.24 All Payors / Plans All Payors / Plans 25.75 other 25.75 25.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTRIAXONE PER 250 MG ERX-636000000 CDM J0696 HCPCS 636 RC 70677-1231-1 NDC JZ 50 ML outpatient 83.2 81.54 All Payors / Plans All Payors / Plans 83.2 other 83.2 83.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTRIAXONE PER 250 MG ERX-636000000 CDM J0696 HCPCS 636 RC 16714-496-01 NDC JZ 5.1 ML outpatient 11.37 11.14 All Payors / Plans All Payors / Plans 11.37 other 11.37 11.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTRIAXONE PER 250 MG ERX-636000000 CDM J0696 HCPCS 636 RC 0121-4950-15 NDC 0.2 UN outpatient 12.43 12.18 All Payors / Plans All Payors / Plans 12.43 other 12.43 12.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTRIAXONE PER 250 MG ERX-636000000 CDM J0696 HCPCS 636 RC 0054-8724-25 NDC JZ 0.5 UN outpatient 5.08 4.98 All Payors / Plans All Payors / Plans 5.08 other 5.08 5.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTRIAXONE PER 250 MG ERX-636000000 CDM J0696 HCPCS 636 RC 0904-6923-61 NDC JZ 1 UN outpatient 5.84 5.72 All Payors / Plans All Payors / Plans 5.84 other 5.84 5.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTRIAXONE PER 250 MG ERX-636000000 CDM J0696 HCPCS 636 RC 10135-775-01 NDC JZ 1 UN outpatient 5.84 5.72 All Payors / Plans All Payors / Plans 5.84 other 5.84 5.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTRIAXONE PER 250 MG ERX-636000000 CDM J0696 HCPCS 636 RC 60687-122-11 NDC JZ 1 UN outpatient 0.55 0.54 All Payors / Plans All Payors / Plans 0.55 other 0.55 0.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFUROXIME PER 750 MG ERX-636000000 CDM J0697 HCPCS 636 RC 60687-134-11 NDC JZ 1 UN outpatient 26.18 25.66 All Payors / Plans All Payors / Plans 26.18 other 26.18 26.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFUROXIME PER 750 MG ERX-636000000 CDM J0697 HCPCS 636 RC 60687-145-01 NDC JZ 1 UN outpatient 15.63 15.32 All Payors / Plans All Payors / Plans 15.63 other 15.63 15.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFUROXIME PER 750 MG ERX-636000000 CDM J0697 HCPCS 636 RC 60687-145-11 NDC JZ 1 UN outpatient 15.63 15.32 All Payors / Plans All Payors / Plans 15.63 other 15.63 15.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFUROXIME PER 750 MG ERX-636000000 CDM J0697 HCPCS 636 RC 64380-782-06 NDC JZ 1 UN outpatient 20.6 20.19 All Payors / Plans All Payors / Plans 20.6 other 20.6 20.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFIDEROCOL PER 10 MG ERX-636000000 CDM J0699 HCPCS 636 RC 0990-7905-09 NDC JZ 1 UN outpatient 589.37 577.58 All Payors / Plans All Payors / Plans 589.37 other 589.37 589.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BETAMETHASONE ACET & SOD PHOS PER 4 MG ERX-636000000 CDM J0702 HCPCS 636 RC 0338-0017-02 NDC 2 ML outpatient 58.02 56.86 All Payors / Plans All Payors / Plans 58.02 other 58.02 58.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTAZIDIME PER 500 MG ERX-636000000 CDM J0713 HCPCS 636 RC 63323-965-02 NDC JZ 0.1125 UN outpatient 2.87 2.81 All Payors / Plans All Payors / Plans 2.87 other 2.87 2.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTAZIDIME PER 500 MG ERX-636000000 CDM J0713 HCPCS 636 RC 63323-965-03 NDC JZ 1 UN outpatient 44.86 43.96 All Payors / Plans All Payors / Plans 44.86 other 44.86 44.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEFTAZIDIME PER 500 MG ERX-636000000 CDM J0713 HCPCS 636 RC 0054-0018-20 NDC JZ 0.135 UN outpatient 2.15 2.11 All Payors / Plans All Payors / Plans 2.15 other 2.15 2.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN PER 300 MG ERX-636000000 CDM J0736 HCPCS 636 RC 5026885511 NDC JZ 50 ML outpatient 16.11 15.79 All Payors / Plans All Payors / Plans 16.11 other 16.11 16.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN PER 300 MG ERX-636000000 CDM J0736 HCPCS 636 RC 5026885515 NDC JZ 1.85 ML outpatient 16.11 15.79 All Payors / Plans All Payors / Plans 16.11 other 16.11 16.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN PER 300 MG ERX-636000000 CDM J0736 HCPCS 636 RC 7733393825 NDC JZ 50 ML outpatient 25.43 24.92 All Payors / Plans All Payors / Plans 25.43 other 25.43 25.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN PER 300 MG ERX-636000000 CDM J0736 HCPCS 636 RC 5026885211 NDC JZ 50 ML outpatient 30.46 29.85 All Payors / Plans All Payors / Plans 30.46 other 30.46 30.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN PER 300 MG ERX-636000000 CDM J0736 HCPCS 636 RC 52817-332-10 NDC JZ 50 ML outpatient 61.73 60.5 All Payors / Plans All Payors / Plans 61.73 other 61.73 61.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN PER 300 MG ERX-636000000 CDM J0736 HCPCS 636 RC 60687-558-01 NDC JZ 50 ML outpatient 64.17 62.89 All Payors / Plans All Payors / Plans 64.17 other 64.17 64.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN IN 0.9% NS 900 MG/50 ML PIGGYBACK ERX-250000000 CDM J0737 HCPCS 250 RC 0409-4276-16 NDC 50 ML outpatient 26.25 25.73 All Payors / Plans All Payors / Plans 26.25 other 26.25 26.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN 600 MG/50 ML PIGGYBACK ERX-636000000 CDM J0737 HCPCS 636 RC 0046-0872-21 NDC JZ 50 ML outpatient 25.3 24.79 All Payors / Plans All Payors / Plans 25.3 other 25.3 25.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLINDAMYCIN 600 MG/50 ML PIGGYBACK ERX-636000000 CDM J0737 HCPCS 636 RC 2055500600 NDC JZ 50 ML outpatient 25.3 24.79 All Payors / Plans All Payors / Plans 25.3 other 25.3 25.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMIPENEM-CILASTATIN PER 250 MG ERX-636000000 CDM J0743 HCPCS 636 RC 0338-0049-02 NDC JZ 1 UN outpatient 50.46 49.45 All Payors / Plans All Payors / Plans 50.46 other 50.46 50.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMIPENEM-CILASTATIN PER 250 MG ERX-636000000 CDM J0743 HCPCS 636 RC 0338-0049-03 NDC JZ 1 UN outpatient 50.46 49.45 All Payors / Plans All Payors / Plans 50.46 other 50.46 50.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMIPENEM-CILASTATIN PER 250 MG ERX-636000000 CDM J0743 HCPCS 636 RC 0338-0049-04 NDC JZ 1 UN outpatient 50.49 49.48 All Payors / Plans All Payors / Plans 50.49 other 50.49 50.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN PER 200 MG ERX-636000000 CDM J0744 HCPCS 636 RC 65219-456-05 NDC 100 ML outpatient 15.27 14.96 All Payors / Plans All Payors / Plans 15.27 other 15.27 15.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN PER 200 MG ERX-636000000 CDM J0744 HCPCS 636 RC 65219-458-05 NDC 200 ML outpatient 42.87 42.01 All Payors / Plans All Payors / Plans 42.87 other 42.87 42.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN PER 200 MG ERX-636000000 CDM J0744 HCPCS 636 RC 65219-460-05 NDC 100 ML outpatient 15.47 15.16 All Payors / Plans All Payors / Plans 15.47 other 15.47 15.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN PER 200 MG ERX-636000000 CDM J0744 HCPCS 636 RC 50484-010-30 NDC JZ 200 ML outpatient 23.39 22.92 All Payors / Plans All Payors / Plans 23.39 other 23.39 23.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN PER 200 MG ERX-636000000 CDM J0744 HCPCS 636 RC 0574030316 NDC JZ 200 ML outpatient 23.39 22.92 All Payors / Plans All Payors / Plans 23.39 other 23.39 23.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIPROFLOXACIN PER 200 MG ERX-636000000 CDM J0744 HCPCS 636 RC 0574030416 NDC JZ 100 ML outpatient 15.27 14.96 All Payors / Plans All Payors / Plans 15.27 other 15.27 15.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROCHLORPERAZINE EDISYLATE PER 10 MG ERX-636000000 CDM J0780 HCPCS 636 RC 70121-1168-1 NDC 0.5 ML outpatient 5.08 4.98 All Payors / Plans All Payors / Plans 5.08 other 5.08 5.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROCHLORPERAZINE EDISYLATE PER 10 MG ERX-636000000 CDM J0780 HCPCS 636 RC 0338-0122-04 NDC 1 ML outpatient 10.15 9.95 All Payors / Plans All Payors / Plans 10.15 other 10.15 10.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROCHLORPERAZINE EDISYLATE PER 10 MG ERX-636000000 CDM J0780 HCPCS 636 RC 0338-0124-04 NDC 1 ML outpatient 7.78 7.62 All Payors / Plans All Payors / Plans 7.78 other 7.78 7.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROCHLORPERAZINE EDISYLATE PER 10 MG ERX-636000000 CDM J0780 HCPCS 636 RC 25021-158-99 NDC 1 ML outpatient 8.09 7.93 All Payors / Plans All Payors / Plans 8.09 other 8.09 8.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COSYNTROPIN PER 0.25 MG ERX-636000000 CDM J0834 HCPCS 636 RC 0069-0209-01 NDC JZ 1 UN outpatient 82.63 80.98 All Payors / Plans All Payors / Plans 82.63 other 82.63 82.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DAPTOMYCIN PER 1 MG ERX-636000000 CDM J0878 HCPCS 636 RC 0409-4699-54 NDC JZ 1 UN outpatient 65.56 64.25 All Payors / Plans All Payors / Plans 65.56 other 65.56 65.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DAPTOMYCIN PER 1 MG ERX-636000000 CDM J0878 HCPCS 636 RC 0409-6010-25 NDC JZ 1.284 UN outpatient 175.23 171.73 All Payors / Plans All Payors / Plans 175.23 other 175.23 175.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DAPTOMYCIN PER 1 MG ERX-636000000 CDM J0878 HCPCS 636 RC 16714-690-01 NDC JZ 1 UN outpatient 61.85 60.61 All Payors / Plans All Payors / Plans 61.85 other 61.85 61.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DARBEPOETIN ALFA-ALBUMIN PER 1 MCG ERX-636000000 CDM J0881 HCPCS 636 RC 70710-1110-1 NDC JZ 1 ML outpatient 2674.03 2620.55 All Payors / Plans All Payors / Plans 2674.03 other 2674.03 2674.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DARBEPOETIN ALFA-POLYSORBATE 100 MCG/0.5 ML SYRINGE ERX-636000000 CDM J0881 HCPCS 636 RC 0597-0360-82 NDC JZ 0.5 ML outpatient 783.24 767.58 All Payors / Plans All Payors / Plans 783.24 other 783.24 783.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DARBEPOETIN ALFA-POLYSORBATE 200 MCG/0.4 ML SYRINGE ERX-636000000 CDM J0881 HCPCS 636 RC 0310-6205-30 NDC JZ 0.4 ML outpatient 1480.29 1450.68 All Payors / Plans All Payors / Plans 1480.29 other 1480.29 1480.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DARBEPOETIN ALFA-POLYSORBATE 25 MCG/0.42 ML SYRINGE ERX-636000000 CDM J0881 HCPCS 636 RC 66993-456-30 NDC JZ 0.42 ML outpatient 256.65 251.52 All Payors / Plans All Payors / Plans 256.65 other 256.65 256.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DARBEPOETIN ALFA-POLYSORBATE 300 MCG/0.6 ML SYRINGE ERX-636000000 CDM J0881 HCPCS 636 RC 43598-705-30 NDC JZ 0.6 ML outpatient 1878.2 1840.64 All Payors / Plans All Payors / Plans 1878.2 other 1878.2 1878.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DARBEPOETIN ALFA-POLYSORBATE 40 MCG/0.4 ML SYRINGE ERX-636000000 CDM J0881 HCPCS 636 RC 69918-101-01 NDC JZ 0.4 ML outpatient 417.74 409.39 All Payors / Plans All Payors / Plans 417.74 other 417.74 417.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DARBEPOETIN ALFA-POLYSORBATE 60 MCG/0.3 ML SYRINGE ERX-636000000 CDM J0881 HCPCS 636 RC 0054-0400-22 NDC JZ 0.3 ML outpatient 624.07 611.59 All Payors / Plans All Payors / Plans 624.07 other 624.07 624.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPOETIN ALFA PER 1000 UNITS ERX-635000000 CDM J0885 HCPCS 636 RC 65862-076-01 NDC JZ 1 ML outpatient 1244.41 1219.52 All Payors / Plans All Payors / Plans 1244.41 other 1244.41 1244.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EPOETIN ALFA PER 1000 UNITS ERX-636000000 CDM J0885 HCPCS 636 RC 0904-5307-80 NDC JZ 1 ML outpatient 347.86 340.9 All Payors / Plans All Payors / Plans 347.86 other 347.86 347.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DECITABINE PER 1 MG ERX-636000000 CDM J0894 HCPCS 636 RC 0338-1049-02 NDC JW 0.3 UN outpatient 51.56 50.53 All Payors / Plans All Payors / Plans 51.56 other 51.56 51.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SOLUTION ERX-636000000 CDM J0897 HCPCS 636 RC 63323-165-03 NDC JZ 1.7 ML outpatient 3871.05 3793.63 All Payors / Plans All Payors / Plans 3871.05 other 3871.05 3871.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DENOSUMAB 60 MG/ML SYRINGE ERX-636000000 CDM J0897 HCPCS 636 RC 24208-720-02 NDC JZ 1 ML outpatient 2417 2368.66 All Payors / Plans All Payors / Plans 2417 other 2417 2417 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DENOSUMAB 60 MG/ML SYRINGE ERX-636000000 CDM J0897 HCPCS 636 RC 0054-3176-44 NDC JZ 1 ML outpatient 2417 2368.66 All Payors / Plans All Payors / Plans 2417 other 2417 2417 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE PER 40 MG ERX-636000000 CDM J1010 HCPCS 636 RC 0713-0351-09 NDC 25 ML outpatient 498.1 488.14 All Payors / Plans All Payors / Plans 498.1 other 498.1 498.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE PER 40 MG ERX-636000000 CDM J1010 HCPCS 636 RC 0904-6667-61 NDC JZ 2 ML outpatient 42.24 41.4 All Payors / Plans All Payors / Plans 42.24 other 42.24 42.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE PER 40 MG ERX-636000000 CDM J1010 HCPCS 636 RC 50268-350-11 NDC JZ 1 ML outpatient 21.13 20.71 All Payors / Plans All Payors / Plans 21.13 other 21.13 21.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEDROXYPROGESTERONE 150 MG/ML SUSPENSION ERX-636000000 CDM J1050 HCPCS 636 RC 0904-6665-61 NDC JZ 1 ML outpatient 155.36 152.25 All Payors / Plans All Payors / Plans 155.36 other 155.36 155.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEDROXYPROGESTERONE 150 MG/ML SUSPENSION ERX-636000000 CDM J1050 HCPCS 636 RC 63739-902-10 NDC JZ 1 ML outpatient 103.4 101.33 All Payors / Plans All Payors / Plans 103.4 other 103.4 103.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEDROXYPROGESTERONE 150 MG/ML SUSPENSION ERX-636000000 CDM J1050 HCPCS 636 RC 59762-5050-1 NDC JZ 1 ML outpatient 44.7 43.81 All Payors / Plans All Payors / Plans 44.7 other 44.7 44.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 1 MG ERX-636000000 CDM J1100 HCPCS 636 RC 0338-1075-02 NDC 3 ML outpatient 5.98 5.86 All Payors / Plans All Payors / Plans 5.98 other 5.98 5.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 1 MG ERX-636000000 CDM J1100 HCPCS 636 RC 67457-533-16 NDC 0.5 ML outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 1 MG ERX-636000000 CDM J1100 HCPCS 636 RC 0054-8176-25 NDC JZ 0.25 ML outpatient 1.47 1.44 All Payors / Plans All Payors / Plans 1.47 other 1.47 1.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 1 MG ERX-636000000 CDM J1100 HCPCS 636 RC 0115-9919-01 NDC JZ 1 ML outpatient 5.88 5.76 All Payors / Plans All Payors / Plans 5.88 other 5.88 5.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 1 MG ERX-636000000 CDM J1100 HCPCS 636 RC 0078-0430-05 NDC JZ 1 ML outpatient 0.85 0.83 All Payors / Plans All Payors / Plans 0.85 other 0.85 0.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 1 MG ERX-636000000 CDM J1100 HCPCS 636 RC 0527-8106-37 NDC JZ 1.5 ML outpatient 1.45 1.42 All Payors / Plans All Payors / Plans 1.45 other 1.45 1.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACETAZOLAMIDE PER 500 MG ERX-636000000 CDM J1120 HCPCS 636 RC 0078-0818-81 NDC JZ 1 UN outpatient 133.64 130.97 All Payors / Plans All Payors / Plans 133.64 other 133.64 133.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIGOXIN 250 MCG/ML (0.25 MG/ML) SOLUTION ERX-636000000 CDM J1160 HCPCS 636 RC 71288-402-11 NDC 1 ML outpatient 8.02 7.86 All Payors / Plans All Payors / Plans 8.02 other 8.02 8.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYTOIN PER 50 MG ERX-636000000 CDM J1165 HCPCS 636 RC 68084-284-11 NDC JZ 1 ML outpatient 5.14 5.04 All Payors / Plans All Payors / Plans 5.14 other 5.14 5.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYTOIN PER 50 MG ERX-636000000 CDM J1165 HCPCS 636 RC 63739-483-10 NDC JZ 4 ML outpatient 8.62 8.45 All Payors / Plans All Payors / Plans 8.62 other 8.62 8.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYTOIN PER 50 MG ERX-636000000 CDM J1165 HCPCS 636 RC 62135-502-47 NDC JZ 4 ML outpatient 12.22 11.98 All Payors / Plans All Payors / Plans 12.22 other 12.22 12.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE 2 MG/ML SYRINGE ERX-636000000 CDM J1170 HCPCS 636 RC 24208-910-19 NDC JZ 0.1 ML outpatient 1.59 1.56 All Payors / Plans All Payors / Plans 1.59 other 1.59 1.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE 0.5 MG/0.5 ML SYRINGE ERX-636000000 CDM J1171 HCPCS 636 RC 0409-1467-61 NDC 0.5 ML outpatient 15.88 15.56 All Payors / Plans All Payors / Plans 15.88 other 15.88 15.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE 0.5 MG/0.5 ML SYRINGE ERX-636000000 CDM J1171 HCPCS 636 RC 0641-6132-01 NDC 0.1 ML outpatient 3.16 3.1 All Payors / Plans All Payors / Plans 3.16 other 3.16 3.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROMORPHONE PER 4 MG ERX-636000000 CDM J1171 HCPCS 636 RC 75834-242-30 NDC JZ 0.2 ML outpatient 3.09 3.03 All Payors / Plans All Payors / Plans 3.09 other 3.09 3.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE PER 50 MG ERX-636000000 CDM J1200 HCPCS 636 RC 71288-420-96 NDC 1 ML outpatient 0.79 0.77 All Payors / Plans All Payors / Plans 0.79 other 0.79 0.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE PER 50 MG ERX-636000000 CDM J1200 HCPCS 636 RC 71288-402-10 NDC 0.25 ML outpatient 0.2 0.2 All Payors / Plans All Payors / Plans 0.2 other 0.2 0.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE PER 50 MG ERX-636000000 CDM J1200 HCPCS 636 RC 51079-285-20 NDC JZ 0.5 ML outpatient 0.4 0.39 All Payors / Plans All Payors / Plans 0.4 other 0.4 0.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE PER 50 MG ERX-636000000 CDM J1200 HCPCS 636 RC 68094-750-59 NDC JZ 0.25 ML outpatient 2.71 2.66 All Payors / Plans All Payors / Plans 2.71 other 2.71 2.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOBUTAMINE PER 250 MG ERX-636000000 CDM J1250 HCPCS 636 RC 0409-1283-05 NDC 250 ML outpatient 44.74 43.85 All Payors / Plans All Payors / Plans 44.74 other 44.74 44.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOPAMINE PER 40 MG ERX-636000000 CDM J1265 HCPCS 636 RC 0143-9720-01 NDC 250 ML outpatient 61.06 59.84 All Payors / Plans All Payors / Plans 61.06 other 61.06 61.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOPAMINE PER 40 MG ERX-636000000 CDM J1265 HCPCS 636 RC 0143-9721-24 NDC 2.541947917 ML outpatient 0.63 0.62 All Payors / Plans All Payors / Plans 0.63 other 0.63 0.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERTAPENEM PER 500 MG ERX-636000000 CDM J1335 HCPCS 636 RC 63323-229-05 NDC JZ 0.5 UN outpatient 51.94 50.9 All Payors / Plans All Payors / Plans 51.94 other 51.94 51.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERTAPENEM PER 500 MG ERX-636000000 CDM J1335 HCPCS 636 RC 63323-229-30 NDC JZ 0.5 UN outpatient 51.94 50.9 All Payors / Plans All Payors / Plans 51.94 other 51.94 51.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ERTAPENEM PER 500 MG ERX-636000000 CDM J1335 HCPCS 636 RC 71288-201-85 NDC JZ 0.5 UN outpatient 68.24 66.88 All Payors / Plans All Payors / Plans 68.24 other 68.24 68.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FERRIC CARBOXYMALTOSE 50 MG IRON/ML SOLUTION ERX-636000000 CDM J1439 HCPCS 636 RC 68084-415-11 NDC JZ 15 ML outpatient 1605.21 1573.11 All Payors / Plans All Payors / Plans 1605.21 other 1605.21 1605.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TBO-FILGRASTIM PER 1 MCG ERX-636000000 CDM J1447 HCPCS 636 RC 65628-080-03 NDC JZ 0.41 ML outpatient 338.01 331.25 All Payors / Plans All Payors / Plans 338.01 other 338.01 338.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TBO-FILGRASTIM PER 1 MCG ERX-636000000 CDM J1447 HCPCS 636 RC 64764-544-30 NDC JZ 0.5 ML outpatient 412.16 403.92 All Payors / Plans All Payors / Plans 412.16 other 412.16 412.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TBO-FILGRASTIM PER 1 MCG ERX-636000000 CDM J1447 HCPCS 636 RC 68382-772-30 NDC JZ 0.8 ML outpatient 629.94 617.34 All Payors / Plans All Payors / Plans 629.94 other 629.94 629.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TBO-FILGRASTIM PER 1 MCG ERX-636000000 CDM J1447 HCPCS 636 RC 59762-0333-2 NDC JZ 0.8 ML outpatient 629.94 617.34 All Payors / Plans All Payors / Plans 629.94 other 629.94 629.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUCONAZOLE PER 200 MG ERX-636000000 CDM J1450 HCPCS 636 RC 0338-1708-40 NDC 50 ML outpatient 12.93 12.67 All Payors / Plans All Payors / Plans 12.93 other 12.93 12.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUCONAZOLE PER 200 MG ERX-636000000 CDM J1450 HCPCS 636 RC 68084-782-11 NDC JZ 200 ML outpatient 30.41 29.8 All Payors / Plans All Payors / Plans 30.41 other 30.41 30.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMUNE GLOBULIN (HUMAN) 10 % SOLUTION ERX-636000000 CDM J1459 HCPCS 636 RC 0378-3352-16 NDC JZ 100 ML outpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMUNE GLOBULIN (HUMAN) 10 % SOLUTION ERX-636000000 CDM J1459 HCPCS 636 RC 42806-087-01 NDC JZ 100 ML outpatient 730 715.4 All Payors / Plans All Payors / Plans 730 other 730 730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMUNE GLOBULIN (HUMAN) 10 % SOLUTION ERX-636000000 CDM J1459 HCPCS 636 RC 0555-0886-02 NDC JZ 200 ML outpatient 1460 1430.8 All Payors / Plans All Payors / Plans 1460 other 1460 1460 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMUNE GLOBULIN (HUMAN) 10 % SOLUTION ERX-636000000 CDM J1459 HCPCS 636 RC 68084-280-11 NDC JZ 200 ML outpatient 1460 1430.8 All Payors / Plans All Payors / Plans 1460 other 1460 1460 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMUNE GLOBULIN (HUMAN) 10 % SOLUTION ERX-636000000 CDM J1459 HCPCS 636 RC 0904-7103-04 NDC JZ 400 ML outpatient 2920 2861.6 All Payors / Plans All Payors / Plans 2920 other 2920 2920 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMUNE GLOBULIN (HUMAN) 10 % SOLUTION ERX-636000000 CDM J1459 HCPCS 636 RC 50268-298-11 NDC JZ 400 ML outpatient 2920 2861.6 All Payors / Plans All Payors / Plans 2920 other 2920 2920 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN 120 MG/100 ML PIGGYBACK ERX-636000000 CDM J1580 HCPCS 636 RC 44567-420-24 NDC 100 ML outpatient 15.31 15 All Payors / Plans All Payors / Plans 15.31 other 15.31 15.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN PER 80 MG ERX-636000000 CDM J1580 HCPCS 636 RC 63323-106-05 NDC 50 ML outpatient 10.88 10.66 All Payors / Plans All Payors / Plans 10.88 other 10.88 10.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN PER 80 MG ERX-636000000 CDM J1580 HCPCS 636 RC 60687-513-11 NDC JZ 3.2 ML outpatient 0.71 0.7 All Payors / Plans All Payors / Plans 0.71 other 0.71 0.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN PER 80 MG ERX-636000000 CDM J1580 HCPCS 636 RC 60687-375-11 NDC JZ 2 ML outpatient 20.31 19.9 All Payors / Plans All Payors / Plans 20.31 other 20.31 20.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN PER 80 MG ERX-636000000 CDM J1580 HCPCS 636 RC 60687-375-21 NDC JZ 2 ML outpatient 20.31 19.9 All Payors / Plans All Payors / Plans 20.31 other 20.31 20.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENTAMICIN PER 80 MG ERX-636000000 CDM J1580 HCPCS 636 RC 0904-7043-04 NDC JZ 2 ML outpatient 10.21 10.01 All Payors / Plans All Payors / Plans 10.21 other 10.21 10.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLYCOPYRROLATE 0.2 MG/ML SOLUTION ERX-636000000 CDM J1596 HCPCS 636 RC 63323-106-15 NDC 1 ML outpatient 39.85 39.05 All Payors / Plans All Payors / Plans 39.85 other 39.85 39.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLYCOPYRROLATE 0.2 MG/ML SOLUTION ERX-636000000 CDM J1596 HCPCS 636 RC 0409-6729-41 NDC 1 ML outpatient 61.66 60.43 All Payors / Plans All Payors / Plans 61.66 other 61.66 61.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLYCOPYRROLATE 0.2 MG/ML SOLUTION ERX-636000000 CDM J1596 HCPCS 636 RC 44567-421-24 NDC 1 ML outpatient 0.84 0.82 All Payors / Plans All Payors / Plans 0.84 other 0.84 0.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLYCOPYRROLATE 0.2 MG/ML SOLUTION ERX-636000000 CDM J1596 HCPCS 636 RC 60687-723-11 NDC JZ 2 ML outpatient 1.67 1.64 All Payors / Plans All Payors / Plans 1.67 other 1.67 1.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLUCAGON 1 MG RECON SOLN ERX-636000000 CDM J1610 HCPCS 636 RC 76329-3321-0 NDC JZ 1 UN outpatient 179.32 175.73 All Payors / Plans All Payors / Plans 179.32 other 179.32 179.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLUCAGON 1 MG/ML RECON SOLN ERX-636000000 CDM J1611 HCPCS 636 RC 44206-300-01 NDC JZ 1 UN outpatient 146.81 143.87 All Payors / Plans All Payors / Plans 146.81 other 146.81 146.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLUCAGON 1 MG/ML RECON SOLN ERX-636000000 CDM J1611 HCPCS 636 RC 44206-300-90 NDC JZ 0.3 UN outpatient 44.05 43.17 All Payors / Plans All Payors / Plans 44.05 other 44.05 44.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HALOPERIDOL LACTATE PER 5 MG ERX-636000000 CDM J1630 HCPCS 636 RC 60687-723-21 NDC JZ 0.4 ML outpatient 0.87 0.85 All Payors / Plans All Payors / Plans 0.87 other 0.87 0.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HEPARIN, PORCINE (PF) 10 UNIT/ML SYRINGE" ERX-636000000 CDM J1642 HCPCS 636 RC 51672-4245-1 NDC JZ 4 ML outpatient 0.44 0.43 All Payors / Plans All Payors / Plans 0.44 other 0.44 0.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HEPARIN, PORCINE (PF) 10 UNIT/ML SYRINGE" ERX-636000000 CDM J1642 HCPCS 636 RC 16714-442-01 NDC JZ 1 ML outpatient 0.26 0.25 All Payors / Plans All Payors / Plans 0.26 other 0.26 0.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HEPARIN, PORCINE (PF) 10 UNIT/ML SYRINGE" ERX-636000000 CDM J1642 HCPCS 636 RC 51672-4038-1 NDC JZ 1 ML outpatient 0.13 0.13 All Payors / Plans All Payors / Plans 0.13 other 0.13 0.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HEPARIN, PORCINE (PF) 10 UNIT/ML SYRINGE 3 ML SYRINGE" ERX-636000000 CDM J1642 HCPCS 636 RC 16729-293-15 NDC JZ 6 ML outpatient 1.16 1.14 All Payors / Plans All Payors / Plans 1.16 other 1.16 1.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HEPARIN, PORCINE (PF) 100 UNIT/ML SYRINGE" ERX-636000000 CDM J1642 HCPCS 636 RC 42291-454-90 NDC JZ 1 ML outpatient 0.16 0.16 All Payors / Plans All Payors / Plans 0.16 other 0.16 0.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HEPARIN (PORCINE) IN 0.9% NACL 5,000 UNIT/500 ML (10 UNIT/ML) PARENTERAL SOLUTION" ERX-250000000 CDM J1644 HCPCS 250 RC 0008-0923-51 NDC 1 ML outpatient 23.14 22.68 All Payors / Plans All Payors / Plans 23.14 other 23.14 23.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 0009-0758-01 NDC 9.576111111 ML outpatient 2.48 2.43 All Payors / Plans All Payors / Plans 2.48 other 2.48 2.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 63323-265-30 NDC 1 ML outpatient 23.1 22.64 All Payors / Plans All Payors / Plans 23.1 other 23.1 23.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM j1644 HCPCS 636 RC 0009-0280-03 NDC 800 ML outpatient 33.53 32.86 All Payors / Plans All Payors / Plans 33.53 other 33.53 33.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 0641-6059-10 NDC 6 ML outpatient 15.64 15.33 All Payors / Plans All Payors / Plans 15.64 other 15.64 15.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 0143-9718-01 NDC 32 ML outpatient 21.88 21.44 All Payors / Plans All Payors / Plans 21.88 other 21.88 21.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 51079-379-01 NDC 1 ML outpatient 2.12 2.08 All Payors / Plans All Payors / Plans 2.12 other 2.12 2.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 51079-721-01 NDC 10 ML outpatient 15.5 15.19 All Payors / Plans All Payors / Plans 15.5 other 15.5 15.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PROCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 68084-918-95 NDC 1 ML outpatient 2.12 2.08 All Payors / Plans All Payors / Plans 2.12 other 2.12 2.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 0904-7044-61 NDC JZ 0.4 ML outpatient 0.37 0.36 All Payors / Plans All Payors / Plans 0.37 other 0.37 0.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 0904-7045-61 NDC JZ 1 ML outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 27241-099-03 NDC JZ 3 ML outpatient 46.73 45.8 All Payors / Plans All Payors / Plans 46.73 other 46.73 46.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 60687-745-11 NDC JZ 0.6 ML outpatient 0.53 0.52 All Payors / Plans All Payors / Plans 0.53 other 0.53 0.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 68084-692-11 NDC JZ 1 ML outpatient 33.04 32.38 All Payors / Plans All Payors / Plans 33.04 other 33.04 33.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 42806-549-09 NDC JZ 250 ML outpatient 36.58 35.85 All Payors / Plans All Payors / Plans 36.58 other 36.58 36.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 0597-0152-30 NDC JZ 1 ML outpatient 10.27 10.06 All Payors / Plans All Payors / Plans 10.27 other 10.27 10.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 0597-0152-37 NDC JZ 1.5 ML outpatient 15.56 15.25 All Payors / Plans All Payors / Plans 15.56 other 15.56 15.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 0597-0153-37 NDC JZ 1 ML outpatient 0.89 0.87 All Payors / Plans All Payors / Plans 0.89 other 0.89 0.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PORCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 65862-354-30 NDC JZ 1 ML outpatient 6.03 5.91 All Payors / Plans All Payors / Plans 6.03 other 6.03 6.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEPARIN (PROCINE) PER 1000 UNITS ERX-636000000 CDM J1644 HCPCS 636 RC 16714-444-01 NDC JZ 1 ML outpatient 0.82 0.8 All Payors / Plans All Payors / Plans 0.82 other 0.82 0.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 10135-747-01 NDC JZ 0.6 ML outpatient 25.44 24.93 All Payors / Plans All Payors / Plans 25.44 other 25.44 25.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 60687-540-11 NDC JZ 1 ML outpatient 61.27 60.04 All Payors / Plans All Payors / Plans 61.27 other 61.27 61.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 0904-5922-61 NDC JZ 1 ML outpatient 61.27 60.04 All Payors / Plans All Payors / Plans 61.27 other 61.27 61.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 0093-0318-01 NDC JZ 0.3 ML outpatient 23.52 23.05 All Payors / Plans All Payors / Plans 23.52 other 23.52 23.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 0093-0319-01 NDC JZ 0.6 ML outpatient 47.03 46.09 All Payors / Plans All Payors / Plans 47.03 other 47.03 47.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 60687-195-11 NDC JZ 0.3 ML outpatient 15.28 14.97 All Payors / Plans All Payors / Plans 15.28 other 15.28 15.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 68682-993-98 NDC JZ 0.3 ML outpatient 15.28 14.97 All Payors / Plans All Payors / Plans 15.28 other 15.28 15.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 50742-249-30 NDC JZ 0.4 ML outpatient 15.76 15.44 All Payors / Plans All Payors / Plans 15.76 other 15.76 15.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 60687-206-11 NDC JZ 0.6 ML outpatient 21.18 20.76 All Payors / Plans All Payors / Plans 21.18 other 21.18 21.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 0904-7219-61 NDC JZ 0.8 ML outpatient 30.6 29.99 All Payors / Plans All Payors / Plans 30.6 other 30.6 30.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 60687-217-11 NDC JZ 0.8 ML outpatient 29.03 28.45 All Payors / Plans All Payors / Plans 29.03 other 29.03 29.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 68682-997-98 NDC JZ 0.8 ML outpatient 40.44 39.63 All Payors / Plans All Payors / Plans 40.44 other 40.44 40.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 51079-924-01 NDC JZ 0.8 ML outpatient 40.44 39.63 All Payors / Plans All Payors / Plans 40.44 other 40.44 40.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 0121-0865-05 NDC JZ 1 ML outpatient 50.55 49.54 All Payors / Plans All Payors / Plans 50.55 other 50.55 50.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENOXAPARIN PER 10 MG ERX-636000000 CDM J1650 HCPCS 636 RC 57896-780-16 NDC JZ 0.4 ML outpatient 15.33 15.02 All Payors / Plans All Payors / Plans 15.33 other 15.33 15.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML RECON SOLN ERX-636000000 CDM J1720 HCPCS 636 RC 0338-0049-48 NDC JZ 0.25 UN outpatient 21.12 20.7 All Payors / Plans All Payors / Plans 21.12 other 21.12 21.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML RECON SOLN ERX-636000000 CDM J1720 HCPCS 636 RC 0264-1800-32 NDC JZ 0.5 UN outpatient 42.41 41.56 All Payors / Plans All Payors / Plans 42.41 other 42.41 42.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROCORTISONE SOD SUCC (PF) 500 MG/4 ML RECON SOLN ERX-636000000 CDM J1720 HCPCS 636 RC 0264-7800-10 NDC JZ 0.4 UN outpatient 79.32 77.73 All Payors / Plans All Payors / Plans 79.32 other 79.32 79.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRON SUCROSE 200 MG IRON/10 ML SOLUTION ERX-636000000 CDM J1756 HCPCS 636 RC 63739-645-10 NDC JZ 5 ML outpatient 97.42 95.47 All Payors / Plans All Payors / Plans 97.42 other 97.42 97.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRON SUCROSE PER 1 MG ERX-636000000 CDM J1756 HCPCS 636 RC 72865-214-05 NDC JZ 2.5 ML outpatient 68.99 67.61 All Payors / Plans All Payors / Plans 68.99 other 68.99 68.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRON SUCROSE PER 1 MG ERX-636000000 CDM J1756 HCPCS 636 RC 70954-316-10 NDC JZ 5 ML outpatient 137.98 135.22 All Payors / Plans All Payors / Plans 137.98 other 137.98 137.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DROPERIDOL PER 5 MG ERX-636000000 CDM J1790 HCPCS 636 RC 0527-1282-01 NDC JZ 0.25 ML outpatient 4.98 4.88 All Payors / Plans All Payors / Plans 4.98 other 4.98 4.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DROPERIDOL PER 5 MG ERX-636000000 CDM J1790 HCPCS 636 RC 60687-380-11 NDC JZ 0.5 ML outpatient 9.96 9.76 All Payors / Plans All Payors / Plans 9.96 other 9.96 9.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ESMOLOL 100 MG/10 ML (10 MG/ML) SOLUTION ERX-636000000 CDM J1805 HCPCS 636 RC 0904-7237-61 NDC JZ 2 ML outpatient 15.21 14.91 All Payors / Plans All Payors / Plans 15.21 other 15.21 15.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ESMOLOL 100 MG/10 ML (10 MG/ML) SOLUTION ERX-636000000 CDM J1805 HCPCS 636 RC 65628-050-04 NDC JZ 5 ML outpatient 20.59 20.18 All Payors / Plans All Payors / Plans 20.59 other 20.59 20.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METRONIDAZOLE 500 MG/100 ML PIGGYBACK ERX-636000000 CDM J1836 HCPCS 636 RC 68084-327-11 NDC JZ 100 ML outpatient 6.03 5.91 All Payors / Plans All Payors / Plans 6.03 other 6.03 6.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METRONIDAZOLE 500 MG/100 ML PIGGYBACK ERX-636000000 CDM J1836 HCPCS 636 RC 50268-362-11 NDC JZ 100 ML outpatient 10.77 10.55 All Payors / Plans All Payors / Plans 10.77 other 10.77 10.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METRONIDAZOLE 500 MG/100 ML PIGGYBACK ERX-636000000 CDM J1836 HCPCS 636 RC 60687-701-11 NDC JZ 100 ML outpatient 15.26 14.95 All Payors / Plans All Payors / Plans 15.26 other 15.26 15.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 68180-150-01 NDC JZ 1 ML outpatient 0.92 0.9 All Payors / Plans All Payors / Plans 0.92 other 0.92 0.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 51079-608-01 NDC JZ 0.5 ML outpatient 0.47 0.46 All Payors / Plans All Payors / Plans 0.47 other 0.47 0.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 60687-629-11 NDC JZ 1 ML outpatient 15.98 15.66 All Payors / Plans All Payors / Plans 15.98 other 15.98 15.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 0378-3065-77 NDC JZ 0.19 ML outpatient 1.14 1.12 All Payors / Plans All Payors / Plans 1.14 other 1.14 1.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 51079-599-01 NDC JZ 0.57 ML outpatient 0.48 0.47 All Payors / Plans All Payors / Plans 0.48 other 0.48 0.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 0378-9119-16 NDC JZ 1 ML outpatient 0.87 0.85 All Payors / Plans All Payors / Plans 0.87 other 0.87 0.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 47781-424-11 NDC JZ 0.5 ML outpatient 2.94 2.88 All Payors / Plans All Payors / Plans 2.94 other 2.94 2.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 47781-427-47 NDC JZ 0.5 ML outpatient 0.41 0.4 All Payors / Plans All Payors / Plans 0.41 other 0.41 0.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 10481-0112-8 NDC JZ 0.5 ML outpatient 0.3 0.29 All Payors / Plans All Payors / Plans 0.3 other 0.3 0.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 0574050811 NDC JZ 0.375 ML outpatient 0.23 0.23 All Payors / Plans All Payors / Plans 0.23 other 0.23 0.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 0087074002 NDC JZ 0.5 ML outpatient 1.47 1.44 All Payors / Plans All Payors / Plans 1.47 other 1.47 1.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 5483800180 NDC JZ 0.5 ML outpatient 1.47 1.44 All Payors / Plans All Payors / Plans 1.47 other 1.47 1.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 0904759060 NDC JZ 0.24 ML outpatient 0.22 0.22 All Payors / Plans All Payors / Plans 0.22 other 0.22 0.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 0904759161 NDC JZ 0.54 ML outpatient 0.48 0.47 All Payors / Plans All Payors / Plans 0.48 other 0.48 0.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KETOROLAC TROMETHAMINE PER 15 MG ERX-636000000 CDM J1885 HCPCS 636 RC 83078-702-02 NDC JZ 1 ML outpatient 6.12 6 All Payors / Plans All Payors / Plans 6.12 other 6.12 6.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 5 MG/ML SOLUTION ERX-636000000 CDM J1920 HCPCS 636 RC 23155-549-31 NDC 2 ML outpatient 10.68 10.47 All Payors / Plans All Payors / Plans 10.68 other 10.68 10.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LABETALOL 5 MG/ML SOLUTION ERX-636000000 CDM J1920 HCPCS 636 RC 52015-080-01 NDC JZ 2 ML outpatient 10.23 10.03 All Payors / Plans All Payors / Plans 10.23 other 10.23 10.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LANREOTIDE 120 MG/0.5 ML SYRINGE ERX-636000000 CDM J1930 HCPCS 636 RC 68084-728-11 NDC JZ 0.5 ML outpatient 10246.46 10041.53 All Payors / Plans All Payors / Plans 10246.46 other 10246.46 10246.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LARONIDASE 2.9 MG/5 ML SOLUTION 5 ML VIAL ERX-636000000 CDM J1931 HCPCS 636 RC 68084-735-11 NDC JZ 55 ML outpatient 19305.22 18919.12 All Payors / Plans All Payors / Plans 19305.22 other 19305.22 19305.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUMETANIDE PER 0.5 MG ERX-636000000 CDM J1939 HCPCS 636 RC 0338-0017-03 NDC 8 ML outpatient 16.21 15.89 All Payors / Plans All Payors / Plans 16.21 other 16.21 16.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUMETANIDE PER 0.5 MG ERX-636000000 CDM J1939 HCPCS 636 RC 62332-055-31 NDC JZ 8 ML outpatient 11.94 11.7 All Payors / Plans All Payors / Plans 11.94 other 11.94 11.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUMETANIDE PER 0.5 MG ERX-636000000 CDM J1939 HCPCS 636 RC 0378-0872-16 NDC JZ 4 ML outpatient 15.96 15.64 All Payors / Plans All Payors / Plans 15.96 other 15.96 15.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUMETANIDE PER 0.5 MG ERX-636000000 CDM J1939 HCPCS 636 RC 0228-2129-10 NDC JZ 4 ML outpatient 10.79 10.57 All Payors / Plans All Payors / Plans 10.79 other 10.79 10.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUMETANIDE PER 0.5 MG ERX-636000000 CDM J1939 HCPCS 636 RC 29300-137-01 NDC JZ 8 ML outpatient 35.86 35.14 All Payors / Plans All Payors / Plans 35.86 other 35.86 35.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 0121-0893-15 NDC JW 5 ML outpatient 15.19 14.89 All Payors / Plans All Payors / Plans 15.19 other 15.19 15.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 57896-401-03 NDC JZ 2 ML outpatient 5.47 5.36 All Payors / Plans All Payors / Plans 5.47 other 5.47 5.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 60687-129-11 NDC JZ 4 ML outpatient 32.56 31.91 All Payors / Plans All Payors / Plans 32.56 other 32.56 32.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 0069-5800-43 NDC JZ 4 ML outpatient 30.45 29.84 All Payors / Plans All Payors / Plans 30.45 other 30.45 30.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 0069-5800-61 NDC JZ 2 ML outpatient 15.23 14.93 All Payors / Plans All Payors / Plans 15.23 other 15.23 15.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 42291-412-60 NDC JZ 1 ML outpatient 0.46 0.45 All Payors / Plans All Payors / Plans 0.46 other 0.46 0.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 49702-228-13 NDC JZ 10 ML outpatient 10.43 10.22 All Payors / Plans All Payors / Plans 10.43 other 10.43 10.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 60687-292-11 NDC JZ 10 ML outpatient 10.58 10.37 All Payors / Plans All Payors / Plans 10.58 other 10.58 10.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 24208-485-10 NDC JZ 2 ML outpatient 0.61 0.6 All Payors / Plans All Payors / Plans 0.61 other 0.61 0.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 70377-081-11 NDC JZ 4 ML outpatient 0.8 0.78 All Payors / Plans All Payors / Plans 0.8 other 0.8 0.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 24208-486-10 NDC JZ 1 ML outpatient 0.21 0.21 All Payors / Plans All Payors / Plans 0.21 other 0.21 0.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 65862-946-01 NDC JZ 2 ML outpatient 0.42 0.41 All Payors / Plans All Payors / Plans 0.42 other 0.42 0.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 0904-5523-61 NDC JZ 2 ML outpatient 0.87 0.85 All Payors / Plans All Payors / Plans 0.87 other 0.87 0.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 16729-414-01 NDC JZ 2 ML outpatient 0.87 0.85 All Payors / Plans All Payors / Plans 0.87 other 0.87 0.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 60505-0096-0 NDC JZ 1 ML outpatient 0.25 0.25 All Payors / Plans All Payors / Plans 0.25 other 0.25 0.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 51079-437-01 NDC JZ 2 ML outpatient 2.08 2.04 All Payors / Plans All Payors / Plans 2.08 other 2.08 2.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FUROSEMIDE PER 20 MG ERX-636000000 CDM J1940 HCPCS 636 RC 69238-1171-9 NDC JZ 25 ML outpatient 25.9 25.38 All Payors / Plans All Payors / Plans 25.9 other 25.9 25.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUPROLIDE ACETATE (3 MONTH) PER 3.75 MG ERX-636000000 CDM J1950 HCPCS 636 RC 0990-7983-61 NDC JZ 1 UN outpatient 5676.15 5562.63 All Payors / Plans All Payors / Plans 5676.15 other 5676.15 5676.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUPROLIDE PER 3.75 MG ERX-636000000 CDM J1950 HCPCS 636 RC 63323-623-53 NDC JZ 1 UN outpatient 2348.34 2301.37 All Payors / Plans All Payors / Plans 2348.34 other 2348.34 2348.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETRIRACETAM PER 10 MG ERX-636000000 CDM J1953 HCPCS 636 RC 16714-696-01 NDC JZ 5 ML outpatient 10.38 10.17 All Payors / Plans All Payors / Plans 10.38 other 10.38 10.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVETRIRACETAM PER 10 MG ERX-636000000 CDM J1953 HCPCS 636 RC 16714-694-01 NDC JZ 2.5 ML outpatient 5.19 5.09 All Payors / Plans All Payors / Plans 5.19 other 5.19 5.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOFLOXACIN PER 250 MG ERX-636000000 CDM J1956 HCPCS 636 RC 63323-012-10 NDC 150 ML outpatient 15.19 14.89 All Payors / Plans All Payors / Plans 15.19 other 15.19 15.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOFLOXACIN PER 250 MG ERX-636000000 CDM J1956 HCPCS 636 RC 70004-085-44 NDC 100 ML outpatient 11 10.78 All Payors / Plans All Payors / Plans 11 other 11 11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOFLOXACIN PER 250 MG ERX-636000000 CDM J1956 HCPCS 636 RC 42852-705-50 NDC 150 ML outpatient 15.67 15.36 All Payors / Plans All Payors / Plans 15.67 other 15.67 15.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOFLOXACIN PER 250 MG ERX-636000000 CDM J1956 HCPCS 636 RC 61703-342-50 NDC 150 ML outpatient 15.67 15.36 All Payors / Plans All Payors / Plans 15.67 other 15.67 15.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOFLOXACIN PER 250 MG ERX-636000000 CDM J1956 HCPCS 636 RC 70860-200-50 NDC 100 ML outpatient 15.23 14.93 All Payors / Plans All Payors / Plans 15.23 other 15.23 15.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEVOFLOXACIN PER 250 MG ERX-636000000 CDM J1956 HCPCS 636 RC 0338-1025-41 NDC 150 ML outpatient 15.53 15.22 All Payors / Plans All Payors / Plans 15.53 other 15.53 15.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2001 HCPCS 636 RC 50111-648-01 NDC JZ 0.08 ML outpatient 0.25 0.25 All Payors / Plans All Payors / Plans 0.25 other 0.25 0.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2001 HCPCS 636 RC 62332-023-31 NDC JZ 5 ML outpatient 10.4 10.19 All Payors / Plans All Payors / Plans 10.4 other 10.4 10.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PER 10 MG ERX-636000000 CDM J2002 HCPCS 636 RC 0641-6142-25 NDC 500 ML outpatient 40.45 39.64 All Payors / Plans All Payors / Plans 40.45 other 40.45 40.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PER 10 MG ERX-636000000 CDM J2002 HCPCS 636 RC 0641-6188-01 NDC 500 ML outpatient 36.21 35.49 All Payors / Plans All Payors / Plans 36.21 other 36.21 36.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 20 MG/ML (2 %) SOLUTION ERX-250000000 CDM J2003 HCPCS 250 RC 68382-528-60 NDC JZ 2 ML outpatient 4.16 4.08 All Payors / Plans All Payors / Plans 4.16 other 4.16 4.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 20 MG/ML (2 %) SOLUTION ERX-250000000 CDM J2003 HCPCS 250 RC 50268-176-11 NDC JZ 1 ML outpatient 5.42 5.31 All Payors / Plans All Payors / Plans 5.42 other 5.42 5.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 20 MG/ML (2 %) SOLUTION ERX-250000000 CDM J2003 HCPCS 250 RC 31722-103-30 NDC JZ 6 ML outpatient 21.51 21.08 All Payors / Plans All Payors / Plans 21.51 other 21.51 21.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 68084-288-11 NDC JZ 30 ML outpatient 15.82 15.5 All Payors / Plans All Payors / Plans 15.82 other 15.82 15.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 51672-1386-3 NDC JZ 2 ML outpatient 2.39 2.34 All Payors / Plans All Payors / Plans 2.39 other 2.39 2.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 17238-900-11 NDC JZ 5 ML outpatient 5.97 5.85 All Payors / Plans All Payors / Plans 5.97 other 5.97 5.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 17238-900-99 NDC JZ 0.8 ML outpatient 2.35 2.3 All Payors / Plans All Payors / Plans 2.35 other 2.35 2.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 0904-5784-61 NDC JZ 10 ML outpatient 20.28 19.87 All Payors / Plans All Payors / Plans 20.28 other 20.28 20.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 50111-647-01 NDC JZ 0.8 ML outpatient 2.41 2.36 All Payors / Plans All Payors / Plans 2.41 other 2.41 2.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 0904-5785-61 NDC JZ 5 ML outpatient 2.58 2.53 All Payors / Plans All Payors / Plans 2.58 other 2.58 2.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 0904-7346-61 NDC JZ 2 ML outpatient 4.16 4.08 All Payors / Plans All Payors / Plans 4.16 other 4.16 4.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 16714-721-02 NDC JZ 0.8 ML outpatient 2.41 2.36 All Payors / Plans All Payors / Plans 2.41 other 2.41 2.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 0121-0721-04 NDC JZ 20 ML outpatient 83.41 81.74 All Payors / Plans All Payors / Plans 83.41 other 83.41 83.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIDOCAINE PF 10 MG/ML (1 %) SOLUTION ERX-636000000 CDM J2003 HCPCS 636 RC 0904-7159-61 NDC JZ 7 ML outpatient 7.27 7.12 All Payors / Plans All Payors / Plans 7.27 other 7.27 7.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINEZOLID PER 200 MG ERX-636000000 CDM J2020 HCPCS 636 RC 72485-504-25 NDC 300 ML outpatient 40.18 39.38 All Payors / Plans All Payors / Plans 40.18 other 40.18 40.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINEZOLID PER 200 MG ERX-636000000 CDM J2020 HCPCS 636 RC 0338-9636-01 NDC 300 ML outpatient 84.91 83.21 All Payors / Plans All Payors / Plans 84.91 other 84.91 84.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINEZOLID PER 200 MG ERX-636000000 CDM J2020 HCPCS 636 RC 50268-368-11 NDC JZ 300 ML outpatient 40.26 39.45 All Payors / Plans All Payors / Plans 40.26 other 40.26 40.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM 2 MG/ML SYRINGE 1 ML CARTRIDGE ERX-636000000 CDM J2060 HCPCS 636 RC 66993-079-96 NDC JZ 0.25 ML outpatient 5.1 5 All Payors / Plans All Payors / Plans 5.1 other 5.1 5.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM PER 2 MG ERX-636000000 CDM J2060 HCPCS 636 RC 0173-0718-20 NDC JZ 0.25 ML outpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM PER 2 MG ERX-636000000 CDM J2060 HCPCS 636 RC 66993-078-96 NDC JZ 0.25 ML outpatient 1.51 1.48 All Payors / Plans All Payors / Plans 1.51 other 1.51 1.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM PER 2 MG ERX-636000000 CDM J2060 HCPCS 636 RC 0054-3270-99 NDC JZ 1 ML outpatient 6.16 6.04 All Payors / Plans All Payors / Plans 6.16 other 6.16 6.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LORAZEPAM PER 2 MG ERX-636000000 CDM J2060 HCPCS 636 RC 60505-0829-1 NDC JZ 1 ML outpatient 6.18 6.06 All Payors / Plans All Payors / Plans 6.18 other 6.18 6.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANNITOL PER 50 ML ERX-636000000 CDM J2150 HCPCS 636 RC 68094-756-59 NDC JZ 50 ML outpatient 11.13 10.91 All Payors / Plans All Payors / Plans 11.13 other 11.13 11.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANNITOL PER 50 ML ERX-636000000 CDM J2150 HCPCS 636 RC 0054-8301-25 NDC JZ 50 ML outpatient 11.13 10.91 All Payors / Plans All Payors / Plans 11.13 other 11.13 11.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MEPERIDINE (PF) 25 MG/ML SOLUTION ERX-636000000 CDM J2175 HCPCS 636 RC 0904-6666-61 NDC JZ 0.5 ML outpatient 7.63 7.48 All Payors / Plans All Payors / Plans 7.63 other 7.63 7.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLERGONOVINE MALEATE PER 0.2 MG ERX-636000000 CDM J2210 HCPCS 636 RC 60687-591-11 NDC JZ 1 ML outpatient 87 85.26 All Payors / Plans All Payors / Plans 87 other 87 87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLERGONOVINE MALEATE PER 0.2 MG ERX-636000000 CDM J2210 HCPCS 636 RC 63739-903-10 NDC JZ 1 ML outpatient 101.27 99.24 All Payors / Plans All Payors / Plans 101.27 other 101.27 101.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICAFUNGIN 100 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J2248 HCPCS 636 RC 0641-6174-01 NDC JW 0.5 UN outpatient 68.84 67.46 All Payors / Plans All Payors / Plans 68.84 other 68.84 68.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICAFUNGIN 100 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J2248 HCPCS 636 RC 0264-7850-00 NDC JZ 1 UN outpatient 138.05 135.29 All Payors / Plans All Payors / Plans 138.05 other 138.05 138.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICAFUNGIN 100 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J2248 HCPCS 636 RC 0143-9746-01 NDC JZ 1 UN outpatient 134.9 132.2 All Payors / Plans All Payors / Plans 134.9 other 134.9 134.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICAFUNGIN PER 1 MG ERX-636000000 CDM J2248 HCPCS 636 RC 0143-9746-10 NDC JZ 1 UN outpatient 244.02 239.14 All Payors / Plans All Payors / Plans 244.02 other 244.02 244.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICAFUNGIN PER 1 MG ERX-636000000 CDM J2248 HCPCS 636 RC 63323-665-00 NDC JZ 1 UN outpatient 81.52 79.89 All Payors / Plans All Payors / Plans 81.52 other 81.52 81.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM PER 1 MG ERX-636000000 CDM J2250 HCPCS 636 RC 23155-294-31 NDC 2 ML outpatient 0.26 0.25 All Payors / Plans All Payors / Plans 0.26 other 0.26 0.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM (PF) 1 MG/ML SOLUTION ERX-636000000 CDM J2250 HCPCS 636 RC 16714-896-01 NDC JZ 2 ML outpatient 2.34 2.29 All Payors / Plans All Payors / Plans 2.34 other 2.34 2.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM (PF) 1 MG/ML SOLUTION ERX-636000000 CDM J2250 HCPCS 636 RC 60687-480-11 NDC JZ 0.5 ML outpatient 0.59 0.58 All Payors / Plans All Payors / Plans 0.59 other 0.59 0.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM (PF) 1 MG/ML SOLUTION ERX-636000000 CDM J2250 HCPCS 636 RC 0904-6637-61 NDC JZ 0.5 ML outpatient 0.19 0.19 All Payors / Plans All Payors / Plans 0.19 other 0.19 0.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM (PF) 1 MG/ML SOLUTION ERX-636000000 CDM J2250 HCPCS 636 RC 50289-3250-1 NDC JZ 0.25 ML outpatient 0.1 0.1 All Payors / Plans All Payors / Plans 0.1 other 0.1 0.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM (PF) 1 MG/ML SOLUTION ERX-636000000 CDM J2250 HCPCS 636 RC 0904-6709-61 NDC JZ 1 ML outpatient 5.12 5.02 All Payors / Plans All Payors / Plans 5.12 other 5.12 5.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM PER 1 MG ERX-636000000 CDM J2250 HCPCS 636 RC 0904-6718-39 NDC JZ 1 ML outpatient 5.85 5.73 All Payors / Plans All Payors / Plans 5.85 other 5.85 5.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM PER 1 MG ERX-636000000 CDM J2250 HCPCS 636 RC 68084-572-01 NDC JZ 0.4 ML outpatient 2.34 2.29 All Payors / Plans All Payors / Plans 2.34 other 2.34 2.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM IN 0.9 % NACL 1 MG/ML SOLUTION ERX-636000000 CDM J2251 HCPCS 636 RC 0121-1488-10 NDC JZ 100 ML outpatient 133.88 131.2 All Payors / Plans All Payors / Plans 133.88 other 133.88 133.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAZOLAM IN 0.9 % NACL 1 MG/ML SOLUTION ERX-636000000 CDM J2251 HCPCS 636 RC 0121-1744-05 NDC JZ 100 ML outpatient 64.26 62.97 All Payors / Plans All Payors / Plans 64.26 other 64.26 64.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MILRINONE 40 MG/200 ML (200 MCG/ML) PIGGYBACK ERX-636000000 CDM J2260 HCPCS 636 RC 70860-778-41 NDC 200 ML outpatient 64.56 63.27 All Payors / Plans All Payors / Plans 64.56 other 64.56 64.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MILRINONE 40 MG/200 ML (200 MCG/ML) PIGGYBACK ERX-636000000 CDM J2260 HCPCS 636 RC 68084-572-11 NDC JZ 200 ML outpatient 63.77 62.49 All Payors / Plans All Payors / Plans 63.77 other 63.77 63.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MILRINONE 40 MG/200 ML (200 MCG/ML) PIGGYBACK ERX-636000000 CDM J2260 HCPCS 636 RC 70436-039-01 NDC JZ 200 ML outpatient 63.77 62.49 All Payors / Plans All Payors / Plans 63.77 other 63.77 63.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 10 MG/ML SYRINGE ERX-636000000 CDM J2270 HCPCS 636 RC 60505-3928-1 NDC JZ 0.4 ML outpatient 4.15 4.07 All Payors / Plans All Payors / Plans 4.15 other 4.15 4.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 2 MG/ML SYRINGE ERX-636000000 CDM J2270 HCPCS 636 RC 4390097647 NDC JZ 0.25 ML outpatient 2.77 2.71 All Payors / Plans All Payors / Plans 2.77 other 2.77 2.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 30 MG/30 ML (1 MG/ML) PATIENT CONTROL.ANALGESIA SOLN ERX-636000000 CDM J2270 HCPCS 636 RC 51079-734-01 NDC JZ 30 ML outpatient 49.85 48.85 All Payors / Plans All Payors / Plans 49.85 other 49.85 49.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 4 MG/ML SYRINGE ERX-636000000 CDM J2270 HCPCS 636 RC 51079-735-01 NDC JZ 0.5 ML outpatient 5.45 5.34 All Payors / Plans All Payors / Plans 5.45 other 5.45 5.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE 4 MG/ML SYRINGE ERX-636000000 CDM J2270 HCPCS 636 RC 51079-736-01 NDC JZ 0.13 ML outpatient 1.42 1.39 All Payors / Plans All Payors / Plans 1.42 other 1.42 1.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE PER 10 MG ERX-636000000 CDM J2270 HCPCS 636 RC 51079-074-01 NDC JZ 0.4 ML outpatient 6.11 5.99 All Payors / Plans All Payors / Plans 6.11 other 6.11 6.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE PER 10 MG ERX-636000000 CDM J2270 HCPCS 636 RC 62135-579-12 NDC JZ 0.2 ML outpatient 3.06 3 All Payors / Plans All Payors / Plans 3.06 other 3.06 3.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE PER 10 MG ERX-636000000 CDM J2272 HCPCS 636 RC 68084-447-11 NDC JZ 0.6 ML outpatient 6.58 6.45 All Payors / Plans All Payors / Plans 6.58 other 6.58 6.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MORPHINE PER 10 MG ERX-636000000 CDM J2274 HCPCS 636 RC 23155-832-01 NDC JZ 0.1 ML outpatient 0.37 0.36 All Payors / Plans All Payors / Plans 0.37 other 0.37 0.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALBUPHINE PER 10 MG ERX-636000000 CDM J2300 HCPCS 636 RC 50268-718-11 NDC 0.5 ML outpatient 15.46 15.15 All Payors / Plans All Payors / Plans 15.46 other 15.46 15.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROGLYCERIN 50 MG/250 ML (200 MCG/ML) SOLUTION ERX-636000000 CDM J2305 HCPCS 636 RC 29300-128-01 NDC JZ 250 ML outpatient 50.13 49.13 All Payors / Plans All Payors / Plans 50.13 other 50.13 50.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NITROGLYCERIN IN 5 % DEXTROSE 25 MG/250 ML (100 MCG/ML) SOLUTION ERX-636000000 CDM J2305 HCPCS 636 RC 60687-593-01 NDC JZ 1 ML outpatient 49.65 48.66 All Payors / Plans All Payors / Plans 49.65 other 49.65 49.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALOXONE PER 1 MG ERX-636000000 CDM J2310 HCPCS 636 RC 0338-0691-04 NDC 0.1 ML outpatient 1.62 1.59 All Payors / Plans All Payors / Plans 1.62 other 1.62 1.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALOXONE 1 MG/ML 1 MG/ML SYRINGE ERX-636000000 CDM J2310 HCPCS 636 RC 31722-520-01 NDC JZ 1 ML outpatient 32.2 31.56 All Payors / Plans All Payors / Plans 32.2 other 32.2 32.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALOXONE 1 MG/ML 1 MG/ML SYRINGE ERX-636000000 CDM J2310 HCPCS 636 RC 51079-075-01 NDC JZ 0.4 ML outpatient 12.88 12.62 All Payors / Plans All Payors / Plans 12.88 other 12.88 12.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALOXONE 1 MG/ML 1 MG/ML SYRINGE ERX-636000000 CDM J2310 HCPCS 636 RC 63739-327-10 NDC JZ 0.4 ML outpatient 10.02 9.82 All Payors / Plans All Payors / Plans 10.02 other 10.02 10.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALOXONE PER 1 MG ERX-636000000 CDM J2310 HCPCS 636 RC 0904-6442-61 NDC JZ 0.1 ML outpatient 2.1 2.06 All Payors / Plans All Payors / Plans 2.1 other 2.1 2.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NALOXONE PER 1 MG ERX-636000000 CDM J2310 HCPCS 636 RC 23155-834-01 NDC JZ 0.1 ML outpatient 2.1 2.06 All Payors / Plans All Payors / Plans 2.1 other 2.1 2.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OCTREOTIDE,MICROSPHERES 20 MG SUSPENSION,EXTENDED REL RECON" ERX-636000000 CDM J2353 HCPCS 636 RC 49281-215-88 NDC JZ 1 UN outpatient 4929.66 4831.07 All Payors / Plans All Payors / Plans 4929.66 other 4929.66 4929.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "OCTREOTIDE,MICROSPHERES 30 MG SUSPENSION,EXTENDED REL RECON" ERX-636000000 CDM J2353 HCPCS 636 RC 49281-400-10 NDC JZ 1 UN outpatient 7041.32 6900.49 All Payors / Plans All Payors / Plans 7041.32 other 7041.32 7041.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCTREOTIDE PER 25 MCG ERX-636000000 CDM J2354 HCPCS 636 RC 60687-593-11 NDC JZ 1 ML outpatient 15.28 14.97 All Payors / Plans All Payors / Plans 15.28 other 15.28 15.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCTREOTIDE PER 25 MCG ERX-636000000 CDM J2354 HCPCS 636 RC 0406-0125-01 NDC JZ 1 ML outpatient 61.21 59.99 All Payors / Plans All Payors / Plans 61.21 other 61.21 61.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCTREOTIDE PER 25 MCG ERX-636000000 CDM J2354 HCPCS 636 RC 0406-0125-23 NDC JZ 1 ML outpatient 15.27 14.96 All Payors / Plans All Payors / Plans 15.27 other 15.27 15.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCTREOTIDE PER 25 MCG ERX-636000000 CDM J2354 HCPCS 636 RC 0406-0123-23 NDC JZ 1 ML outpatient 65.57 64.26 All Payors / Plans All Payors / Plans 65.57 other 65.57 65.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCTREOTIDE PER 25 MCG ERX-636000000 CDM J2354 HCPCS 636 RC 0904-6824-61 NDC JZ 0.5 ML outpatient 7.76 7.6 All Payors / Plans All Payors / Plans 7.76 other 7.76 7.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCTREOTIDE PER 25 MCG ERX-636000000 CDM J2354 HCPCS 636 RC 0121-2316-15 NDC JZ 1 ML outpatient 50.03 49.03 All Payors / Plans All Payors / Plans 50.03 other 50.03 50.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCTREOTIDE PER 25 MCG ERX-636000000 CDM J2354 HCPCS 636 RC 0168-0015-31 NDC JZ 1 ML outpatient 50.03 49.03 All Payors / Plans All Payors / Plans 50.03 other 50.03 50.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLANZAPINE 10 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J2359 HCPCS 636 RC 14789-102-02 NDC JZ 0.5 UN outpatient 83.39 81.72 All Payors / Plans All Payors / Plans 83.39 other 83.39 83.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPHRINE IN 0.9% NACL 40 MG/250 ML (160 MCG/ML) SOLUTION ERX-250000000 CDM J2371 HCPCS 250 RC 0186-0777-39 NDC 4.875 ML outpatient 81.87 80.23 All Payors / Plans All Payors / Plans 81.87 other 81.87 81.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPHRINE IN 0.9% NACL 40 MG/250 ML (160 MCG/ML) SOLUTION ERX-250000000 CDM J2371 HCPCS 250 RC 0517-9302-01 NDC 1.48125 ML outpatient 151.1 148.08 All Payors / Plans All Payors / Plans 151.1 other 151.1 151.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPHRINE 0.5 MG/5 ML (100 MCG/ML) SYRINGE ERX-636000000 CDM J2371 HCPCS 636 RC 0469-0607-73 NDC 2 ML outpatient 0.1 0.1 All Payors / Plans All Payors / Plans 0.1 other 0.1 0.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPHRINE PER 1 ML ERX-636000000 CDM J2371 HCPCS 636 RC 0904-6624-61 NDC 15 ML outpatient 76.16 74.64 All Payors / Plans All Payors / Plans 76.16 other 76.16 76.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPHRINE PER 1 ML ERX-636000000 CDM J2371 HCPCS 636 RC 68084-449-11 NDC 1 ML outpatient 0.99 0.97 All Payors / Plans All Payors / Plans 0.99 other 0.99 0.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENYLEPHRINE 0.5 MG/5 ML (100 MCG/ML) SYRINGE ERX-636000000 CDM J2371 HCPCS 636 RC 49884-724-01 NDC JZ 0.04 ML outpatient 0.25 0.25 All Payors / Plans All Payors / Plans 0.25 other 0.25 0.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLOROPROCAINE 20 MG/ML (2 %) SOLUTION ERX-636000000 CDM J2401 HCPCS 636 RC 0990-7923-36 NDC 2.5 ML outpatient 6.79 6.65 All Payors / Plans All Payors / Plans 6.79 other 6.79 6.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLOROPROCAINE PER 30 ML ERX-636000000 CDM J2401 HCPCS 636 RC 0904-7120-04 NDC JZ 3 ML outpatient 12.7 12.45 All Payors / Plans All Payors / Plans 12.7 other 12.7 12.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICARDIPINE 25 MG/10 ML SOLUTION ERX-636000000 CDM J2404 HCPCS 636 RC 60687-833-11 NDC JZ 0.04 ML outpatient 65.57 64.26 All Payors / Plans All Payors / Plans 65.57 other 65.57 65.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NICARDIPINE 25 MG/10 ML SOLUTION 10 ML VIAL ERX-636000000 CDM J2404 HCPCS 636 RC 63739-328-10 NDC JZ 20 ML outpatient 99.7 97.71 All Payors / Plans All Payors / Plans 99.7 other 99.7 99.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 1 MG ERX-636000000 CDM J2405 HCPCS 636 RC 0338-0553-18 NDC 4 ML outpatient 4.16 4.08 All Payors / Plans All Payors / Plans 4.16 other 4.16 4.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 1 MG ERX-636000000 CDM J2405 HCPCS 636 RC 59762-0074-1 NDC JZ 2 ML outpatient 0.5 0.49 All Payors / Plans All Payors / Plans 0.5 other 0.5 0.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 1 MG ERX-636000000 CDM J2405 HCPCS 636 RC 60687-582-01 NDC JZ 2 ML outpatient 0.5 0.49 All Payors / Plans All Payors / Plans 0.5 other 0.5 0.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 1 MG ERX-636000000 CDM J2405 HCPCS 636 RC 60687-582-11 NDC JZ 0.61 ML outpatient 0.19 0.19 All Payors / Plans All Payors / Plans 0.19 other 0.19 0.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONDANSETRON PER 1 MG ERX-636000000 CDM J2405 HCPCS 636 RC 62559-138-11 NDC JZ 1 ML outpatient 0.31 0.3 All Payors / Plans All Payors / Plans 0.31 other 0.31 0.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAMIDRONATE DISODIUM PER 30 MG ERX-636000000 CDM J2430 HCPCS 636 RC 0713-0503-06 NDC JZ 10 ML outpatient 142.46 139.61 All Payors / Plans All Payors / Plans 142.46 other 142.46 142.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAMIDRONATE DISODIUM PER 30 MG ERX-636000000 CDM J2430 HCPCS 636 RC 59762-0073-1 NDC JZ 10 ML outpatient 44.81 43.91 All Payors / Plans All Payors / Plans 44.81 other 44.81 44.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAPAVERINE PER 60 MG ERX-636000000 CDM J2440 HCPCS 636 RC 0406-3243-01 NDC JZ 2 ML outpatient 65.57 64.26 All Payors / Plans All Payors / Plans 65.57 other 65.57 65.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PALONOSETRON PER 25 MCG ERX-636000000 CDM J2469 HCPCS 636 RC 0168-0146-30 NDC JZ 5 ML outpatient 31.02 30.4 All Payors / Plans All Payors / Plans 31.02 other 31.02 31.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEGFILGRASTIM PER 6 MG ERX-636000000 CDM J2506 HCPCS 636 RC 42858-301-01 NDC JZ 0.6 ML outpatient 5180.41 5076.8 All Payors / Plans All Payors / Plans 5180.41 other 5180.41 5180.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PENICILLIN G POTASSIUM PER 600000 UNITS ERX-636000000 CDM J2540 HCPCS 636 RC 0781-3411-95 NDC 50 ML outpatient 64.95 63.65 All Payors / Plans All Payors / Plans 64.95 other 64.95 64.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PENICILLIN G POTASSIUM PER 600000 UNITS ERX-636000000 CDM J2540 HCPCS 636 RC 0409-3515-11 NDC JZ 0.024 UN outpatient 1.53 1.5 All Payors / Plans All Payors / Plans 1.53 other 1.53 1.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 68084-450-01 NDC 50 ML outpatient 51.34 50.31 All Payors / Plans All Payors / Plans 51.34 other 51.34 51.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 50268-398-11 NDC JZ 100 ML outpatient 62.1 60.86 All Payors / Plans All Payors / Plans 62.1 other 62.1 62.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 0338-3580-48 NDC JZ 1 UN outpatient 30.5 29.89 All Payors / Plans All Payors / Plans 30.5 other 30.5 30.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 63323-221-01 NDC JZ 1 UN outpatient 10.71 10.5 All Payors / Plans All Payors / Plans 10.71 other 10.71 10.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 63323-221-10 NDC JZ 0.074666667 UN outpatient 0.83 0.81 All Payors / Plans All Payors / Plans 0.83 other 0.83 0.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 63323-284-01 NDC JZ 1 UN outpatient 10.72 10.51 All Payors / Plans All Payors / Plans 10.72 other 10.72 10.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 63323-284-20 NDC JZ 1 UN outpatient 10.72 10.51 All Payors / Plans All Payors / Plans 10.72 other 10.72 10.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 67457-339-00 NDC JZ 0.074666667 UN outpatient 0.83 0.81 All Payors / Plans All Payors / Plans 0.83 other 0.83 0.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 67457-823-12 NDC JZ 1 UN outpatient 11.3 11.07 All Payors / Plans All Payors / Plans 11.3 other 11.3 11.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 67457-823-99 NDC JZ 1 UN outpatient 16.09 15.77 All Payors / Plans All Payors / Plans 16.09 other 16.09 16.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 42023-164-01 NDC JZ 1 UN outpatient 16.09 15.77 All Payors / Plans All Payors / Plans 16.09 other 16.09 16.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 61703-309-16 NDC JZ 1 UN outpatient 20.66 20.25 All Payors / Plans All Payors / Plans 20.66 other 20.66 20.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 61703-309-06 NDC JZ 1 UN outpatient 21.01 20.59 All Payors / Plans All Payors / Plans 21.01 other 21.01 21.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIPERACILLIN SOD-TAZOBACTAM PER 1 G ERX-636000000 CDM J2543 HCPCS 636 RC 39822-1077-1 NDC JZ 0.074666667 UN outpatient 1.53 1.5 All Payors / Plans All Payors / Plans 1.53 other 1.53 1.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROMETHAZINE PER 50 MG ERX-636000000 CDM J2550 HCPCS 636 RC 68094-503-59 NDC JZ 1 ML outpatient 10.68 10.47 All Payors / Plans All Payors / Plans 10.68 other 10.68 10.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROMETHAZINE PER 50 MG ERX-636000000 CDM J2550 HCPCS 636 RC 68094-600-61 NDC JZ 0.5 ML outpatient 5.33 5.22 All Payors / Plans All Payors / Plans 5.33 other 5.33 5.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENOBARBITAL PER 120 MG ERX-636000000 CDM J2560 HCPCS 636 RC 60687-579-11 NDC JZ 1 ML outpatient 141.69 138.86 All Payors / Plans All Payors / Plans 141.69 other 141.69 141.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENOBARBITAL PER 120 MG ERX-636000000 CDM J2560 HCPCS 636 RC 68084-269-11 NDC JZ 5.79 ML outpatient 786.1 770.38 All Payors / Plans All Payors / Plans 786.1 other 786.1 786.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYTOCIN IN 0.9 NACL 30 UNIT/500 ML SOLUTION ERX-636000000 CDM J2590 HCPCS 636 RC 0338-9159-30 NDC 500 ML outpatient 63.77 62.49 All Payors / Plans All Payors / Plans 63.77 other 63.77 63.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYTOCIN IN 0.9 NACL 30 UNIT/500 ML SOLUTION ERX-636000000 CDM J2590 HCPCS 636 RC 0338-0013-06 NDC 500 ML outpatient 62.9 61.64 All Payors / Plans All Payors / Plans 62.9 other 62.9 62.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYTOCIN IN LACTATED RINGERS 30 UNIT/500 ML SOLUTION ERX-636000000 CDM J2590 HCPCS 636 RC 0264-2101-10 NDC 500 ML outpatient 49.71 48.72 All Payors / Plans All Payors / Plans 49.71 other 49.71 49.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXYTOCIN PER 10 UNITS ERX-636000000 CDM J2590 HCPCS 636 RC 0472-0337-30 NDC JZ 1 ML outpatient 10.58 10.37 All Payors / Plans All Payors / Plans 10.58 other 10.58 10.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DESMOPRESSIN PER 1 MCG ERX-636000000 CDM J2597 HCPCS 636 RC 0054-4183-25 NDC JZ 0.25 ML outpatient 32.94 32.28 All Payors / Plans All Payors / Plans 32.94 other 32.94 32.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VASOPRESSIN 0.4 UNIT/ML SOLUTION ERX-250000000 CDM J2598 HCPCS 250 RC 61314-656-25 NDC JZ 5 ML outpatient 16.44 16.11 All Payors / Plans All Payors / Plans 16.44 other 16.44 16.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VASOPRESSIN 0.4 UNIT/ML SOLUTION ERX-250000000 CDM J2598 HCPCS 250 RC 0143-9927-01 NDC JZ 100 ML outpatient 328.63 322.06 All Payors / Plans All Payors / Plans 328.63 other 328.63 328.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VASOPRESSIN 20 UNIT/ML SOLUTION ERX-636000000 CDM J2598 HCPCS 636 RC 51672-2116-2 NDC 0.15 ML outpatient 82.49 80.84 All Payors / Plans All Payors / Plans 82.49 other 82.49 82.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VASOPRESSIN 20 UNIT/ML SOLUTION ERX-636000000 CDM J2598 HCPCS 636 RC 60687-450-01 NDC JZ 0.15 ML outpatient 87.07 85.33 All Payors / Plans All Payors / Plans 87.07 other 87.07 87.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 60687-446-01 NDC JZ 1.5 ML outpatient 0.84 0.82 All Payors / Plans All Payors / Plans 0.84 other 0.84 0.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 60687-446-11 NDC JZ 1 ML outpatient 0.56 0.55 All Payors / Plans All Payors / Plans 0.56 other 0.56 0.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 0904-5854-61 NDC JZ 7 ML outpatient 3.15 3.09 All Payors / Plans All Payors / Plans 3.15 other 3.15 3.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 0904-5855-61 NDC JZ 2 ML outpatient 0.9 0.88 All Payors / Plans All Payors / Plans 0.9 other 0.9 0.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 60687-468-11 NDC JZ 8 ML outpatient 4.41 4.32 All Payors / Plans All Payors / Plans 4.41 other 4.41 4.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 65162-466-10 NDC JZ 2.5 ML outpatient 1 0.98 All Payors / Plans All Payors / Plans 1 other 1 1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 64380-169-01 NDC JZ 55.343 ML outpatient 22.49 22.04 All Payors / Plans All Payors / Plans 22.49 other 22.49 22.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 69315-135-01 NDC JZ 3 ML outpatient 2.29 2.24 All Payors / Plans All Payors / Plans 2.29 other 2.29 2.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 0228-2597-11 NDC JZ 1 ML outpatient 0.72 0.71 All Payors / Plans All Payors / Plans 0.72 other 0.72 0.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 62559-511-01 NDC JZ 15 ML outpatient 9.34 9.15 All Payors / Plans All Payors / Plans 9.34 other 9.34 9.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROPOFOL 10 MG/ML EMULSION ERX-636000000 CDM J2704 HCPCS 636 RC 50268-430-11 NDC JZ 7 ML outpatient 3.86 3.78 All Payors / Plans All Payors / Plans 3.86 other 3.86 3.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEOSTIGMINE METHYLSULFATE 3 MG/3 ML (1 MG/ML) SYRINGE ERX-636000000 CDM J2710 HCPCS 636 RC 50111-328-01 NDC JZ 2 ML outpatient 41.6 40.77 All Payors / Plans All Payors / Plans 41.6 other 41.6 41.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEOSTIGMINE PER 0.5 MG ERX-636000000 CDM J2710 HCPCS 636 RC 51079-076-01 NDC JZ 2 ML outpatient 24.58 24.09 All Payors / Plans All Payors / Plans 24.58 other 24.58 24.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROTAMINE SULFATE PER 10 MG ERX-636000000 CDM J2720 HCPCS 636 RC 68462-406-01 NDC JZ 1 ML outpatient 12.17 11.93 All Payors / Plans All Payors / Plans 12.17 other 12.17 12.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROTAMINE SULFATE PER 10 MG ERX-636000000 CDM J2720 HCPCS 636 RC 68462-302-01 NDC JZ 1.5 ML outpatient 18.25 17.89 All Payors / Plans All Payors / Plans 18.25 other 18.25 18.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROTAMINE SULFATE PER 10 MG ERX-636000000 CDM J2720 HCPCS 636 RC 70710-1852-7 NDC JZ 20 ML outpatient 109.5 107.31 All Payors / Plans All Payors / Plans 109.5 other 109.5 109.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHENTOLAMINE MESYLATE PER 5 MG ERX-636000000 CDM J2760 HCPCS 636 RC 0338-3552-48 NDC JZ 1 UN outpatient 658.42 645.25 All Payors / Plans All Payors / Plans 658.42 other 658.42 658.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE PER 10 MG ERX-636000000 CDM J2765 HCPCS 636 RC 60687-224-11 NDC JZ 2 ML outpatient 5.88 5.76 All Payors / Plans All Payors / Plans 5.88 other 5.88 5.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE PER 10 MG ERX-636000000 CDM J2765 HCPCS 636 RC 0713-0683-15 NDC JZ 1 ML outpatient 2.94 2.88 All Payors / Plans All Payors / Plans 2.94 other 2.94 2.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE PER 10 MG ERX-636000000 CDM J2765 HCPCS 636 RC 45802-056-35 NDC JZ 1 ML outpatient 2.94 2.88 All Payors / Plans All Payors / Plans 2.94 other 2.94 2.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE PER 10 MG ERX-636000000 CDM J2765 HCPCS 636 RC 52565-085-15 NDC JZ 1 ML outpatient 2.94 2.88 All Payors / Plans All Payors / Plans 2.94 other 2.94 2.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE PER 10 MG ERX-636000000 CDM J2765 HCPCS 636 RC 24208-580-60 NDC JZ 1 ML outpatient 10.3 10.09 All Payors / Plans All Payors / Plans 10.3 other 10.3 10.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE PER 10 MG ERX-636000000 CDM J2765 HCPCS 636 RC 50268-359-11 NDC JZ 1 ML outpatient 0.5 0.49 All Payors / Plans All Payors / Plans 0.5 other 0.5 0.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METOCLOPRAMIDE PER 10 MG ERX-636000000 CDM J2765 HCPCS 636 RC 68084-326-11 NDC JZ 1 ML outpatient 0.5 0.49 All Payors / Plans All Payors / Plans 0.5 other 0.5 0.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RASBURICASE PER 0.5 MG ERX-636000000 CDM J2783 HCPCS 636 RC 70100-424-01 NDC JZ 2 UN outpatient 2833.5 2776.83 All Payors / Plans All Payors / Plans 2833.5 other 2833.5 2833.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility REGADENOSON 0.4 MG/5 ML SYRINGE ERX-636000000 CDM J2785 HCPCS 636 RC 0088-2219-05 NDC JZ 5 ML outpatient 36.35 35.62 All Payors / Plans All Payors / Plans 36.35 other 36.35 36.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility REGADENOSON 0.4 MG/5 ML SYRINGE ERX-636000000 CDM J2785 HCPCS 636 RC 0088-2220-33 NDC JZ 5 ML outpatient 61.8 60.56 All Payors / Plans All Payors / Plans 61.8 other 61.8 61.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML SYRINGE" ERX-636000000 CDM J2791 HCPCS 636 RC 0955-1729-01 NDC JZ 2 ML outpatient 242.13 237.29 All Payors / Plans All Payors / Plans 242.13 other 242.13 242.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML SYRINGE" ERX-636000000 CDM J2791 HCPCS 636 RC 0002-7510-01 NDC JZ 2 ML outpatient 203.92 199.84 All Payors / Plans All Payors / Plans 203.92 other 203.92 203.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPIVACAINE PER 1 MG ERX-636000000 CDM J2795 HCPCS 636 RC 0002-7737-01 NDC JZ 20 ML outpatient 20.62 20.21 All Payors / Plans All Payors / Plans 20.62 other 20.62 20.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPIVACAINE PER 1 MG ERX-636000000 CDM J2795 HCPCS 636 RC 0024-5926-05 NDC JZ 100 ML outpatient 82.26 80.61 All Payors / Plans All Payors / Plans 82.26 other 82.26 82.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPIVACAINE PER 1 MG ERX-636000000 CDM J2795 HCPCS 636 RC 0002-8222-01 NDC JZ 15 ML outpatient 10.61 10.4 All Payors / Plans All Payors / Plans 10.61 other 10.61 10.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPIVACAINE PER 1 MG ERX-636000000 CDM J2795 HCPCS 636 RC 0002-8222-59 NDC JZ 10 ML outpatient 20.29 19.88 All Payors / Plans All Payors / Plans 20.29 other 20.29 20.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROPIVACAINE PER 1 MG ERX-636000000 CDM J2795 HCPCS 636 RC 0002-8799-01 NDC JZ 40 ML outpatient 63.52 62.25 All Payors / Plans All Payors / Plans 63.52 other 63.52 63.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROMIPLOSTIM PER 10 MCG ERX-636000000 CDM J2796 HCPCS 636 RC 43598-750-11 NDC JG 0.08 UN outpatient 159.64 156.45 All Payors / Plans All Payors / Plans 159.64 other 159.64 159.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROMIPLOSTIM PER 10 MCG ERX-636000000 CDM J2796 HCPCS 636 RC 63323-376-00 NDC JW 0.04 UN outpatient 132.25 129.61 All Payors / Plans All Payors / Plans 132.25 other 132.25 132.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROMIPLOSTIM PER 10 MCG ERX-636000000 CDM J2796 HCPCS 636 RC 63323-377-00 NDC JW 0.1 UN outpatient 592.78 580.92 All Payors / Plans All Payors / Plans 592.78 other 592.78 592.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SINCALIDE PER 5 MCG ERX-636000000 CDM J2805 HCPCS 636 RC 43598-848-11 NDC JZ 0.24 UN outpatient 78.98 77.4 All Payors / Plans All Payors / Plans 78.98 other 78.98 78.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NA FERRIC GLUC CPLX PER 12.5 MG ERX-636000000 CDM J2916 HCPCS 636 RC 0904-6441-61 NDC JZ 5 ML outpatient 82.17 80.53 All Payors / Plans All Payors / Plans 82.17 other 82.17 82.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE PER 125 MG ERX-636000000 CDM J2919 HCPCS 636 RC 70954-518-10 NDC 1 UN outpatient 85.57 83.86 All Payors / Plans All Payors / Plans 85.57 other 85.57 85.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE PER 125 MG ERX-636000000 CDM J2919 HCPCS 636 RC 63135-312-13 NDC 0.5 UN outpatient 31.72 31.09 All Payors / Plans All Payors / Plans 31.72 other 31.72 31.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "METHYLPREDNISOLONE SOD SUC(PF) 1,000 MG/8 ML RECON SOLN 1 EACH VIAL" ERX-636000000 CDM J2919 HCPCS 636 RC 65219-472-05 NDC JZ 0.5 UN outpatient 92.47 90.62 All Payors / Plans All Payors / Plans 92.47 other 92.47 92.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML RECON SOLN ERX-636000000 CDM J2919 HCPCS 636 RC 65219-474-05 NDC JZ 0.65 UN outpatient 25.78 25.26 All Payors / Plans All Payors / Plans 25.78 other 25.78 25.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML RECON SOLN ERX-636000000 CDM J2919 HCPCS 636 RC 0264-7800-09 NDC JZ 0.32 UN outpatient 12.69 12.44 All Payors / Plans All Payors / Plans 12.69 other 12.69 12.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML RECON SOLN ERX-636000000 CDM J2919 HCPCS 636 RC 0264-7800-20 NDC JZ 1 UN outpatient 25.82 25.3 All Payors / Plans All Payors / Plans 25.82 other 25.82 25.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML RECON SOLN 1 EACH VIAL ERX-636000000 CDM J2919 HCPCS 636 RC 0338-9543-02 NDC JZ 0.201 UN outpatient 5.19 5.09 All Payors / Plans All Payors / Plans 5.19 other 5.19 5.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALTEPLASE 2 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J2997 HCPCS 636 RC 23155-547-31 NDC JZ 1 UN outpatient 427.43 418.88 All Payors / Plans All Payors / Plans 427.43 other 427.43 427.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL PER 0.1 MG ERX-636000000 CDM J3010 HCPCS 636 RC 0904-6363-45 NDC JZ 2 ML outpatient 10.56 10.35 All Payors / Plans All Payors / Plans 10.56 other 10.56 10.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL PER 0.1 MG ERX-636000000 CDM J3010 HCPCS 636 RC 51079-766-01 NDC JZ 0.5 ML outpatient 1.54 1.51 All Payors / Plans All Payors / Plans 1.54 other 1.54 1.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL PER 0.1 MG ERX-636000000 CDM J3010 HCPCS 636 RC 0904-6860-61 NDC JZ 0.2 ML outpatient 1.04 1.02 All Payors / Plans All Payors / Plans 1.04 other 1.04 1.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL PER 0.1 MG ERX-636000000 CDM J3010 HCPCS 636 RC 29300-139-01 NDC JZ 1 ML outpatient 2.19 2.15 All Payors / Plans All Payors / Plans 2.19 other 2.19 2.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL PER 0.1 MG ERX-636000000 CDM J3010 HCPCS 636 RC 68084-776-11 NDC JZ 0.25 ML outpatient 2.58 2.53 All Payors / Plans All Payors / Plans 2.58 other 2.58 2.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL PER 0.1 MG ERX-636000000 CDM J3010 HCPCS 636 RC 0904-7182-61 NDC JZ 0.5 ML outpatient 5.29 5.18 All Payors / Plans All Payors / Plans 5.29 other 5.29 5.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FENTANYL PER 0.1 MG ERX-636000000 CDM J3010 HCPCS 636 RC 50268-260-13 NDC JZ 0.5 ML outpatient 2.65 2.6 All Payors / Plans All Payors / Plans 2.65 other 2.65 2.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TENECTEPLASE PER 50 MG ERX-636000000 CDM J3101 HCPCS 636 RC 43598-750-58 NDC JG 0.34 UN outpatient 2814.26 2757.97 All Payors / Plans All Payors / Plans 2814.26 other 2814.26 2814.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TENECTEPLASE PER 50 MG ERX-636000000 CDM J3101 HCPCS 636 RC 76329-3369-1 NDC JG 0.3 UN outpatient 2483.17 2433.51 All Payors / Plans All Payors / Plans 2483.17 other 2483.17 2483.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TERBUTALINE PER 1 MG ERX-636000000 CDM J3105 HCPCS 636 RC 60505-1003-1 NDC JZ 0.25 ML outpatient 2.58 2.53 All Payors / Plans All Payors / Plans 2.58 other 2.58 2.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TERBUTALINE PER 1 MG ERX-636000000 CDM J3105 HCPCS 636 RC 61314-126-05 NDC JZ 0.25 ML outpatient 2.58 2.53 All Payors / Plans All Payors / Plans 2.58 other 2.58 2.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TERBUTALINE PER 1 MG ERX-636000000 CDM J3105 HCPCS 636 RC 0378-1134-01 NDC JZ 0.25 ML outpatient 2.6 2.55 All Payors / Plans All Payors / Plans 2.6 other 2.6 2.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHLORPROMAZINE PER 50 MG ERX-636000000 CDM J3230 HCPCS 636 RC 42292-054-01 NDC JZ 1 ML outpatient 52.77 51.71 All Payors / Plans All Payors / Plans 52.77 other 52.77 52.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIROFIBAN-0.9% SODIUM CHLORIDE 12.5 MG/250 ML (50 MCG/ML) SOLUTION ERX-636000000 CDM J3246 HCPCS 636 RC 71247-126-01 NDC JZ 250 ML outpatient 323.11 316.65 All Payors / Plans All Payors / Plans 323.11 other 323.11 323.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOBRAMYCIN PER 80 MG ERX-636000000 CDM J3260 HCPCS 636 RC 45802-732-30 NDC 2 ML outpatient 20.38 19.97 All Payors / Plans All Payors / Plans 20.38 other 20.38 20.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOBRAMYCIN PER 80 MG ERX-636000000 CDM J3260 HCPCS 636 RC 0121-1314-00 NDC 0.5 ML outpatient 5.1 5 All Payors / Plans All Payors / Plans 5.1 other 5.1 5.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOBRAMYCIN PER 80 MG ERX-636000000 CDM J3260 HCPCS 636 RC 59417-101-10 NDC 2 UN outpatient 311.4 305.17 All Payors / Plans All Payors / Plans 311.4 other 311.4 311.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRIAMCINOLONE PER 10 MG ERX-636000000 CDM J3301 HCPCS 636 RC 0121-1314-11 NDC 0.1 ML outpatient 3.07 3.01 All Payors / Plans All Payors / Plans 3.07 other 3.07 3.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRIAMCINOLONE PER 10 MG ERX-636000000 CDM J3301 HCPCS 636 RC 68094-231-59 NDC 0.05 ML outpatient 0.51 0.5 All Payors / Plans All Payors / Plans 0.51 other 0.51 0.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIAZEPAM 5 MG/ML SYRINGE ERX-636000000 CDM J3360 HCPCS 636 RC 0121-1276-10 NDC JZ 0.2 ML outpatient 4.17 4.09 All Payors / Plans All Payors / Plans 4.17 other 4.17 4.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIAZEPAM 5 MG/ML SYRINGE ERX-636000000 CDM J3360 HCPCS 636 RC 69339-149-05 NDC JZ 0.2 ML outpatient 4.17 4.09 All Payors / Plans All Payors / Plans 4.17 other 4.17 4.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIAZEPAM 5 MG/ML SYRINGE ERX-636000000 CDM J3360 HCPCS 636 RC 70030-510-79 NDC JZ 0.1 ML outpatient 1.57 1.54 All Payors / Plans All Payors / Plans 1.57 other 1.57 1.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIAZEPAM 5 MG/ML SYRINGE ERX-636000000 CDM J3360 HCPCS 636 RC 0574006915 NDC JZ 1 ML outpatient 15.61 15.3 All Payors / Plans All Payors / Plans 15.61 other 15.61 15.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 1.25 GRAM/250 ML PIGGYBACK ERX-636000000 CDM J3370 HCPCS 636 RC 68094-231-61 NDC 250 ML outpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 1.5 GRAM/300 ML PIGGYBACK ERX-636000000 CDM J3370 HCPCS 636 RC 51672-2116-0 NDC 300 ML outpatient 139 136.22 All Payors / Plans All Payors / Plans 139 other 139 139 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 0904-7110-61 NDC JZ 6.6 ML outpatient 4.47 4.38 All Payors / Plans All Payors / Plans 4.47 other 4.47 4.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 23155-724-01 NDC JZ 33 ML outpatient 51.54 50.51 All Payors / Plans All Payors / Plans 51.54 other 51.54 51.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 10 GRAM RECON SOLN ERX-636000000 CDM J3370 HCPCS 636 RC 59417-103-10 NDC 0.0125 UN outpatient 0.83 0.81 All Payors / Plans All Payors / Plans 0.83 other 0.83 0.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 10 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J3370 HCPCS 636 RC 0904-6798-61 NDC 0.125 UN outpatient 15.54 15.23 All Payors / Plans All Payors / Plans 15.54 other 15.54 15.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 10 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J3370 HCPCS 636 RC 43547-353-10 NDC 0.15 UN outpatient 45.5 44.59 All Payors / Plans All Payors / Plans 45.5 other 45.5 45.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 0591-0405-01 NDC 0.5 UN outpatient 5.36 5.25 All Payors / Plans All Payors / Plans 5.36 other 5.36 5.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 60687-656-11 NDC 1 UN outpatient 15.67 15.36 All Payors / Plans All Payors / Plans 15.67 other 15.67 15.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 0904-6799-61 NDC 1 UN outpatient 26.24 25.72 All Payors / Plans All Payors / Plans 26.24 other 26.24 26.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 43547-354-10 NDC 1 UN outpatient 26.24 25.72 All Payors / Plans All Payors / Plans 26.24 other 26.24 26.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 1.5 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J3370 HCPCS 636 RC 72266-160-01 NDC JZ 1 UN outpatient 62.41 61.16 All Payors / Plans All Payors / Plans 62.41 other 62.41 62.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN 1.5 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J3370 HCPCS 636 RC 72266-160-10 NDC JZ 1 UN outpatient 62.41 61.16 All Payors / Plans All Payors / Plans 62.41 other 62.41 62.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 67457-390-54 NDC JZ 0.066 UN outpatient 0.72 0.71 All Payors / Plans All Payors / Plans 0.72 other 0.72 0.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 70860-210-51 NDC JZ 1 UN outpatient 10.9 10.68 All Payors / Plans All Payors / Plans 10.9 other 10.9 10.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 76125-150-02 NDC JZ 0.033 UN outpatient 0.37 0.36 All Payors / Plans All Payors / Plans 0.37 other 0.37 0.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 76125-150-10 NDC JZ 0.5 UN outpatient 5.51 5.4 All Payors / Plans All Payors / Plans 5.51 other 5.51 5.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3370 HCPCS 636 RC 50632-010-01 NDC JZ 1 UN outpatient 10.9 10.68 All Payors / Plans All Payors / Plans 10.9 other 10.9 10.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3371 HCPCS 636 RC 0024-5154-11 NDC JZ 1 UN outpatient 84.03 82.35 All Payors / Plans All Payors / Plans 84.03 other 84.03 84.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VANCOMYCIN PER 500 MG ERX-636000000 CDM J3371 HCPCS 636 RC 0069-0238-01 NDC JZ 1 UN outpatient 84.03 82.35 All Payors / Plans All Payors / Plans 84.03 other 84.03 84.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROXYZINE PER 25 MG ERX-636000000 CDM J3410 HCPCS 636 RC 0904-6426-61 NDC JZ 0.5 ML outpatient 42.67 41.82 All Payors / Plans All Payors / Plans 42.67 other 42.67 42.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THIAMINE PER 100 MG ERX-636000000 CDM J3411 HCPCS 636 RC 25021-830-82 NDC 1 ML outpatient 10.48 10.27 All Payors / Plans All Payors / Plans 10.48 other 10.48 10.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THIAMINE PER 100 MG ERX-636000000 CDM J3411 HCPCS 636 RC 45802-732-00 NDC 1 ML outpatient 10.48 10.27 All Payors / Plans All Payors / Plans 10.48 other 10.48 10.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYANOCOBALAMIN PER 1000 MCG ERX-636000000 CDM J3420 HCPCS 636 RC 0641-0376-25 NDC 1 ML outpatient 20.29 19.88 All Payors / Plans All Payors / Plans 20.29 other 20.29 20.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYANOCOBALAMIN PER 1000 MCG ERX-636000000 CDM J3420 HCPCS 636 RC 60687-558-11 NDC JZ 0.1 ML outpatient 1.55 1.52 All Payors / Plans All Payors / Plans 1.55 other 1.55 1.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYANOCOBALAMIN PER 1000 MCG ERX-636000000 CDM J3420 HCPCS 636 RC 69097-846-07 NDC JZ 1 ML outpatient 15.45 15.14 All Payors / Plans All Payors / Plans 15.45 other 15.45 15.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML SYRINGE ERX-636000000 CDM J3430 HCPCS 636 RC 0185-0674-01 NDC JZ 0.5 ML outpatient 103.3 101.23 All Payors / Plans All Payors / Plans 103.3 other 103.3 103.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PHYTONADIONE (VITAMIN K1) 10 MG/ML SOLUTION 1 ML AMPUL ERX-636000000 CDM J3430 HCPCS 636 RC 0904-7065-61 NDC JZ 0.25 ML outpatient 20.89 20.47 All Payors / Plans All Payors / Plans 20.89 other 20.89 20.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VORICONAZOLE PER 10 MG ERX-636000000 CDM J3465 HCPCS 636 RC 63459-910-11 NDC JZ 1 UN outpatient 101.32 99.29 All Payors / Plans All Payors / Plans 101.32 other 101.32 101.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VORICONAZOLE PER 10 MG ERX-636000000 CDM J3465 HCPCS 636 RC 63459-910-12 NDC JZ 1 UN outpatient 64.87 63.57 All Payors / Plans All Payors / Plans 64.87 other 64.87 64.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HYALURONIDASE, HUMAN RECOMB. 150 UNIT/ML SOLUTION 1 ML VIAL" ERX-636000000 CDM J3473 HCPCS 636 RC 69452-151-20 NDC JZ 1 ML outpatient 143.88 141 All Payors / Plans All Payors / Plans 143.88 other 143.88 143.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 1 GRAM/100 ML PIGGYBACK ERX-636000000 CDM J3475 HCPCS 636 RC 0338-0709-48 NDC 100 ML outpatient 15.96 15.64 All Payors / Plans All Payors / Plans 15.96 other 15.96 15.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 1 GRAM/100 ML PIGGYBACK ERX-636000000 CDM J3475 HCPCS 636 RC 0338-0705-41 NDC 100 ML outpatient 16.04 15.72 All Payors / Plans All Payors / Plans 16.04 other 16.04 16.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) PIGGYBACK ERX-636000000 CDM J3475 HCPCS 636 RC 0338-0695-04 NDC 50 ML outpatient 15.73 15.42 All Payors / Plans All Payors / Plans 15.73 other 15.73 15.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) PIGGYBACK ERX-636000000 CDM J3475 HCPCS 636 RC 0338-0703-41 NDC 50 ML outpatient 21.16 20.74 All Payors / Plans All Payors / Plans 21.16 other 21.16 21.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) PIGGYBACK ERX-636000000 CDM J3475 HCPCS 636 RC 0338-0704-34 NDC 50 ML outpatient 20.47 20.06 All Payors / Plans All Payors / Plans 20.47 other 20.47 20.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) PARENTERAL SOLUTION ERX-636000000 CDM J3475 HCPCS 636 RC 0338-0705-48 NDC 100 ML outpatient 4.16 4.08 All Payors / Plans All Payors / Plans 4.16 other 4.16 4.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE PER 500 MG MAGNESIUM ERX-636000000 CDM J3475 HCPCS 636 RC 0990-7075-26 NDC 100 ML outpatient 25.98 25.46 All Payors / Plans All Payors / Plans 25.98 other 25.98 25.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE PER 500 MG MAGNESIUM ERX-636000000 CDM J3475 HCPCS 636 RC 0713-0351-02 NDC 100 ML outpatient 20.72 20.31 All Payors / Plans All Payors / Plans 20.72 other 20.72 20.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE 1 GRAM/100 ML PIGGYBACK ERX-636000000 CDM J3475 HCPCS 636 RC 60505-0165-1 NDC JZ 100 ML outpatient 15.24 14.94 All Payors / Plans All Payors / Plans 15.24 other 15.24 15.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE PER 500 MG MAGNESIUM ERX-636000000 CDM J3475 HCPCS 636 RC 0904-7224-61 NDC JZ 100 ML outpatient 15.37 15.06 All Payors / Plans All Payors / Plans 15.37 other 15.37 15.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE PER 500 MG OF MAGNESIUM ERX-636000000 CDM J3475 HCPCS 636 RC 60687-681-01 NDC JZ 0.09 ML outpatient 0.12 0.12 All Payors / Plans All Payors / Plans 0.12 other 0.12 0.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE PER 500 MG OF MAGNESIUM ERX-636000000 CDM J3475 HCPCS 636 RC 60687-681-11 NDC JZ 2 ML outpatient 10.2 10 All Payors / Plans All Payors / Plans 10.2 other 10.2 10.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE PER 500 MG OF MAGNESIUM ERX-636000000 CDM J3475 HCPCS 636 RC 0054-8297-25 NDC JZ 2 ML outpatient 10.2 10 All Payors / Plans All Payors / Plans 10.2 other 10.2 10.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE PER 500 MG OF MAGNESIUM ERX-636000000 CDM J3475 HCPCS 636 RC 64980-562-01 NDC JZ 1.971 ML outpatient 2.06 2.02 All Payors / Plans All Payors / Plans 2.06 other 2.06 2.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAGNESIUM SULFATE PER 500 MG OF MAGNESIUM ERX-636000000 CDM J3475 HCPCS 636 RC 0054-8299-25 NDC JZ 0.14 ML outpatient 0.18 0.18 All Payors / Plans All Payors / Plans 0.18 other 0.18 0.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE 10 MEQ/100 ML PIGGYBACK ERX-636000000 CDM J3480 HCPCS 636 RC 68084-450-11 NDC 100 ML outpatient 22.55 22.1 All Payors / Plans All Payors / Plans 22.55 other 22.55 22.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE 10 MEQ/50 ML PIGGYBACK ERX-636000000 CDM J3480 HCPCS 636 RC 0641-6228-01 NDC 50 ML outpatient 11.11 10.89 All Payors / Plans All Payors / Plans 11.11 other 11.11 11.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE IN 0.9%NACL 40 MEQ/L PARENTERAL SOLUTION ERX-636000000 CDM J3480 HCPCS 636 RC 0641-6228-25 NDC 1000 ML outpatient 15.96 15.64 All Payors / Plans All Payors / Plans 15.96 other 15.96 15.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE PER 2 MEQ ERX-636000000 CDM J3480 HCPCS 636 RC 39822-0412-1 NDC 50 ML outpatient 11.13 10.91 All Payors / Plans All Payors / Plans 11.13 other 11.13 11.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE PER 2 MEQ ERX-636000000 CDM J3480 HCPCS 636 RC 63323-306-01 NDC 1000 ML outpatient 15.5 15.19 All Payors / Plans All Payors / Plans 15.5 other 15.5 15.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE PER 2 MEQ ERX-636000000 CDM J3480 HCPCS 636 RC 63323-306-02 NDC 100 ML outpatient 15.28 14.97 All Payors / Plans All Payors / Plans 15.28 other 15.28 15.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE PER 2 MEQ ERX-636000000 CDM J3480 HCPCS 636 RC 0003-0293-20 NDC 100 ML outpatient 26.15 25.63 All Payors / Plans All Payors / Plans 26.15 other 26.15 26.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 0.9 % WITH KCL 20 MEQ/L INFUSION 20 MEQ/L PARENTERAL SOLUTION ERX-636000000 CDM J3480 HCPCS 636 RC 0143-9164-01 NDC 1000 ML outpatient 15.19 14.89 All Payors / Plans All Payors / Plans 15.19 other 15.19 15.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE IN 5 % DEX 20 MEQ/L PARENTERAL SOLUTION ERX-636000000 CDM J3480 HCPCS 636 RC 0185-0676-01 NDC JZ 1000 ML outpatient 23.26 22.79 All Payors / Plans All Payors / Plans 23.26 other 23.26 23.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE IN 5 % DEX 20 MEQ/L PARENTERAL SOLUTION ERX-636000000 CDM J3480 HCPCS 636 RC 50268-399-11 NDC JZ 1000 ML outpatient 43.84 42.96 All Payors / Plans All Payors / Plans 43.84 other 43.84 43.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE PER 2 MEQ ERX-636000000 CDM J3480 HCPCS 636 RC 77790-022-15 NDC JZ 50 ML outpatient 103.19 101.13 All Payors / Plans All Payors / Plans 103.19 other 103.19 103.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE PER 2 MEQ OF POTASSIUM ERX-636000000 CDM J3480 HCPCS 636 RC 0121-1828-00 NDC JZ 0.06 ML outpatient 0.07 0.07 All Payors / Plans All Payors / Plans 0.07 other 0.07 0.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE PER 2 MEQ OF POTASSIUM ERX-636000000 CDM J3480 HCPCS 636 RC 0121-1828-10 NDC JZ 10 ML outpatient 5.21 5.11 All Payors / Plans All Payors / Plans 5.21 other 5.21 5.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POTASSIUM CHLORIDE PER 2 MEQ OF POTASSIUM ERX-636000000 CDM J3480 HCPCS 636 RC 68094-494-59 NDC JZ 5 ML outpatient 2.99 2.93 All Payors / Plans All Payors / Plans 2.99 other 2.99 2.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZIPRASIDONE MESYLATE PER 10 MG ERX-636000000 CDM J3486 HCPCS 636 RC 63459-912-11 NDC JZ 1 UN outpatient 45.3 44.39 All Payors / Plans All Payors / Plans 45.3 other 45.3 45.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZIPRASIDONE MESYLATE PER 10 MG ERX-636000000 CDM J3486 HCPCS 636 RC 63459-912-12 NDC JZ 1 UN outpatient 65.65 64.34 All Payors / Plans All Payors / Plans 65.65 other 65.65 65.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZIPRASIDONE MESYLATE PER 10 MG ERX-636000000 CDM J3486 HCPCS 636 RC 0703-4248-01 NDC JZ 1 UN outpatient 65.65 64.34 All Payors / Plans All Payors / Plans 65.65 other 65.65 65.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZOLEDRONIC ACID PER 1 MG ERX-636000000 CDM J3489 HCPCS 636 RC 0904-6773-61 NDC 100 ML outpatient 104.45 102.36 All Payors / Plans All Payors / Plans 104.45 other 104.45 104.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZOLEDRONIC ACID PER 1 MG ERX-636000000 CDM J3489 HCPCS 636 RC 68094-330-59 NDC 100 ML outpatient 152.75 149.7 All Payors / Plans All Payors / Plans 152.75 other 152.75 152.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZOLEDRONIC ACID PER 1 MG ERX-636000000 CDM J3489 HCPCS 636 RC 13668-047-01 NDC JZ 4.1 ML outpatient 113.97 111.69 All Payors / Plans All Payors / Plans 113.97 other 113.97 113.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ZOLEDRONIC ACID-MANNITOL-WATER 4 MG/100 ML PIGGYBACK ERX-636000000 CDM J3489 HCPCS 636 RC 68084-319-11 NDC JZ 100 ML outpatient 45.33 44.42 All Payors / Plans All Payors / Plans 45.33 other 45.33 45.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FAMOTIDINE 20 MG/2 ML SOLUTION 2 ML VIAL ERX-636000000 CDM J3490 HCPCS 636 RC 71205-909-90 NDC JZ 2 ML outpatient 0.8 0.78 All Payors / Plans All Payors / Plans 0.8 other 0.8 0.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FAMOTIDINE PER 20 MG ERX-636000000 CDM J3490 HCPCS 636 RC 0832-7122-11 NDC JZ 50 ML outpatient 10.74 10.53 All Payors / Plans All Payors / Plans 10.74 other 10.74 10.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7030 HCPCS 636 RC 0002-8215-17 NDC JZ 10 ML outpatient 0.18 0.18 All Payors / Plans All Payors / Plans 0.18 other 0.18 0.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7030 HCPCS 636 RC 50268-447-11 NDC JZ 700 ML outpatient 16.04 15.72 All Payors / Plans All Payors / Plans 16.04 other 16.04 16.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7030 HCPCS 636 RC 0904-6450-61 NDC JZ 500 ML outpatient 11.46 11.23 All Payors / Plans All Payors / Plans 11.46 other 11.46 11.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250ML ERX-636000000 CDM J7030 HCPCS 636 RC 55513-800-60 NDC JZ 986.5 ML outpatient 22.71 22.26 All Payors / Plans All Payors / Plans 22.71 other 22.71 22.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7040 HCPCS 636 RC 0169-3004-01 NDC JZ 300 ML outpatient 19.06 18.68 All Payors / Plans All Payors / Plans 19.06 other 19.06 19.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7040 HCPCS 636 RC 0002-8215-01 NDC JZ 150 ML outpatient 5.31 5.2 All Payors / Plans All Payors / Plans 5.31 other 5.31 5.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7040 HCPCS 636 RC 59651-539-01 NDC JZ 250 ML outpatient 11.33 11.1 All Payors / Plans All Payors / Plans 11.33 other 11.33 11.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility D5 % AND 0.9 % SODIUM CHLORIDE PARENTERAL SOLUTION ERX-636000000 CDM J7042 HCPCS 636 RC 24208-735-01 NDC JZ 500 ML outpatient 17.88 17.52 All Payors / Plans All Payors / Plans 17.88 other 17.88 17.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility D5 % AND 0.9 % SODIUM CHLORIDE PARENTERAL SOLUTION ERX-636000000 CDM J7042 HCPCS 636 RC 0023-9163-30 NDC JZ 500 ML outpatient 33.1 32.44 All Payors / Plans All Payors / Plans 33.1 other 33.1 33.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility D5 % AND 0.9 % SODIUM CHLORIDE PARENTERAL SOLUTION ERX-636000000 CDM J7042 HCPCS 636 RC 68180-214-30 NDC JZ 1000 ML outpatient 18.39 18.02 All Payors / Plans All Payors / Plans 18.39 other 18.39 18.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% AND 0.9% SODIUM CHLORIDE PARENTERAL SOLUTION ERX-636000000 CDM J7042 HCPCS 636 RC 0555-0972-02 NDC JZ 250 ML outpatient 4.5 4.41 All Payors / Plans All Payors / Plans 4.5 other 4.5 4.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250ML ERX-636000000 CDM J7050 HCPCS 636 RC 70594-048-01 NDC 100 ML outpatient 23.1 22.64 All Payors / Plans All Payors / Plans 23.1 other 23.1 23.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250ML ERX-636000000 CDM J7050 HCPCS 636 RC 0143-9162-01 NDC 10 ML outpatient 2.34 2.29 All Payors / Plans All Payors / Plans 2.34 other 2.34 2.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 0.9 % ERX-636000000 CDM J7050 HCPCS 636 RC 0002-8799-59 NDC JZ 30 ML outpatient 13.82 13.54 All Payors / Plans All Payors / Plans 13.82 other 13.82 13.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE 0.9 % ERX-636000000 CDM J7050 HCPCS 636 RC 0002-8233-01 NDC JZ 100 ML outpatient 17.73 17.38 All Payors / Plans All Payors / Plans 17.73 other 17.73 17.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 0002-8233-05 NDC JZ 100 ML outpatient 23.03 22.57 All Payors / Plans All Payors / Plans 23.03 other 23.03 23.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 0169-3004-15 NDC JZ 40 ML outpatient 2.83 2.77 All Payors / Plans All Payors / Plans 2.83 other 2.83 2.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 0169-1833-11 NDC JZ 1 ML outpatient 0.72 0.71 All Payors / Plans All Payors / Plans 0.72 other 0.72 0.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 0338-0126-12 NDC JZ 10 ML outpatient 3.54 3.47 All Payors / Plans All Payors / Plans 3.54 other 3.54 3.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 31722-730-30 NDC JZ 10 ML outpatient 1.77 1.73 All Payors / Plans All Payors / Plans 1.77 other 1.77 1.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 50268-440-11 NDC JZ 1.809 ML outpatient 0.64 0.63 All Payors / Plans All Payors / Plans 0.64 other 0.64 0.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 0555-0071-02 NDC JZ 1.125 ML outpatient 0.4 0.39 All Payors / Plans All Payors / Plans 0.4 other 0.4 0.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 68084-082-11 NDC JZ 125 ML outpatient 31.45 30.82 All Payors / Plans All Payors / Plans 31.45 other 31.45 31.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 0781-1695-01 NDC JZ 2.25 ML outpatient 0.81 0.79 All Payors / Plans All Payors / Plans 0.81 other 0.81 0.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 63739-367-10 NDC JZ 5.94 ML outpatient 1.08 1.06 All Payors / Plans All Payors / Plans 1.08 other 1.08 1.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 68084-083-11 NDC JZ 250 ML outpatient 22.54 22.09 All Payors / Plans All Payors / Plans 22.54 other 22.54 22.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250 ML ERX-636000000 CDM J7050 HCPCS 636 RC 0904-6449-61 NDC JZ 5.94 ML outpatient 0.54 0.53 All Payors / Plans All Payors / Plans 0.54 other 0.54 0.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250ML ERX-636000000 CDM J7050 HCPCS 636 RC 55513-810-60 NDC JZ 202 ML outpatient 18.73 18.36 All Payors / Plans All Payors / Plans 18.73 other 18.73 18.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SODIUM CHLORIDE PER 250ML ERX-636000000 CDM J7050 HCPCS 636 RC 0168-0099-15 NDC JZ 225 ML outpatient 20.28 19.87 All Payors / Plans All Payors / Plans 20.28 other 20.28 20.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5 % PIGGYBACK 100 ML BAG ERX-636000000 CDM J7060 HCPCS 636 RC 67457-781-08 NDC 1.92 ML outpatient 0.45 0.44 All Payors / Plans All Payors / Plans 0.45 other 0.45 0.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5 % PIGGYBACK 100 ML BAG ERX-636000000 CDM J7060 HCPCS 636 RC 0338-1009-02 NDC 100 ML outpatient 23.31 22.84 All Payors / Plans All Payors / Plans 23.31 other 23.31 23.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5 % PIGGYBACK 100 ML BAG ERX-636000000 CDM J7060 HCPCS 636 RC 0409-7810-22 NDC 100 ML outpatient 22.7 22.25 All Payors / Plans All Payors / Plans 22.7 other 22.7 22.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5 % PIGGYBACK 250 ML BAG ERX-636000000 CDM J7060 HCPCS 636 RC 50242-100-39 NDC 250 ML outpatient 31.73 31.1 All Payors / Plans All Payors / Plans 31.73 other 31.73 31.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 42023-315-10 NDC 475 ML outpatient 30.49 29.88 All Payors / Plans All Payors / Plans 30.49 other 30.49 30.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 61553-712-61 NDC 225 ML outpatient 28.63 28.06 All Payors / Plans All Payors / Plans 28.63 other 28.63 28.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 71019-085-02 NDC 1.92 ML outpatient 0.14 0.14 All Payors / Plans All Payors / Plans 0.14 other 0.14 0.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 16729-114-08 NDC 446 ML outpatient 15.85 15.53 All Payors / Plans All Payors / Plans 15.85 other 15.85 15.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 16729-114-11 NDC 43 ML outpatient 15.21 14.91 All Payors / Plans All Payors / Plans 15.21 other 15.21 15.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 25021-184-82 NDC 1.92 ML outpatient 0.34 0.33 All Payors / Plans All Payors / Plans 0.34 other 0.34 0.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 0338-0507-48 NDC 36 ML outpatient 12.73 12.48 All Payors / Plans All Payors / Plans 12.73 other 12.73 12.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 0338-0509-41 NDC 100 ML outpatient 17.68 17.33 All Payors / Plans All Payors / Plans 17.68 other 17.68 17.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 63323-578-05 NDC 50 ML outpatient 17.79 17.43 All Payors / Plans All Payors / Plans 17.79 other 17.79 17.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 70700-167-22 NDC 1.92 ML outpatient 0.35 0.34 All Payors / Plans All Payors / Plans 0.35 other 0.35 0.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 0264-9587-20 NDC 500 ML outpatient 37.79 37.03 All Payors / Plans All Payors / Plans 37.79 other 37.79 37.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 0338-0424-18 NDC 50 ML outpatient 18.39 18.02 All Payors / Plans All Payors / Plans 18.39 other 18.39 18.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 25021-400-10 NDC 50 ML outpatient 18.33 17.96 All Payors / Plans All Payors / Plans 18.33 other 18.33 18.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 25021-402-10 NDC 100 ML outpatient 12.75 12.5 All Payors / Plans All Payors / Plans 12.75 other 12.75 12.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 67457-384-31 NDC 500 ML outpatient 32.43 31.78 All Payors / Plans All Payors / Plans 32.43 other 32.43 32.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 42806-341-01 NDC JZ 250 ML outpatient 18.28 17.91 All Payors / Plans All Payors / Plans 18.28 other 18.28 18.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7060 HCPCS 636 RC 0121-0638-05 NDC JZ 100 ML outpatient 17.91 17.55 All Payors / Plans All Payors / Plans 17.91 other 17.91 17.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7070 HCPCS 636 RC 63323-104-25 NDC 850 ML outpatient 15.21 14.91 All Payors / Plans All Payors / Plans 15.21 other 15.21 15.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% PER 500 ML ERX-636000000 CDM J7070 HCPCS 636 RC 70860-781-01 NDC 1000 ML outpatient 38.18 37.42 All Payors / Plans All Payors / Plans 38.18 other 38.18 38.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACTATED RINGERS PER 1000 ML ERX-636000000 CDM J7120 HCPCS 636 RC 60687-428-65 NDC JZ 60 ML outpatient 2.14 2.1 All Payors / Plans All Payors / Plans 2.14 other 2.14 2.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACTATED RINGERS PER 1000 ML ERX-636000000 CDM J7120 HCPCS 636 RC 0054-0011-20 NDC JZ 200 ML outpatient 3.62 3.55 All Payors / Plans All Payors / Plans 3.62 other 3.62 3.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LACTATED RINGERS PER 1000 ML ERX-636000000 CDM J7120 HCPCS 636 RC 0054-0010-20 NDC JZ 90 ML outpatient 2.1 2.06 All Payors / Plans All Payors / Plans 2.1 other 2.1 2.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% IN LACTATED RINGERS PER 1000 ML ERX-636000000 CDM J7121 HCPCS 636 RC 50242-100-40 NDC 500 ML outpatient 17.92 17.56 All Payors / Plans All Payors / Plans 17.92 other 17.92 17.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% IN LACTATED RINGERS PER 1000 ML ERX-636000000 CDM J7121 HCPCS 636 RC 42023-168-01 NDC 1000 ML outpatient 17.99 17.63 All Payors / Plans All Payors / Plans 17.99 other 17.99 17.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXTROSE 5% IN LACTATED RINGERS PER 1000 ML ERX-636000000 CDM J7121 HCPCS 636 RC 42023-315-01 NDC 250 ML outpatient 19.09 18.71 All Payors / Plans All Payors / Plans 19.09 other 19.09 19.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1240 UNIT) RECON SOLN" ERX-636000000 CDM J7168 HCPCS 636 RC 63323-285-13 NDC JZ 1 UN outpatient 1757.8 1722.64 All Payors / Plans All Payors / Plans 1757.8 other 1757.8 1757.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1240 UNIT) RECON SOLN" ERX-636000000 CDM J7168 HCPCS 636 RC 63323-285-28 NDC JZ 1 UN outpatient 2442.26 2393.41 All Payors / Plans All Payors / Plans 2442.26 other 2442.26 2442.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HUMAN PROTHROMBIN COMPLEX (PCC) 500 UNIT (400-620 UNIT) RECON SOLN ERX-636000000 CDM J7168 HCPCS 636 RC 0270-0556-15 NDC JZ 1 UN outpatient 1459.46 1430.27 All Payors / Plans All Payors / Plans 1459.46 other 1459.46 1459.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HUMAN PROTHROMBIN COMPLEX (PCC) 500 UNIT (400-620 UNIT) RECON SOLN ERX-636000000 CDM J7168 HCPCS 636 RC 0264-1800-31 NDC JZ 3 UN outpatient 3009.46 2949.27 All Payors / Plans All Payors / Plans 3009.46 other 3009.46 3009.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ANTIHEMOPHILIC FACTOR-VWF 1,000-1,000 UNIT RECON SOLN" ERX-636000000 CDM J7183 HCPCS 636 RC 50242-145-01 NDC JZ 4 UN outpatient 4484.46 4394.77 All Payors / Plans All Payors / Plans 4484.46 other 4484.46 4484.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANTIHEMOPHILIC FACTOR-VWF 500-500 UNIT RECON SOLN ERX-636000000 CDM J7183 HCPCS 636 RC 0641-0477-21 NDC JZ 1 UN outpatient 405 396.9 All Payors / Plans All Payors / Plans 405 other 405 405 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "COAGULATION FACTOR IX (RFIXFC) 1,000 UNIT RECON SOLN 1 EACH VIAL" ERX-636000000 CDM J7201 HCPCS 636 RC 0641-0928-21 NDC JZ 4 UN outpatient 64.46 63.17 All Payors / Plans All Payors / Plans 64.46 other 64.46 64.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COAGULATION FACTOR IX (RFIXFC) 500 UNIT RECON SOLN 1 EACH VIAL ERX-636000000 CDM J7201 HCPCS 636 RC 0641-1495-35 NDC JZ 1 UN outpatient 3.44 3.37 All Payors / Plans All Payors / Plans 3.44 other 3.44 3.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZATHIOPRINE PER 50 MG ERX-636000000 CDM J7500 HCPCS 636 RC 25021-673-77 NDC 1 UN outpatient 2.57 2.52 All Payors / Plans All Payors / Plans 2.57 other 2.57 2.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZATHIOPRINE PER 50 MG ERX-636000000 CDM J7500 HCPCS 636 RC 76329-3013-5 NDC 1 UN outpatient 2.57 2.52 All Payors / Plans All Payors / Plans 2.57 other 2.57 2.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOSPORINE MODIFIED PER 100 MG ERX-636000000 CDM J7502 HCPCS 636 RC 62135-712-42 NDC 1 UN outpatient 18.81 18.43 All Payors / Plans All Payors / Plans 18.81 other 18.81 18.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TACROLIMUS PER 1 MG ERX-636000000 CDM J7507 HCPCS 636 RC 10882-529-30 NDC 1 UN outpatient 9.95 9.75 All Payors / Plans All Payors / Plans 9.95 other 9.95 9.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TACROLIMUS PER 1 MG ERX-636000000 CDM J7507 HCPCS 636 RC 0904-6553-04 NDC 0.6 UN outpatient 10.01 9.81 All Payors / Plans All Payors / Plans 10.01 other 10.01 10.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TACROLIMUS PER 1 MG ERX-636000000 CDM J7507 HCPCS 636 RC 67877-419-33 NDC 1 UN outpatient 3.34 3.27 All Payors / Plans All Payors / Plans 3.34 other 3.34 3.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TACROLIMUS PER 1 MG ERX-636000000 CDM J7507 HCPCS 636 RC 60793-116-01 NDC 2 UN outpatient 6.95 6.81 All Payors / Plans All Payors / Plans 6.95 other 6.95 6.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TACROLIMUS PER 1 MG ERX-636000000 CDM J7507 HCPCS 636 RC 59762-1206-1 NDC 1 UN outpatient 3.48 3.41 All Payors / Plans All Payors / Plans 3.48 other 3.48 3.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE PER 4 MG ERX-636000000 CDM J7509 HCPCS 636 RC 63323-623-76 NDC JZ 1 UN outpatient 1.87 1.83 All Payors / Plans All Payors / Plans 1.87 other 1.87 1.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHYLPREDNISOLONE PER 4 MG ERX-636000000 CDM J7509 HCPCS 636 RC 65219-470-05 NDC JZ 1 UN outpatient 1.9 1.86 All Payors / Plans All Payors / Plans 1.9 other 1.9 1.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 65219-190-30 NDC JZ 2 UN outpatient 2.17 2.13 All Payors / Plans All Payors / Plans 2.17 other 2.17 2.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 0409-4887-23 NDC JZ 1 UN outpatient 1.06 1.04 All Payors / Plans All Payors / Plans 1.06 other 1.06 1.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 63323-185-07 NDC JZ 0.5 UN outpatient 0.49 0.48 All Payors / Plans All Payors / Plans 0.49 other 0.49 0.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 0409-4887-10 NDC JZ 1 UN outpatient 0.95 0.93 All Payors / Plans All Payors / Plans 0.95 other 0.95 0.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 0409-4887-17 NDC JZ 0.5 UN outpatient 0.5 0.49 All Payors / Plans All Payors / Plans 0.5 other 0.5 0.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 63323-185-10 NDC JZ 0.5 UN outpatient 0.5 0.49 All Payors / Plans All Payors / Plans 0.5 other 0.5 0.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 0409-4887-20 NDC JZ 0.5 UN outpatient 0.51 0.5 All Payors / Plans All Payors / Plans 0.51 other 0.51 0.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 0487-6105-01 NDC JZ 0.5 UN outpatient 0.51 0.5 All Payors / Plans All Payors / Plans 0.51 other 0.51 0.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PREDNISONE PER 5 MG ERX-636000000 CDM J7512 HCPCS 636 RC 0409-4887-24 NDC JZ 0.5 UN outpatient 0.47 0.46 All Payors / Plans All Payors / Plans 0.47 other 0.47 0.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOSPORINE MODIFIED PER 25 MG ERX-636000000 CDM J7515 HCPCS 636 RC 72888-125-26 NDC 2 UN outpatient 18.2 17.84 All Payors / Plans All Payors / Plans 18.2 other 18.2 18.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MYCOPHENOLATE MOFETIL PER 250 MG ERX-636000000 CDM J7517 HCPCS 636 RC 0168-0204-37 NDC 1 UN outpatient 2.74 2.69 All Payors / Plans All Payors / Plans 2.74 other 2.74 2.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MYCOPHENOLATE MOFETIL PER 250 MG ERX-636000000 CDM J7517 HCPCS 636 RC 38779-0082-4 NDC 1 UN outpatient 2.01 1.97 All Payors / Plans All Payors / Plans 2.01 other 2.01 2.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MYCOPHENOLATE SODIUM 360 MG TABLET,DELAYED RELEASE (DR/EC)" ERX-636000000 CDM J7518 HCPCS 636 RC 51552-1345-1 NDC 1 UN outpatient 16.2 15.88 All Payors / Plans All Payors / Plans 16.2 other 16.2 16.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIROLIMUS PER 1 MG ERX-636000000 CDM J7520 HCPCS 636 RC 10882-528-30 NDC 1 UN outpatient 15.22 14.92 All Payors / Plans All Payors / Plans 15.22 other 15.22 15.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DORNASE ALFA PER 1 MG ERX-636000000 CDM J7639 HCPCS 636 RC 0409-4444-01 NDC 2.5 ML outpatient 148.16 145.2 All Payors / Plans All Payors / Plans 148.16 other 148.16 148.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DORNASE ALFA PER 1 MG ERX-636000000 CDM J7639 HCPCS 636 RC 0409-4444-24 NDC 2.5 ML outpatient 148.16 145.2 All Payors / Plans All Payors / Plans 148.16 other 148.16 148.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 0.25 MG ERX-636000000 CDM J8540 HCPCS 636 RC 0054-3505-47 NDC 2 UN outpatient 2.04 2 All Payors / Plans All Payors / Plans 2.04 other 2.04 2.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 0.25 MG ERX-636000000 CDM J8540 HCPCS 636 RC 23155-345-33 NDC JZ 1 UN outpatient 4.13 4.05 All Payors / Plans All Payors / Plans 4.13 other 4.13 4.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEXAMETHASONE PER 0.25 MG ERX-636000000 CDM J8540 HCPCS 636 RC 25021-608-20 NDC JZ 1 UN outpatient 3.5 3.43 All Payors / Plans All Payors / Plans 3.5 other 3.5 3.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHOTREXATE PER 2.5 MG ERX-636000000 CDM J8610 HCPCS 636 RC 63323-623-74 NDC JZ 6 UN outpatient 15.69 15.38 All Payors / Plans All Payors / Plans 15.69 other 15.69 15.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXORUBICIN 50 MG/25 ML SOLUTION ERX-636000000 CDM J9000 HCPCS 636 RC 51079-374-01 NDC JW 8 ML outpatient 5.74 5.63 All Payors / Plans All Payors / Plans 5.74 other 5.74 5.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXORUBICIN 10 MG/5 ML SOLUTION ERX-636000000 CDM J9000 HCPCS 636 RC 82347-0405-4 NDC JZ 4 ML outpatient 5.6 5.49 All Payors / Plans All Payors / Plans 5.6 other 5.6 5.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXORUBICIN 50 MG/25 ML SOLUTION ERX-636000000 CDM J9000 HCPCS 636 RC 0904-6987-61 NDC JZ 25 ML outpatient 12.19 11.95 All Payors / Plans All Payors / Plans 12.19 other 12.19 12.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AZACITIDINE 100 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J9025 HCPCS 636 RC 69374-902-05 NDC JW 0.4 UN outpatient 8.55 8.38 All Payors / Plans All Payors / Plans 8.55 other 8.55 8.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBOPLATIN PER 50 MG ERX-636000000 CDM J9045 HCPCS 636 RC 0338-0017-18 NDC 15 ML outpatient 106.12 104 All Payors / Plans All Payors / Plans 106.12 other 106.12 106.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBOPLATIN PER 50 MG ERX-636000000 CDM J9045 HCPCS 636 RC 0338-0017-31 NDC 15 ML outpatient 62.41 61.16 All Payors / Plans All Payors / Plans 62.41 other 62.41 62.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARBOPLATIN PER 50 MG ERX-636000000 CDM J9045 HCPCS 636 RC 61314-547-01 NDC Q1 15 ML outpatient 31.24 30.62 All Payors / Plans All Payors / Plans 31.24 other 31.24 31.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CETUXIMAB PER 10 MG ERX-636000000 CDM J9055 HCPCS 636 RC 0121-1775-05 NDC JZ 300 ML outpatient 5165.95 5062.63 All Payors / Plans All Payors / Plans 5165.95 other 5165.95 5165.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CISPLATIN PER 50 MG ERX-636000000 CDM J9060 HCPCS 636 RC 0641-1410-31 NDC 25 ML outpatient 7.15 7.01 All Payors / Plans All Payors / Plans 7.15 other 7.15 7.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CISPLATIN PER 50 MG ERX-636000000 CDM J9060 HCPCS 636 RC 0641-0376-21 NDC 100 ML outpatient 138.33 135.56 All Payors / Plans All Payors / Plans 138.33 other 138.33 138.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CISPLATIN 50 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J9060 HCPCS 636 RC 0143-9542-10 NDC JW 0.36 UN outpatient 305.92 299.8 All Payors / Plans All Payors / Plans 305.92 other 305.92 305.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOPHOSPHAMIDE 500 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J9075 HCPCS 636 RC 0121-4950-40 NDC 0.36 UN outpatient 66.8 65.46 All Payors / Plans All Payors / Plans 66.8 other 66.8 66.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOPHOSPHAMIDE 1 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J9075 HCPCS 636 RC 0143-9689-01 NDC JW 0.2 UN outpatient 27.87 27.31 All Payors / Plans All Payors / Plans 27.87 other 27.87 27.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOPHOSPHAMIDE 1 GRAM RECON SOLN 1 EACH VIAL ERX-636000000 CDM J9075 HCPCS 636 RC 0069-0209-10 NDC JZ 1 UN outpatient 439.05 430.27 All Payors / Plans All Payors / Plans 439.05 other 439.05 439.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CYCLOPHOSPHAMIDE 500 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J9075 HCPCS 636 RC 0409-4699-24 NDC JZ 0.08 UN outpatient 6.64 6.51 All Payors / Plans All Payors / Plans 6.64 other 6.64 6.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOCETAXEL 160 MG/16 ML (10 MG/ML) SOLUTION 16 ML VIAL ERX-636000000 CDM J9171 HCPCS 636 RC 0409-4264-11 NDC 16 ML outpatient 682.62 668.97 All Payors / Plans All Payors / Plans 682.62 other 682.62 682.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOCETAXEL 160 MG/8 ML (20 MG/ML) SOLUTION 8 ML VIAL ERX-636000000 CDM J9171 HCPCS 636 RC 0143-9622-01 NDC 4 ML outpatient 85.61 83.9 All Payors / Plans All Payors / Plans 85.61 other 85.61 85.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOPOSIDE 20 MG/ML SOLUTION 25 ML VIAL ERX-636000000 CDM J9181 HCPCS 636 RC 66794-219-63 NDC 9 ML outpatient 82.78 81.12 All Payors / Plans All Payors / Plans 82.78 other 82.78 82.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOPOSIDE 20 MG/ML SOLUTION 25 ML VIAL ERX-636000000 CDM J9181 HCPCS 636 RC 0264-4400-54 NDC 8.5 ML outpatient 63.4 62.13 All Payors / Plans All Payors / Plans 63.4 other 63.4 63.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ETOPOSIDE 20 MG/ML SOLUTION 50 ML VIAL ERX-636000000 CDM J9181 HCPCS 636 RC 67457-567-00 NDC 7.5 ML outpatient 64.77 63.47 All Payors / Plans All Payors / Plans 64.77 other 64.77 64.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOROURACIL PER 500 MG ERX-636000000 CDM J9190 HCPCS 636 RC 68084-782-61 NDC JZ 0.5 ML outpatient 0.12 0.12 All Payors / Plans All Payors / Plans 0.12 other 0.12 0.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FLUOROURACIL PER 500 MG ERX-636000000 CDM J9190 HCPCS 636 RC 68084-313-01 NDC JZ 54 ML outpatient 12.07 11.83 All Payors / Plans All Payors / Plans 12.07 other 12.07 12.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GEMCITABINE PER 200 MG ERX-636000000 CDM J9201 HCPCS 636 RC 0904-0428-04 NDC JZ 26.3 ML outpatient 84.41 82.72 All Payors / Plans All Payors / Plans 84.41 other 84.41 84.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GEMCITABINE PER 200 MG ERX-636000000 CDM J9201 HCPCS 636 RC 50268-278-11 NDC JZ 2.63 ML outpatient 2.18 2.14 All Payors / Plans All Payors / Plans 2.18 other 2.18 2.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GOSERELIN ACETATE PER 3.6 MG ERX-636000000 CDM J9202 HCPCS 636 RC 43066-015-01 NDC JZ 1 UN outpatient 3468.09 3398.73 All Payors / Plans All Payors / Plans 3468.09 other 3468.09 3468.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GOSERELIN PER 3.6 MG ERX-636000000 CDM J9202 HCPCS 636 RC 43066-152-10 NDC JZ 1 UN outpatient 1677.28 1643.73 All Payors / Plans All Payors / Plans 1677.28 other 1677.28 1677.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRINOTECAN PER 20 MG ERX-636000000 CDM J9206 HCPCS 636 RC 0904-7193-61 NDC JZ 1 ML outpatient 1.73 1.7 All Payors / Plans All Payors / Plans 1.73 other 1.73 1.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRINOTECAN PER 20 MG ERX-636000000 CDM J9206 HCPCS 636 RC 60687-595-11 NDC JZ 10 ML outpatient 65.26 63.95 All Payors / Plans All Payors / Plans 65.26 other 65.26 65.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUPROLIDE (3 MONTH) 22.5 MG SYRINGE ERX-636000000 CDM J9217 HCPCS 636 RC 0338-0049-18 NDC JZ 1 UN outpatient 733.66 718.99 All Payors / Plans All Payors / Plans 733.66 other 733.66 733.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUPROLIDE (4 MONTH) 30 MG SYRINGE ERX-636000000 CDM J9217 HCPCS 636 RC 0338-0049-31 NDC JZ 1 UN outpatient 849.77 832.77 All Payors / Plans All Payors / Plans 849.77 other 849.77 849.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEUPROLIDE 7.5 MG (1 MONTH) SYRINGE ERX-636000000 CDM J9217 HCPCS 636 RC 0338-0049-41 NDC JZ 1 UN outpatient 323.98 317.5 All Payors / Plans All Payors / Plans 323.98 other 323.98 323.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility METHOTREXATE SODIUM PER 5 MG ERX-636000000 CDM J9260 HCPCS 636 RC 60687-591-01 NDC JZ 0.48 ML outpatient 0.6 0.59 All Payors / Plans All Payors / Plans 0.6 other 0.6 0.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXALIPLATIN PER 0.5 MG ERX-636000000 CDM J9263 HCPCS 636 RC 69339-138-15 NDC JW 2 ML outpatient 3.72 3.65 All Payors / Plans All Payors / Plans 3.72 other 3.72 3.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXALIPLATIN PER 0.5 MG ERX-636000000 CDM J9263 HCPCS 636 RC 69339-138-19 NDC JW 2 ML outpatient 3.72 3.65 All Payors / Plans All Payors / Plans 3.72 other 3.72 3.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OXALIPLATIN PER 0.5 MG ERX-636000000 CDM J9263 HCPCS 636 RC 0168-0080-31 NDC JZ 4 ML outpatient 2.16 2.12 All Payors / Plans All Payors / Plans 2.16 other 2.16 2.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACLITAXEL PROTEIN-BOUND PART PER 1 MG ERX-636000000 CDM J9264 HCPCS 636 RC 23155-688-31 NDC JW 0.25 UN outpatient 366.93 359.59 All Payors / Plans All Payors / Plans 366.93 other 366.93 366.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACLITAXEL PER 30 MG ERX-636000000 CDM J9267 HCPCS 636 RC 0338-0004-04 NDC 11 ML outpatient 65.22 63.92 All Payors / Plans All Payors / Plans 65.22 other 65.22 65.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACLITAXEL PER 30 MG ERX-636000000 CDM J9267 HCPCS 636 RC 0338-0004-03 NDC 13 ML outpatient 62.78 61.52 All Payors / Plans All Payors / Plans 62.78 other 62.78 62.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MITOMYCIN PER 5 MG ERX-636000000 CDM J9280 HCPCS 636 RC 0641-6176-01 NDC JW 0.25 UN outpatient 43.55 42.68 All Payors / Plans All Payors / Plans 43.55 other 43.55 43.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEMETREXED DISODIUM 100 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM J9305 HCPCS 636 RC 25021-465-01 NDC JW 0.5 UN outpatient 5.2 5.1 All Payors / Plans All Payors / Plans 5.2 other 5.2 5.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEMETREXED PER 10 MG ERX-636000000 CDM J9305 HCPCS 636 RC 0409-3515-01 NDC JZ 1 UN outpatient 201.49 197.46 All Payors / Plans All Payors / Plans 201.49 other 201.49 201.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PERTUZUMAB 420 MG/14 ML (30 MG/ML) SOLUTION 14 ML VIAL ERX-636000000 CDM J9306 HCPCS 636 RC 60687-579-01 NDC JZ 14 ML outpatient 7211.24 7067.02 All Payors / Plans All Payors / Plans 7211.24 other 7211.24 7211.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOPOTECAN PER 4 MG ERX-636000000 CDM J9351 HCPCS 636 RC 0904-7130-61 NDC JW 1.6 ML outpatient 9.07 8.89 All Payors / Plans All Payors / Plans 9.07 other 9.07 9.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VINCRISTINE 2 MG/2 ML SOLUTION 2 ML VIAL ERX-636000000 CDM J9370 HCPCS 636 RC 60687-450-11 NDC JZ 2 ML outpatient 63.44 62.17 All Payors / Plans All Payors / Plans 63.44 other 63.44 63.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VINCRISTINE PER 1 MG ERX-636000000 CDM J9370 HCPCS 636 RC 63629-2214-1 NDC JZ 1 ML outpatient 63.49 62.22 All Payors / Plans All Payors / Plans 63.49 other 63.49 63.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FULVESTRANT PER 25 MG ERX-636000000 CDM J9395 HCPCS 636 RC 0121-1870-00 NDC JZ 10 ML outpatient 199.54 195.55 All Payors / Plans All Payors / Plans 199.54 other 199.54 199.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FULVESTRANT PER 25 MG ERX-636000000 CDM J9395 HCPCS 636 RC 0121-1870-10 NDC JZ 10 ML outpatient 310.05 303.85 All Payors / Plans All Payors / Plans 310.05 other 310.05 310.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FULVESTRANT PER 25 MG ERX-636000000 CDM J9395 HCPCS 636 RC 63739-976-01 NDC JZ 10 ML outpatient 310.05 303.85 All Payors / Plans All Payors / Plans 310.05 other 310.05 310.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FULVESTRANT PER 25 MG ERX-636000000 CDM J9395 HCPCS 636 RC 0904-7183-61 NDC JZ 10 ML outpatient 201.65 197.62 All Payors / Plans All Payors / Plans 201.65 other 201.65 201.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUMIN HUMAN 5% PER 50 ML ERX-250000000 CDM P9045 HCPCS 250 RC 51079-058-01 NDC JZ 250 ML outpatient 138.47 135.7 All Payors / Plans All Payors / Plans 138.47 other 138.47 138.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUMIN HUMAN 5% PER 50 ML ERX-250000000 CDM P9045 HCPCS 250 RC 0378-0213-01 NDC JZ 500 ML outpatient 195.82 191.9 All Payors / Plans All Payors / Plans 195.82 other 195.82 195.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUMIN HUMAN 5% PER 50 ML ERX-250000000 CDM P9045 HCPCS 250 RC 7733394825 NDC JZ 250 ML outpatient 138.47 135.7 All Payors / Plans All Payors / Plans 138.47 other 138.47 138.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUMIN HUMAN 5% PER 50 ML ERX-250000000 CDM P9045 HCPCS 250 RC 0087086644 NDC JZ 500 ML outpatient 195.82 191.9 All Payors / Plans All Payors / Plans 195.82 other 195.82 195.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUMIN HUMAN 25% PER 50 ML ERX-636000000 CDM P9047 HCPCS 636 RC 0904-6085-61 NDC JZ 50 ML outpatient 138.47 135.7 All Payors / Plans All Payors / Plans 138.47 other 138.47 138.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUMIN HUMAN 25% PER 50 ML ERX-636000000 CDM P9047 HCPCS 636 RC 65862-006-01 NDC JZ 50 ML outpatient 97.91 95.95 All Payors / Plans All Payors / Plans 97.91 other 97.91 97.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUMIN HUMAN 25% PER 50 ML ERX-636000000 CDM P9047 HCPCS 636 RC 76282-208-90 NDC JZ 50 ML outpatient 138.47 135.7 All Payors / Plans All Payors / Plans 138.47 other 138.47 138.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALBUMIN HUMAN 25% PER 50 ML ERX-636000000 CDM P9047 HCPCS 636 RC 50268-179-11 NDC JZ 50 ML outpatient 97.91 95.95 All Payors / Plans All Payors / Plans 97.91 other 97.91 97.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIPHENHYDRAMINE PER 50 MG ERX-636000000 CDM Q0163 HCPCS 636 RC 25021-608-50 NDC JZ 1 UN outpatient 0.91 0.89 All Payors / Plans All Payors / Plans 0.91 other 0.91 0.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOSPHENYTOIN 500 MG PE/10 ML SOLUTION 10 ML VIAL ERX-636000000 CDM Q2009 HCPCS 636 RC 68084-313-11 NDC JZ 26 ML outpatient 217.13 212.79 All Payors / Plans All Payors / Plans 217.13 other 217.13 217.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXORUBICIN LIPOSOMAL PER 10 MG ERX-636000000 CDM Q2050 HCPCS 636 RC 60687-369-11 NDC JZ 17 ML outpatient 299.37 293.38 All Payors / Plans All Payors / Plans 299.37 other 299.37 299.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXORUBICIN LIPOSOMAL PER 10 MG ERX-636000000 CDM Q2050 HCPCS 636 RC 0054-0622-63 NDC JZ 25 ML outpatient 825.58 809.07 All Payors / Plans All Payors / Plans 825.58 other 825.58 825.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOXORUBICIN LIPOSOMAL PER 10 MG ERX-636000000 CDM Q2050 HCPCS 636 RC 17856-0623-1 NDC JZ 23 ML outpatient 235.02 230.32 All Payors / Plans All Payors / Plans 235.02 other 235.02 235.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FILGRASTIM-SNDZ PER 1 MCG ERX-636000000 CDM Q5101 HCPCS 636 RC 0832-7124-89 NDC JZ 0.5 ML outpatient 340.4 333.59 All Payors / Plans All Payors / Plans 340.4 other 340.4 340.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FILGRASTIM-SNDZ PER 1 MCG ERX-636000000 CDM Q5101 HCPCS 636 RC 29300-140-01 NDC JZ 0.8 ML outpatient 597.36 585.41 All Payors / Plans All Payors / Plans 597.36 other 597.36 597.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "EPOETIN ALFA-EPBX 40,000 UNIT/ML SOLUTION" ERX-635000000 CDM Q5106 HCPCS 636 RC 0904-7083-61 NDC JZ 1 ML outpatient 749.95 734.95 All Payors / Plans All Payors / Plans 749.95 other 749.95 749.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BEVACIZUMAB-AWWB 25 MG/ML SOLUTION 16 ML VIAL ERX-636000000 CDM Q5107 HCPCS 636 RC 0228-2127-10 NDC JZ 16 ML outpatient 3310.41 3244.2 All Payors / Plans All Payors / Plans 3310.41 other 3310.41 3310.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BEVACIZUMAB-AWWB 25 MG/ML SOLUTION 4 ML VIAL ERX-636000000 CDM Q5107 HCPCS 636 RC 60687-113-01 NDC JZ 8 ML outpatient 1313 1286.74 All Payors / Plans All Payors / Plans 1313 other 1313 1313 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEGFILGRASTIM-JMDB 6 MG/0.6 ML SYRINGE ERX-636000000 CDM Q5108 HCPCS 636 RC 51079-597-20 NDC JG 0.2 ML outpatient 785.5 769.79 All Payors / Plans All Payors / Plans 785.5 other 785.5 785.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEGFILGRASTIM-CBQV 6 MG/0.6 ML SYRINGE ERX-636000000 CDM Q5111 HCPCS 636 RC 0832-6017-00 NDC JW 0.2 ML outpatient 754.53 739.44 All Payors / Plans All Payors / Plans 754.53 other 754.53 754.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PEGFILGRASTIM-CBQV 6 MG/0.6 ML SYRINGE, W/ WEARABLE INJECTOR" ERX-636000000 CDM Q5111 HCPCS 636 RC 42858-301-25 NDC JZ 0.6 ML outpatient 3841.79 3764.95 All Payors / Plans All Payors / Plans 3841.79 other 3841.79 3841.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRASTUZUMAB-QYYP 420 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM Q5116 HCPCS 636 RC 70069-071-10 NDC JG 0.40476 UN outpatient 1669.7 1636.31 All Payors / Plans All Payors / Plans 1669.7 other 1669.7 1669.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRASTUZUMAB-QYYP 420 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM Q5116 HCPCS 636 RC 76045-383-30 NDC JG 0.02385 UN outpatient 58.06 56.9 All Payors / Plans All Payors / Plans 58.06 other 58.06 58.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRASTUZUMAB-ANNS 420 MG RECON SOLN 1 EACH VIAL ERX-636000000 CDM Q5117 HCPCS 636 RC 70069-071-01 NDC JG 0.1429 UN outpatient 512.03 501.79 All Payors / Plans All Payors / Plans 512.03 other 512.03 512.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BEVACIZUMAB-BVZR 25 MG/ML SOLUTION 16 ML VIAL ERX-636000000 CDM Q5118 HCPCS 636 RC 60687-113-11 NDC JZ 16 ML outpatient 2835.97 2779.25 All Payors / Plans All Payors / Plans 2835.97 other 2835.97 2835.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BEVACIZUMAB-BVZR 25 MG/ML SOLUTION 4 ML VIAL ERX-636000000 CDM Q5118 HCPCS 636 RC 0378-0871-16 NDC JZ 8 ML outpatient 1075.74 1054.23 All Payors / Plans All Payors / Plans 1075.74 other 1075.74 1075.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RITUXIMAB-PVVR 10 MG/ML SOLUTION 50 ML VIAL ERX-636000000 CDM Q5119 HCPCS 636 RC 69238-1058-1 NDC JW 5 ML outpatient 264.22 258.94 All Payors / Plans All Payors / Plans 264.22 other 264.22 264.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RITUXIMAB-PVVR 10 MG/ML SOLUTION 10 ML VIAL ERX-636000000 CDM Q5119 HCPCS 636 RC 4467710202 NDC JZ 10 ML outpatient 528.43 517.86 All Payors / Plans All Payors / Plans 528.43 other 528.43 528.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BEVACIZUMAB-MALY 25 MG/ML SOLUTION 16 ML VIAL ERX-636000000 CDM Q5126 HCPCS 636 RC 0228-2128-10 NDC JZ 16 ML outpatient 2664.06 2610.78 All Payors / Plans All Payors / Plans 2664.06 other 2664.06 2664.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BEVACIZUMAB-MALY 25 MG/ML SOLUTION 4 ML VIAL ERX-636000000 CDM Q5126 HCPCS 636 RC 60687-124-11 NDC JZ 4 ML outpatient 880.22 862.62 All Payors / Plans All Payors / Plans 880.22 other 880.22 880.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility .035 180CM INQWIRE WIRE J TIP SUP-481000000 CDM 270 RC inpatient 12.98 12.72 All Payors / Plans All Payors / Plans 12.98 other 12.98 12.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility .035 NAVILYST GUIDEWIRE 175J SUP-481000000 CDM 270 RC inpatient 24.18 23.7 All Payors / Plans All Payors / Plans 24.18 other 24.18 24.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "1.1MM TROCAR TIP WIRE 2X ENDED, 150MM" SUP-270000000 CDM 270 RC inpatient 1103.76 1081.68 All Payors / Plans All Payors / Plans 1103.76 other 1103.76 1103.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 1.25MM X 150MM K-WIRE SUP-270000000 CDM 270 RC inpatient 91.98 90.14 All Payors / Plans All Payors / Plans 91.98 other 91.98 91.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 1.25MMX150MM TROCAR TIP SUP-270000000 CDM 270 RC inpatient 517.14 506.8 All Payors / Plans All Payors / Plans 517.14 other 517.14 517.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 1.8MM SHORT DRILL BIT SUP-270000000 CDM 270 RC inpatient 175.5 171.99 All Payors / Plans All Payors / Plans 175.5 other 175.5 175.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 10.5F PRELUDE SNAP SUP-270010030 CDM 270 RC inpatient 174.3 170.81 All Payors / Plans All Payors / Plans 174.3 other 174.3 174.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 12.0MM REAMER HEAD FOR RIA 2 STERILE SUP-270000000 CDM 270 RC inpatient 1643.9 1611.02 All Payors / Plans All Payors / Plans 1643.9 other 1643.9 1643.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 14.5MM REAMER HEAD FOR RIA 2 SUP-270000000 CDM 270 RC inpatient 1643.9 1611.02 All Payors / Plans All Payors / Plans 1643.9 other 1643.9 1643.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.0 DRILL TIP KWIRE SUP-270000000 CDM 270 RC inpatient 1103.76 1081.68 All Payors / Plans All Payors / Plans 1103.76 other 1103.76 1103.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.0 FENESTRATION DRILL SUP-270000000 CDM 270 RC inpatient 403 394.94 All Payors / Plans All Payors / Plans 403 other 403 403 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.0 X 150MM K-WIRE DRILL TIP SUP-270000000 CDM 270 RC inpatient 438 429.24 All Payors / Plans All Payors / Plans 438 other 438 438 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "2.0MM DRILL TIP WIRE, 150MM" SUP-270000000 CDM 270 RC inpatient 2207.52 2163.37 All Payors / Plans All Payors / Plans 2207.52 other 2207.52 2207.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.0MM LOND DRILLS SUP-270000000 CDM 270 RC inpatient 221.76 217.32 All Payors / Plans All Payors / Plans 221.76 other 221.76 221.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.3 KWIRE SUP-270000000 CDM 270 RC inpatient 54.6 53.51 All Payors / Plans All Payors / Plans 54.6 other 54.6 54.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.4 DRILL SUP-270000000 CDM 270 RC inpatient 403 394.94 All Payors / Plans All Payors / Plans 403 other 403 403 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.5 PERCUTANEOUS DRILL BIT SUP-270000000 CDM 270 RC inpatient 453.6 444.53 All Payors / Plans All Payors / Plans 453.6 other 453.6 453.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.5MM CALIBRATED DRILL BIT SUP-270000000 CDM 270 RC inpatient 462 452.76 All Payors / Plans All Payors / Plans 462 other 462 462 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "2.7MM DRILL, 130MM" SUP-270000000 CDM 270 RC inpatient 176.4 172.87 All Payors / Plans All Payors / Plans 176.4 other 176.4 176.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.8 DRILL SUP-270000000 CDM 270 RC inpatient 403 394.94 All Payors / Plans All Payors / Plans 403 other 403 403 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 25+ FINESSE FLEX LOOP SUP-270000000 CDM 270 RC inpatient 267.83 262.47 All Payors / Plans All Payors / Plans 267.83 other 267.83 267.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 260 J WIRE SUP-270000000 CDM 270 RC inpatient 31.62 30.99 All Payors / Plans All Payors / Plans 31.62 other 31.62 31.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 3.8 DRILL SUP-270000000 CDM 270 RC inpatient 903.5 885.43 All Payors / Plans All Payors / Plans 903.5 other 903.5 903.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 3.9MM SWIVELOCK ANCHOR SUP-270000000 CDM 270 RC inpatient 787.5 771.75 All Payors / Plans All Payors / Plans 787.5 other 787.5 787.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 4.0MM RAD60 BLADE SUP-270000000 CDM 270 RC inpatient 640.92 628.1 All Payors / Plans All Payors / Plans 640.92 other 640.92 640.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 4.5 LOCKING SCREW 58MM SUP-270000000 CDM 270 RC inpatient 518.7 508.33 All Payors / Plans All Payors / Plans 518.7 other 518.7 518.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 4.6 DRILL SUP-270000000 CDM 270 RC inpatient 903.5 885.43 All Payors / Plans All Payors / Plans 903.5 other 903.5 903.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 40CC SENSATION PLUS IABP CATHETER SUP-270000000 CDM 270 RC inpatient 2217.08 2172.74 All Payors / Plans All Payors / Plans 2217.08 other 2217.08 2217.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 4F MICROPUNCTURE INTRODUCER SET 10CM SUP-481000000 CDM 270 RC inpatient 27.77 27.21 All Payors / Plans All Payors / Plans 27.77 other 27.77 27.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 5.5F PRONTO V4 EXTRACTION CATHETER SUP-270000000 CDM 270 RC inpatient 699.3 685.31 All Payors / Plans All Payors / Plans 699.3 other 699.3 699.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 5F DXTERITY JL 3.5 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC inpatient 11.25 11.03 All Payors / Plans All Payors / Plans 11.25 other 11.25 11.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 5F DXTERITY JL 4.0 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC inpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 5F DXTERITY JL 4.5 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC inpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 5F DXTERITY JR 4.0 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC inpatient 11.25 11.03 All Payors / Plans All Payors / Plans 11.25 other 11.25 11.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 5F DXTERITY PIG STR DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC inpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F C-PIGTAIL PERFORMA SUP-270000000 CDM 270 RC inpatient 19 18.62 All Payors / Plans All Payors / Plans 19 other 19 19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F 145 PIGTAIL CATHETER 110CM SUP-481000000 CDM 270 RC inpatient 7.68 7.53 All Payors / Plans All Payors / Plans 7.68 other 7.68 7.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F AL1 DIAGNOSTIC CATHETER 100CM SUP-481000000 CDM 270 RC inpatient 9.69 9.5 All Payors / Plans All Payors / Plans 9.69 other 9.69 9.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F AL2 DIAGNOSTIC CATHETER 100CM SUP-481000000 CDM 270 RC inpatient 17.54 17.19 All Payors / Plans All Payors / Plans 17.54 other 17.54 17.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F C PIG PERFORMA SUP-270000000 CDM 270 RC inpatient 19 18.62 All Payors / Plans All Payors / Plans 19 other 19 19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F C PIGTAIL PERFORMA SUP-270000000 CDM 270 RC inpatient 19 18.62 All Payors / Plans All Payors / Plans 19 other 19 19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY 145 PIGTAIL DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC inpatient 15.3 14.99 All Payors / Plans All Payors / Plans 15.3 other 15.3 15.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY 3DRC DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC inpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY AR MOD DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC inpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY IMA DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC inpatient 9.18 9 All Payors / Plans All Payors / Plans 9.18 other 9.18 9.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY JL 3.5 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC inpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY JL 4.0 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC inpatient 9.18 9 All Payors / Plans All Payors / Plans 9.18 other 9.18 9.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY JL 4.5 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC inpatient 15.3 14.99 All Payors / Plans All Payors / Plans 15.3 other 15.3 15.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY JR 4.0 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC inpatient 9.18 9 All Payors / Plans All Payors / Plans 9.18 other 9.18 9.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY PIG STR DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC inpatient 9.18 9 All Payors / Plans All Payors / Plans 9.18 other 9.18 9.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY ULTRA 3.5 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC inpatient 63 61.74 All Payors / Plans All Payors / Plans 63 other 63 63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F EXPORT ASPIRATION CATHETER SUP-270000000 CDM 270 RC inpatient 892.5 874.65 All Payors / Plans All Payors / Plans 892.5 other 892.5 892.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F FL3.5 DIAGNOSTIC CATHETER 100CM SUP-481000000 CDM 270 RC inpatient 12.79 12.53 All Payors / Plans All Payors / Plans 12.79 other 12.79 12.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F FR4 DIAGNOSTIC CATHETER 100CM SUP-481000000 CDM 270 RC inpatient 12.79 12.53 All Payors / Plans All Payors / Plans 12.79 other 12.79 12.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F FR5 DIAGNOSTIC CATHETER 100CM SUP-481000000 CDM 270 RC inpatient 25.87 25.35 All Payors / Plans All Payors / Plans 25.87 other 25.87 25.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F GUIDELINER SUP-270000000 CDM 270 RC inpatient 676.6 663.07 All Payors / Plans All Payors / Plans 676.6 other 676.6 676.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F IM DIAGNOSTIC CATHETER 100CM SUP-481000000 CDM 270 RC inpatient 16.28 15.95 All Payors / Plans All Payors / Plans 16.28 other 16.28 16.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F PERFORMA PIGTAIL CATHETER SUP-481000000 CDM 270 RC inpatient 23.53 23.06 All Payors / Plans All Payors / Plans 23.53 other 23.53 23.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F PIGTAIL CATHETER 110CM SUP-481000000 CDM 270 RC inpatient 7.68 7.53 All Payors / Plans All Payors / Plans 7.68 other 7.68 7.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F VISTA GUIDE XB 3.5 S/H SUP-481000000 CDM 270 RC inpatient 91.35 89.52 All Payors / Plans All Payors / Plans 91.35 other 91.35 91.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6FR OPTISEAL 13CM SUP-275000000 CDM 270 RC inpatient 121.58 119.15 All Payors / Plans All Payors / Plans 121.58 other 121.58 121.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 7 FR SWAN S-TIP THERMODILUTION CATHETER SUP-481000000 CDM 270 RC inpatient 207.9 203.74 All Payors / Plans All Payors / Plans 207.9 other 207.9 207.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 7.0 DRILL SUP-270000000 CDM 270 RC inpatient 902.2 884.16 All Payors / Plans All Payors / Plans 902.2 other 902.2 902.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 7FR OPTISEAL 13CM SUP-275000000 CDM 270 RC inpatient 150.19 147.19 All Payors / Plans All Payors / Plans 150.19 other 150.19 150.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 8817791002 TUNNELING DEVICE KIT SUP-270000000 CDM 270 RC inpatient 267.19 261.85 All Payors / Plans All Payors / Plans 267.19 other 267.19 267.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 8F PRELUDE SNAP SUP-481000000 CDM 270 RC inpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "8F, 45 DEGREE FIXED-CURVE TRANSSEPTAL GUIDING SHEATH" SUP-481000000 CDM 270 RC inpatient 163.2 159.94 All Payors / Plans All Payors / Plans 163.2 other 163.2 163.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACCESS VERSACROSS STEERABLE 0.035 IN. 230 PIGTAIL CM RF WIRE 71CM BI-DIRECTIONAL STEERABLE SHEATH MEDIUM D1 CURVE 8.5 FRENCH SUP-481000000 CDM 270 RC inpatient 3727.5 3652.95 All Payors / Plans All Payors / Plans 3727.5 other 3727.5 3727.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACIST NAVVUS CATHETER SUP-481000000 CDM 270 RC inpatient 1312.5 1286.25 All Payors / Plans All Payors / Plans 1312.5 other 1312.5 1312.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACTIS COLLARED HIGH STEM SIZE 5 SUP-270010024 CDM 270 RC inpatient 7980 7820.4 All Payors / Plans All Payors / Plans 7980 other 7980 7980 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACUFEX ACCESS ADV POSITIONING KIT SUP-270000000 CDM 270 RC inpatient 520.41 510 All Payors / Plans All Payors / Plans 520.41 other 520.41 520.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACUITY SUP-481000000 CDM 270 RC inpatient 249 244.02 All Payors / Plans All Payors / Plans 249 other 249 249 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACUITY PRO SUP-481000000 CDM 270 RC inpatient 504.9 494.8 All Payors / Plans All Payors / Plans 504.9 other 504.9 504.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACUSON ACUNAV ULTRASOUND CATHETER CONNECTOR COVER SUP-270000000 CDM 270 RC inpatient 13.6 13.33 All Payors / Plans All Payors / Plans 13.6 other 13.6 13.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADAPTER ANGIOGRAPHY NAMIC OPTION 125 200 PSI 3/8 IN 24 THREAD ID .125 IN ID SEC .1 IN 3 STERILE SUP-270000000 CDM 270 RC inpatient 2.64 2.59 All Payors / Plans All Payors / Plans 2.64 other 2.64 2.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADAPTER BRONCHOSCOPE ILLUMISITE STERILE LATEX FREE REUSABLE OLYMPUS BRONCHOSCOPE SUP-270000000 CDM 270 RC inpatient 180.6 176.99 All Payors / Plans All Payors / Plans 180.6 other 180.6 180.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADAPTER BRONCHOSCOPE PNEUPAC OD15 MM 2 AXIS SWIVEL FIBER OPTIC O2 STERILE LATEX FREE DISPOSABLE BLUE SUP-270000000 CDM 270 RC inpatient 13.18 12.92 All Payors / Plans All Payors / Plans 13.18 other 13.18 13.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADAPTER DRAINAGE OD20-40 FR TUBING MULTIPURPOSE SUP-270000000 CDM 270 RC inpatient 27.25 26.71 All Payors / Plans All Payors / Plans 27.25 other 27.25 27.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADAPTER FEMORAL GMK 5 MM OFFSET KNEE REVISION CONNECTOR SUP-270010024 CDM 270 RC inpatient 31743.5 31108.63 All Payors / Plans All Payors / Plans 31743.5 other 31743.5 31743.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADAPTER SMOKE EVACUATOR OPTIMUMM OD1 1/3-3/8 IN PREFILTER NONSTERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 3.61 3.54 All Payors / Plans All Payors / Plans 3.61 other 3.61 3.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADHESIVE LIQUID MASTISOL STYRAX GUM MASTIC ALCOHOL METHYL SALICYLATE 2/3 ML SKIN VIAL AMPULE PREP STERILE LATEX FREE NONHAZARDOUS SUP-270000000 CDM 270 RC inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADHESIVE SKIN CLOSURE DERMABOND ADVANCED .7ML 2 OCTYL CYANOACRYLATE MICROBIAL BARRIER APPLICATOR FLEXIBLE LIQUID SUP-270000000 CDM 270 RC inpatient 19.38 18.99 All Payors / Plans All Payors / Plans 19.38 other 19.38 19.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADHESIVE SKIN CLOSURE DERMABOND MINI .36 ML 2-OCTYL CYANOACRYLATE HIGH VISCOSITY LIQUID APPLICATOR MICROBIAL BARRIER STERILE SUP-270000000 CDM 270 RC inpatient 11.1 10.88 All Payors / Plans All Payors / Plans 11.1 other 11.1 11.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADHESIVE SKIN CLOSURE DERMABOND PRINEO 2 OCTYL CYANOACRYLATE L22 CM 3.8 ML TOPICAL MESH APPLICATOR LIQUID DISPENSER STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 176.26 172.73 All Payors / Plans All Payors / Plans 176.26 other 176.26 176.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADHESIVE SKIN CLOSURE DERMABOND PROPEN 2 OCTYL CYANOACRYLATE XL .75 ML HIGH VISCOSITY LIQUID STRONG FLEXIBLE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 153.76 150.68 All Payors / Plans All Payors / Plans 153.76 other 153.76 153.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADHESIVE SKIN CLOSURE LIQUIBAND BUTYL .5 ML TOPICAL FLOW CONTROL MICROBIAL BARRIER PROTECTION UNIQUE WING APPLICATOR STERILE CLEAR SUP-270000000 CDM 270 RC inpatient 27.05 26.51 All Payors / Plans All Payors / Plans 27.05 other 27.05 27.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADHESIVE SURGICAL BIOGLUE BOVINE SERUM ALBUMIN GLUTARALDEHYDE L12 MM 10 ML SOFT TISSUE PREFILL SYRINGE PLUNGER 3 SPREADER 4 STANDARD TIP STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 2278 2232.44 All Payors / Plans All Payors / Plans 2278 other 2278 2278 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADHESIVE SURGICAL BIOGLUE L 12 MM SYRINGE SPREADER TIP SUP-270000000 CDM 270 RC inpatient 1300 1274 All Payors / Plans All Payors / Plans 1300 other 1300 1300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADPATER ANGIOGRAPHY NAMIC OPTION 125 200 PSI 3/8 IN 24 THREAD ID .125 IN STERILE SUP-270000000 CDM 270 RC inpatient 48.27 47.3 All Payors / Plans All Payors / Plans 48.27 other 48.27 48.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADPATER TITANIUM FOR TRANSFER KIT SUP-270000000 CDM 270 RC inpatient 220.5 216.09 All Payors / Plans All Payors / Plans 220.5 other 220.5 220.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AGENT HEMOSTATIC CELLERATERX COLLAGEN 5 GM POWDER BOTTLE SUP-270000000 CDM 270 RC inpatient 3139.5 3076.71 All Payors / Plans All Payors / Plans 3139.5 other 3139.5 3139.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AGENT HEMOSTATIC CELLERATERX HYDROLYZED BOVINE COLLAGEN POWDER SUP-270000000 CDM 270 RC inpatient 1039.5 1018.71 All Payors / Plans All Payors / Plans 1039.5 other 1039.5 1039.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AGENT HEMOSTATIC SURGIFLO THROMBIN 8 ML KIT MATRIX STERILE SUP-270000000 CDM 270 RC inpatient 184.9 181.2 All Payors / Plans All Payors / Plans 184.9 other 184.9 184.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AGILIS HISPTRO SLITTER SUP-270010030 CDM 270 RC inpatient 73.5 72.03 All Payors / Plans All Payors / Plans 73.5 other 73.5 73.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AIRSEAL 8MM ACCESS PORT AND OBTURATOR SUP-270000000 CDM 270 RC inpatient 193.48 189.61 All Payors / Plans All Payors / Plans 193.48 other 193.48 193.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALCOHOL 70% ISOPROPYL 16OZ SUP-270000000 CDM 270 RC inpatient 1.56 1.53 All Payors / Plans All Payors / Plans 1.56 other 1.56 1.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ALLOGRAFT OATS DISPOSABLE KIT, 22.5MM" SUP-270000000 CDM 270 RC inpatient 2520 2469.6 All Payors / Plans All Payors / Plans 2520 other 2520 2520 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOSYNC EXPAND 10CC SUP-270000000 CDM 270 RC inpatient 1219.92 1195.52 All Payors / Plans All Payors / Plans 1219.92 other 1219.92 1219.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOSYNC EXPAND 1CC SUP-270000000 CDM 270 RC inpatient 520 509.6 All Payors / Plans All Payors / Plans 520 other 520 520 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOSYNC EXPAND 5CC SUP-270000000 CDM 270 RC inpatient 1275 1249.5 All Payors / Plans All Payors / Plans 1275 other 1275 1275 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANCHOR SUTURE PUSHLOCK BIOCOMPOSITE SHORT L12.5 MM OD2.9 MM CANNULATED EYELET HANDLE INSERTER STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 840 823.2 All Payors / Plans All Payors / Plans 840 other 840 840 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANCHOR SUTURE SWIVELOCK C BIOCOMPOSITE PEEK L19.1 MM OD4.75 MM CLOSED EYELET VENT STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 840 823.2 All Payors / Plans All Payors / Plans 840 other 840 840 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANESTHESIA SET SMART SITE 2 CHECKVALVES 4 NEEDLE-FREE VALVES 3 PORT MANIFOLD VENTED/NONVENTED SUP-270000000 CDM 270 RC inpatient 39.51 38.72 All Payors / Plans All Payors / Plans 39.51 other 39.51 39.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANESTHESIA TUBING SUP-270000000 CDM 270 RC inpatient 4.52 4.43 All Payors / Plans All Payors / Plans 4.52 other 4.52 4.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANGIOSCULPT SCORING BALLOON 2.0 X 6 SUP-481000000 CDM 270 RC inpatient 1680 1646.4 All Payors / Plans All Payors / Plans 1680 other 1680 1680 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANGIOSCULPT SCORING BALLOON 2.5 X 10 MM SUP-481000000 CDM 270 RC inpatient 1680 1646.4 All Payors / Plans All Payors / Plans 1680 other 1680 1680 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLICATOR ENDOSCOPIC SURGIFLO 34CM DISPOSABLE STERILE LF SUP-270000000 CDM 270 RC inpatient 105.98 103.86 All Payors / Plans All Payors / Plans 105.98 other 105.98 105.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLICATOR LAPAROSCOPIC VISTASEAL L45 CM DUAL APPLICATOR FLEXIBLE SUP-270000000 CDM 270 RC inpatient 168.97 165.59 All Payors / Plans All Payors / Plans 168.97 other 168.97 168.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLICATOR LAPROSCOPIC VISTASEAL L 35CM DUAL SUP-270000000 CDM 270 RC inpatient 66.29 64.96 All Payors / Plans All Payors / Plans 66.29 other 66.29 66.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLICATOR PREP CHLORAPREP FREPP ENTURIA 70% ISOPROPYL ALCOHOL 2% CHLORHEXIDINE GLUCONATE 1.5 ML 1 STEP AMPULE DRIP RESISTANT STERILE LATEX FREE DISPOSABLE SUP-270009040 CDM 270 RC inpatient 10.26 10.05 All Payors / Plans All Payors / Plans 10.26 other 10.26 10.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLICATOR PREP CHLORAPREP HI-LITE ORANGE 70% ISOPROPYL ALCOHOL 2% CHLORHEXIDINE GLUCONATE 10.5 ML ANTIMICROBIAL 1 STEP DEHP FREE STERILE LATEX FREE DISPOSABLE SUP-270009040 CDM 270 RC inpatient 3.42 3.35 All Payors / Plans All Payors / Plans 3.42 other 3.42 3.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLICATOR PREP CHLORAPREP HI-LITE ORANGE 70% ISOPROPYL ALCOHOL 2% CHLORHEXIDINE GLUCONATE 26 ML ANTIMICROBIAL 1 STEP DEHP FREE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 6.51 6.38 All Payors / Plans All Payors / Plans 6.51 other 6.51 6.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLIER INTERNAL CLIP 30D MED 11.5IN TITANIUM MULTIPLE LIGATE LIGACLIP STERILE LF SUP-270009085 CDM 270 RC inpatient 68.68 67.31 All Payors / Plans All Payors / Plans 68.68 other 68.68 68.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLIER INTERNAL CLIP ATRICLIP PRO2 GILLINOV-COSGROVE L40 MM PRELOAD STERILE LATEX FREE DISPOSABLE LEFT ATRIAL APPENDAGE EXCLUSION SYSTEM SUP-270000000 CDM 270 RC inpatient 9880 9682.4 All Payors / Plans All Payors / Plans 9880 other 9880 9880 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLIER INTERNAL CLIP ENDO CLIP TITANIUM 19 MEDIUM LARGE L10 MM CARTRIDGE STERILE LATEX FREE DISPOSABLE K2 SUP-270000000 CDM 270 RC inpatient 55.59 54.48 All Payors / Plans All Payors / Plans 55.59 other 55.59 55.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLIER INTERNAL CLIP LIGACLIP 30D MED 11.5IN TITANIUM DISPOSABLE STERILE LF LIGATE MULTIPLE OPEN 20 CLIP SUP-270009085 CDM 270 RC inpatient 68.68 67.31 All Payors / Plans All Payors / Plans 68.68 other 68.68 68.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLIER INTERNAL CLIP LIGACLIP SM 23.8CM TITANIUM DISPOSABLE STERILE LF LIGATE MULTIPLE OPEN SUP-270009085 CDM 270 RC inpatient 68.68 67.31 All Payors / Plans All Payors / Plans 68.68 other 68.68 68.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLIER INTERNAL CLIP LIGAMAX LIGACLIP MED LG 8.8MM 10MM TITANIUM DISPOSABLE STERILE LF VASCULAR ANGLE JAW DISTAL TIP SUP-270009088 CDM 270 RC inpatient 132.68 130.03 All Payors / Plans All Payors / Plans 132.68 other 132.68 132.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLIER INTERNAL CLIP LIGAMAX MED LG 5MM TITANIUM DISPOSABLE STERILE ANGLE JAW DISTAL TIP CLOSE ANTIBACKUP LAST LOCKOUT SUP-270000000 CDM 270 RC inpatient 159.17 155.99 All Payors / Plans All Payors / Plans 159.17 other 159.17 159.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLIER INTERNAL CLIP WECK HEM-O-LOK AUTO ENDO5 POLYMER 5 MM BOW STRAIGHT L33 CM AUTOMATIC CLOSURE MEDIUM LARGE CLIP LOCK NONABSORBABLE STERILE LATEX FREE DISPOSABLE ENDO SURGERY SUP-270000000 CDM 270 RC inpatient 234.36 229.67 All Payors / Plans All Payors / Plans 234.36 other 234.36 234.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AQUAMANTYS 2.3 BIPOLAR SEALER SUP-270000000 CDM 270 RC inpatient 1038.87 1018.09 All Payors / Plans All Payors / Plans 1038.87 other 1038.87 1038.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARRAY TRACKER VELYS KNEEE SET SUP-270010025 CDM 270 RC inpatient 339.66 332.87 All Payors / Plans All Payors / Plans 339.66 other 339.66 339.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AVAFLEX CURVED NEEDLE SUP-270000000 CDM 270 RC inpatient 1288.72 1262.95 All Payors / Plans All Payors / Plans 1288.72 other 1288.72 1288.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AXS INFINITY SHEATH 90CM SUP-270000000 CDM 270 RC inpatient 1102.5 1080.45 All Payors / Plans All Payors / Plans 1102.5 other 1102.5 1102.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AXS VECTA 046 CATH 125CM - US SUP-270000000 CDM 270 RC inpatient 3815.7 3739.39 All Payors / Plans All Payors / Plans 3815.7 other 3815.7 3815.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BAG 24"" DOME LARGE" SUP-270000000 CDM 270 RC inpatient 2.91 2.85 All Payors / Plans All Payors / Plans 2.91 other 2.91 2.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAG DRAINAGE ROUND TEARDROP 2000ML DISPOSABLE STERILE LF ANTIREFLUX CHAMBER MICROBICIDAL OUTLET TUBE SUP-270009001 CDM 270 RC inpatient 3.34 3.27 All Payors / Plans All Payors / Plans 3.34 other 3.34 3.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAG DRAINAGE URINARY LATEX FREE 2000CC SUP-270009001 CDM 270 RC inpatient 5.41 5.3 All Payors / Plans All Payors / Plans 5.41 other 5.41 5.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAG DRAINAGE UROLOGY SEIMENS NONSTERILE W/ REDUCER SUP-270000000 CDM 270 RC inpatient 20.18 19.78 All Payors / Plans All Payors / Plans 20.18 other 20.18 20.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAG EQUIPMENT MICROSHIELD L40 IN X W20 IN OD40 IN CIRCULAR SEWN ELASTIC BAND STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAG SPECIMEN POLYETHYLENE L14 IN X W8 IN TRANSPORT STERILE SUP-270000000 CDM 270 RC inpatient 2.85 2.79 All Payors / Plans All Payors / Plans 2.85 other 2.85 2.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAG SPECIMEN RETRIEVAL AMI L5 MM 100 ML ABDOMEN TROCAR STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 152.25 149.21 All Payors / Plans All Payors / Plans 152.25 other 152.25 152.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAG SPECIMEN RETRIEVAL ENDOPOUCH PLASTIC LARGE L6 IN X W4 IN OD10 MM 224 ML INTRODUCER TUBE FLEXIBLE THUMB RING HANDLE SYRINGE MOTION DEPLOYMENT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 51.51 50.48 All Payors / Plans All Payors / Plans 51.51 other 51.51 51.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAG TISSUE RETRIEVAL ANCHOR C4000 ML 25 MM L38.1 CM OD16.5 CM INTRODUCER TROCAR SUP-270000000 CDM 270 RC inpatient 551.75 540.72 All Payors / Plans All Payors / Plans 551.75 other 551.75 551.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALL COTTON SILK SMALL L15 IN OD1/2 IN 2 STRUNG RADIOPAQUE STERILE LATEX FREE BLUE SUP-270000000 CDM 270 RC inpatient 2.13 2.09 All Payors / Plans All Payors / Plans 2.13 other 2.13 2.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALL TIP GUIDE WIRE SUP-270000000 CDM 270 RC inpatient 643.5 630.63 All Payors / Plans All Payors / Plans 643.5 other 643.5 643.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALLOON - STERLING OTW 5.0X20 SUP-272C17251 CDM 270 RC inpatient 525 514.5 All Payors / Plans All Payors / Plans 525 other 525 525 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALLOON DISSECTOR LAPAROSCOPIC SPACEMAKER PLUS BTT ENDO LUBE FOAM OVAL PREPERITONEAL 3 VALVE RIGID SPRING GRIP LOCK COLLAR BLUNT TIP TROCAR LATEX DISPOSABLE HERNIA SUP-270000000 CDM 270 RC inpatient 1570.01 1538.61 All Payors / Plans All Payors / Plans 1570.01 other 1570.01 1570.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALLOON PRESTERILIZED LATEX SUP-270000000 CDM 270 RC inpatient 45.9 44.98 All Payors / Plans All Payors / Plans 45.9 other 45.9 45.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALLOON RETRIEVAL EXTRACTOR PRO XL 200CM 6-7FR 12-15MM DISPOSABLE STERILE LATEX BILIARY 3 LUMEN BELOW INJECTION SQUARE SUP-270000000 CDM 270 RC inpatient 217.22 212.88 All Payors / Plans All Payors / Plans 217.22 other 217.22 217.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALLOON RETRIEVAL EXTRACTOR PRO XL 200CM 6-7FR 9-12MM DISPOSABLE STERILE LATEX BILIARY 3 LUMEN ABOVE INJECTION SQUARE SUP-270000000 CDM 270 RC inpatient 106.43 104.3 All Payors / Plans All Payors / Plans 106.43 other 106.43 106.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALLOON RETRIEVAL EXTRACTOR PRO XL 200CM 6-7FR 9-12MM DISPOSABLE STERILE LATEX BILIARY 3 LUMEN BELOW INJECTION SQUARE SUP-270000000 CDM 270 RC inpatient 105.51 103.4 All Payors / Plans All Payors / Plans 105.51 other 105.51 105.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAND BAG SUP-270000000 CDM 270 RC inpatient 12.5 12.25 All Payors / Plans All Payors / Plans 12.5 other 12.5 12.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAND COMPRESSION TRANSRADIAL BAND LG INFLATOR SUP-270000000 CDM 270 RC inpatient 31.25 30.63 All Payors / Plans All Payors / Plans 31.25 other 31.25 31.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAND COMPRESSION TRANSRADIAL BAND STD INFLATOR SUP-270000000 CDM 270 RC inpatient 42.5 41.65 All Payors / Plans All Payors / Plans 42.5 other 42.5 42.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE ADHESIVE COVERLET 3X2IN FABRIC STERILE LF PATCH XL WOUND PAD ABSORBENT ELASTIC SUP-270009017 CDM 270 RC inpatient 3.84 3.76 All Payors / Plans All Payors / Plans 3.84 other 3.84 3.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE ADHESIVE L5 YD X W4 IN SELF ADHERENT NONSTERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE COMPRESSION REB L5 YD X W3 IN REINFORCE ELASTIC LIGHTWEIGHT STRETCH LATEX FREE STANDARD SUP-270000000 CDM 270 RC inpatient 1.24 1.22 All Payors / Plans All Payors / Plans 1.24 other 1.24 1.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE COMPRESSION REB L5 YD X W4 IN REINFORCE ELASTIC LIGHTWEIGHT STRETCH LATEX FREE STANDARD SUP-270000000 CDM 270 RC inpatient 1.29 1.26 All Payors / Plans All Payors / Plans 1.29 other 1.29 1.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE COMPRESSION REB L5 YD X W6 IN REINFORCE ELASTIC LIGHTWEIGHT STRETCH LATEX FREE STANDARD SUP-270000000 CDM 270 RC inpatient 2.76 2.7 All Payors / Plans All Payors / Plans 2.76 other 2.76 2.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE COMPRESSION SOFT-WRAP 5YDX4IN BEIGE POLYESTER COTTON STERILE LF ELASTIC CLIP CLOSURE STRETCH BREATHABLE SUP-270000000 CDM 270 RC inpatient 7.37 7.22 All Payors / Plans All Payors / Plans 7.37 other 7.37 7.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE COMPRESSION SOFT-WRAP 5YDX6IN BEIGE POLYESTER COTTON STERILE LF ELASTIC CLIP CLOSURE STRETCH BREATHABLE SUP-270000000 CDM 270 RC inpatient 2.16 2.12 All Payors / Plans All Payors / Plans 2.16 other 2.16 2.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE ELASTIC ESMARK STERILE 4X12 LF SUP-270000000 CDM 270 RC inpatient 5.95 5.83 All Payors / Plans All Payors / Plans 5.95 other 5.95 5.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE GAUZE KERLIX LG 4 1/8YDX4.5IN COTTON STERILE LF 6 PLY ABSORBENT SOFT POUCH LINT FREE SUP-270000000 CDM 270 RC inpatient 1.17 1.15 All Payors / Plans All Payors / Plans 1.17 other 1.17 1.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE HEMOSTATIC INTERVENTIONAL QUICKCLOT SUP-270000000 CDM 270 RC inpatient 42 41.16 All Payors / Plans All Payors / Plans 42 other 42 42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE HEMOSTATIC THROMBIX SILVER LF TOPICAL PATCH SUP-270000000 CDM 270 RC inpatient 26.52 25.99 All Payors / Plans All Payors / Plans 26.52 other 26.52 26.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE SELF ADHESIVE 4IN X 5YD LATEX FREE STERILE SUP-270009185 CDM 270 RC inpatient 3.4 3.33 All Payors / Plans All Payors / Plans 3.4 other 3.4 3.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE SELF ADHESIVE 6IN X 5YD LATEX FREE STERILE SUP-270009185 CDM 270 RC inpatient 3.4 3.33 All Payors / Plans All Payors / Plans 3.4 other 3.4 3.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAR EXTERNAL FIXATION L225 MM OD6 MM SUP-270000000 CDM 270 RC inpatient 317.52 311.17 All Payors / Plans All Payors / Plans 317.52 other 317.52 317.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BARRIER ADHESION INTERCEED L4 IN X W3 IN PELVIS ABSORBABLE STERILE SUP-270000000 CDM 270 RC inpatient 674.31 660.82 All Payors / Plans All Payors / Plans 674.31 other 674.31 674.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BASEPLATE TIBIAL ATTUNE SIZE 4 CEMENTED SUP-270010025 CDM 270 RC inpatient 6720 6585.6 All Payors / Plans All Payors / Plans 6720 other 6720 6720 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BASEPLATE TIBIAL ATTUNE SIZE 5 CEMENTED SUP-270010025 CDM 270 RC inpatient 6720 6585.6 All Payors / Plans All Payors / Plans 6720 other 6720 6720 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BASEPLATE TIBIAL ATTUNE SIZE 8 CEMENTED SUP-270010025 CDM 270 RC inpatient 3264 3198.72 All Payors / Plans All Payors / Plans 3264 other 3264 3264 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BASKET STONE RETRIEVAL ZEROTIP NITINOL L120 CM OD16 MM ODSEC3 FR URETERAL 4 WIRE FLAT DISTAL SURFACE KNOT TIPLESS STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 405.15 397.05 All Payors / Plans All Payors / Plans 405.15 other 405.15 405.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BASKET ZERO TIP 1.9 FR SUP-270000000 CDM 270 RC inpatient 460.34 451.13 All Payors / Plans All Payors / Plans 460.34 other 460.34 460.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BATTERY BIOMET THINFLAP PLATING SYSTEM SUP-270000000 CDM 270 RC inpatient 99.96 97.96 All Payors / Plans All Payors / Plans 99.96 other 99.96 99.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BATTERY SURGICAL DRIVER MATRIXPRO STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 959.7 940.51 All Payors / Plans All Payors / Plans 959.7 other 959.7 959.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BAYLIS GROUNDING PAD 10' CABLE, ADULT" SUP-270000000 CDM 270 RC inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BETADINE 5% STERILE OPTHALMIC PREP SOLUTION SUP-270000000 CDM 270 RC inpatient 10.46 10.25 All Payors / Plans All Payors / Plans 10.46 other 10.46 10.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BINDER ABDOMINAL 30-45X12IN 4 ELASTIC PANEL COMFORT CONTACT CLOSURE MED SUP-270009158 CDM 270 RC inpatient 18.59 18.22 All Payors / Plans All Payors / Plans 18.59 other 18.59 18.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BINDER ABDOMINAL 46-62X12IN 4 ELASTIC PANEL CONTACT CLOSURE COMFORT LG LATEX SUP-270009158 CDM 270 RC inpatient 18.59 18.22 All Payors / Plans All Payors / Plans 18.59 other 18.59 18.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BINDER ABDOMINAL COMFORT LARGE L46-62 IN X W12 IN 4 ELASTIC PANEL CONTACT CLOSURE LATEX SUP-270009158 CDM 270 RC inpatient 18.59 18.22 All Payors / Plans All Payors / Plans 18.59 other 18.59 18.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BINDER ABDOMINAL MEDIUM L30-45 IN X W12 IN 4 ELASTIC PANEL COMFORT CONTACT CLOSURE SUP-270009158 CDM 270 RC inpatient 18.59 18.22 All Payors / Plans All Payors / Plans 18.59 other 18.59 18.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BINDER ABDOMINAL PROCARE XL 12IN 62-74IN FLANNEL COTTON 4 PANEL ELASTIC CONTACT CLOSURE SUP-270009158 CDM 270 RC inpatient 18.59 18.22 All Payors / Plans All Payors / Plans 18.59 other 18.59 18.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIOGEL PI INDICATOR SYNTHETIC UNDERGLOVE SIZE 7 BOX SUP-270000000 CDM 270 RC inpatient 2.74 2.69 All Payors / Plans All Payors / Plans 2.74 other 2.74 2.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIOPSY NEEDLE KIT SUP-270000000 CDM 270 RC inpatient 1155.16 1132.06 All Payors / Plans All Payors / Plans 1155.16 other 1155.16 1155.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL 110MM 2.5MM GOLD NS QUICK COUPLING SUP-270010022 CDM 270 RC inpatient 319.52 313.13 All Payors / Plans All Payors / Plans 319.52 other 319.52 319.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL 110MM 3.5MM NS QUICK COUPLING SUP-270010022 CDM 270 RC inpatient 181.58 177.95 All Payors / Plans All Payors / Plans 181.58 other 181.58 181.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL 2.5MM SUP-270000000 CDM 270 RC inpatient 178.5 174.93 All Payors / Plans All Payors / Plans 178.5 other 178.5 178.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL 2MM SUP-270000000 CDM 270 RC inpatient 199.5 195.51 All Payors / Plans All Payors / Plans 199.5 other 199.5 199.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL CRANIAL 5.8MM SUP-270000000 CDM 270 RC inpatient 142.95 140.09 All Payors / Plans All Payors / Plans 142.95 other 142.95 142.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL EVOS OD1.8MM RADIUS DISTAL AO QUICK CONNECT STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 361.76 354.52 All Payors / Plans All Payors / Plans 361.76 other 361.76 361.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL L 155 MM OD 2.7MM CANNULATED DISPOSABLE SUP-270000000 CDM 270 RC inpatient 728.28 713.71 All Payors / Plans All Payors / Plans 728.28 other 728.28 728.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL SURGICAL EVOS LARGE OD 2.5 MM TARGETER AO QUICK STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 469.35 459.96 All Payors / Plans All Payors / Plans 469.35 other 469.35 469.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL TRIGEN LONG OD 4 MM AO PILOT STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 125 122.5 All Payors / Plans All Payors / Plans 125 other 125 125 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE OPHTHALMIC ASB HOCKEY STICK SHARP ALL AROUND SUP-270000000 CDM 270 RC inpatient 35.55 34.84 All Payors / Plans All Payors / Plans 35.55 other 35.55 35.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE OPHTHALMIC GRIESHABER DSP OD25 GA MVR DISPOSABLE SUP-270000000 CDM 270 RC inpatient 46.03 45.11 All Payors / Plans All Payors / Plans 46.03 other 46.03 46.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE OSCILLATOR SUP-270000000 CDM 270 RC inpatient 37.8 37.04 All Payors / Plans All Payors / Plans 37.8 other 37.8 37.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE REAMER NEXGEN STAINLESS STEEL OD41 MM KNEE PATELLA PILOT HOLE NONSTERILE SUP-270010025 CDM 270 RC inpatient 260 254.8 All Payors / Plans All Payors / Plans 260 other 260 260 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE REAMER PATELLA WITH PILOT HOLE SIZE 41 SUP-270000000 CDM 270 RC inpatient 210 205.8 All Payors / Plans All Payors / Plans 210 other 210 210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW BONE SAGITTAL COARSE MICRO STERILE 5.5 X 25.5 X 0.4MM SUP-270000000 CDM 270 RC inpatient 33.6 32.93 All Payors / Plans All Payors / Plans 33.6 other 33.6 33.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW GIGLI STAINLESS STEEL L510 MM STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 26.53 26 All Payors / Plans All Payors / Plans 26.53 other 26.53 26.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW L90 MM X W18 MM X H1.19 MM SAGITTAL 2 CUT STERILE SUP-270000000 CDM 270 RC inpatient 51.18 50.16 All Payors / Plans All Payors / Plans 51.18 other 51.18 51.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW L90 MM X W21 MM X H1.19 MM SAGITTAL SUP-270000000 CDM 270 RC inpatient 59.8 58.6 All Payors / Plans All Payors / Plans 59.8 other 59.8 59.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW MICRO 100 MICROPOWER L25.5 MM X W9.5 MM X H.4 MM SAGITTAL FINE TOOTH STERILE SUP-270000000 CDM 270 RC inpatient 22.64 22.19 All Payors / Plans All Payors / Plans 22.64 other 22.64 22.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW SAGITTAL HEAVY DUTY SUP-270000000 CDM 270 RC inpatient 40 39.2 All Payors / Plans All Payors / Plans 40 other 40 40 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW SHORT THIN XWIDE SAGITTAL SUP-270000000 CDM 270 RC inpatient 58.13 56.97 All Payors / Plans All Payors / Plans 58.13 other 58.13 58.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW STAINLESS STEEL L70 MM X W12.5 MM X H.8 MM 2 SIDED RECIPROCATING STERILE LATEX FREE ARTHROPLASTY SUP-270000000 CDM 270 RC inpatient 30.6 29.99 All Payors / Plans All Payors / Plans 30.6 other 30.6 30.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW STAINLESS STEEL LONG L75 MM X W12 MM X H.8 MM RECIPROCATING HEAVY DUTY STERILE SUP-270000000 CDM 270 RC inpatient 30.6 29.99 All Payors / Plans All Payors / Plans 30.6 other 30.6 30.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW STAINLESS STEEL THK.05 IN L3.543 IN X W.709 IN 2 CUT SAGITTAL STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 103.24 101.18 All Payors / Plans All Payors / Plans 103.24 other 103.24 103.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW STAINLESS STEEL THK.64 MM XSHORT NARROW THIN L24.5 MM X W9 MM SAGITTAL STERILE SUP-270000000 CDM 270 RC inpatient 47.06 46.12 All Payors / Plans All Payors / Plans 47.06 other 47.06 47.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW STAINLESS STEEL THK.8 MM MEDIUM NARROW L73.8 MM X W18.6 MM SAGITTAL STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 28.23 27.67 All Payors / Plans All Payors / Plans 28.23 other 28.23 28.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW STAINLESS STEEL THK1.19 MM NARROW THICK L81.5 MM X W12.5 MM SAGITTAL STERILE SUP-270000000 CDM 270 RC inpatient 28.23 27.67 All Payors / Plans All Payors / Plans 28.23 other 28.23 28.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW STAINLESS STEEL THK1.37 MM L90 MM X W25 MM SAGITTAL 2 CUT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 51.18 50.16 All Payors / Plans All Payors / Plans 51.18 other 51.18 51.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW THK.64 MM D33 MM THIN W9.4 MM STERNUM STERILE SUP-270000000 CDM 270 RC inpatient 16.22 15.9 All Payors / Plans All Payors / Plans 16.22 other 16.22 16.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW THK1.27 MM L90 MM X W18 MM SAGITTAL STERILE SUP-270000000 CDM 270 RC inpatient 53.24 52.18 All Payors / Plans All Payors / Plans 53.24 other 53.24 53.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW VELYS SUP-270010025 CDM 270 RC inpatient 57.12 55.98 All Payors / Plans All Payors / Plans 57.12 other 57.12 57.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SHAVER MCDEB OD4 MM AGGRESSIVE IRRIGATE SERRATE STERILE SUP-270000000 CDM 270 RC inpatient 245.41 240.5 All Payors / Plans All Payors / Plans 245.41 other 245.41 245.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SHAVER QUADCUT L13 CM OD4.3 MM SUP-270000000 CDM 270 RC inpatient 695.1 681.2 All Payors / Plans All Payors / Plans 695.1 other 695.1 695.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SHAVER SABRETOOTH COOLCUT STAINLESS STEEL CURVE L13 CM OD4 MM RESECTION STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 77.7 76.15 All Payors / Plans All Payors / Plans 77.7 other 77.7 77.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SHAVER TORPEDO CURVE 13CM 4MM SUP-270000000 CDM 270 RC inpatient 212.1 207.86 All Payors / Plans All Payors / Plans 212.1 other 212.1 212.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SURGICAL CLIPPER DISPOSABLE NS LF SPECIALTY SURGICAL COARSE HAIR SUP-270000000 CDM 270 RC inpatient 9.97 9.77 All Payors / Plans All Payors / Plans 9.97 other 9.97 9.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLANKET WARMING 3M BAIR HUGGER 60X36IN WHITE POLYMER DISPOSABLE STERILE LF ADULT 4OZ LOWER BODY AIR SYSTEM LIGHTWEIGHT SUP-270000000 CDM 270 RC inpatient 4.51 4.42 All Payors / Plans All Payors / Plans 4.51 other 4.51 4.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLANKET WARMING L10.5 IN X W10.5 IN KNEE SHOULDER COLD MOTORIZED PORTABLE NONSTERILE SUP-270000000 CDM 270 RC inpatient 44.35 43.46 All Payors / Plans All Payors / Plans 44.35 other 44.35 44.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLOCK LORDOTIC SR CORTICAL 8X14X11MM SUP-270010012 CDM 270 RC inpatient 1995 1955.1 All Payors / Plans All Payors / Plans 1995 other 1995 1995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BODY CONE RESTORATION +10 MM OD21 MM HIP MODULAR REVISION SUP-270010024 CDM 270 RC inpatient 4034.4 3953.71 All Payors / Plans All Payors / Plans 4034.4 other 4034.4 4034.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOSTON SCIENTIFIC EMERGE BALLOON 2.50 X 12MM SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOSTON SCIENTIFIC EMERGE BALLOON 3.00 X 15MM SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOSTON SCIENTIFIC NC EMERGE 2.25 X 8MM SUP-481000000 CDM 270 RC inpatient 127.5 124.95 All Payors / Plans All Payors / Plans 127.5 other 127.5 127.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOSTON SCIENTIFIC NC EMERGE 2.50 X 12MM SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOSTON SCIENTIFIC NC EMERGE 3.00 X 12MM SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOTTLE MEDICINE PLASTIC TALL 1 L GRADUATE PITCHER STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOWL CEMENT MIXING ORTHOPAEDIC STERILE WITH SPATULA DISPOSABLE SUP-270009196 CDM 270 RC inpatient 60.12 58.92 All Payors / Plans All Payors / Plans 60.12 other 60.12 60.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOWL GUIDEWIRE 5 TAB BASIN RING GRASPABLE STERILE LATEX SUP-481000000 CDM 270 RC inpatient 12.45 12.2 All Payors / Plans All Payors / Plans 12.45 other 12.45 12.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOWL SOLUTION LG 32OZ LIGHT BLUE PLASTIC STERILE LF GRADUATED NO AUTOCLAVABLE SUP-270000000 CDM 270 RC inpatient 1.59 1.56 All Payors / Plans All Payors / Plans 1.59 other 1.59 1.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRA ELIZABETH PINK SURGICAL SIZE 3XL SUP-270009195 CDM 270 RC inpatient 45.24 44.34 All Payors / Plans All Payors / Plans 45.24 other 45.24 45.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRA ELIZABETH PINK SURGICAL SIZE EXTRA LARGE SUP-270009195 CDM 270 RC inpatient 45.24 44.34 All Payors / Plans All Payors / Plans 45.24 other 45.24 45.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRA ELIZABETH PINK SURGICAL SIZE LARGE SUP-270009195 CDM 270 RC inpatient 45.24 44.34 All Payors / Plans All Payors / Plans 45.24 other 45.24 45.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRA ELIZABETH PINK SURGICAL SIZE MED SUP-270009195 CDM 270 RC inpatient 45.24 44.34 All Payors / Plans All Payors / Plans 45.24 other 45.24 45.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRACE ORTHOPEDIC REGULAR FOAM KNEE STREAMLINED HINGE TELE-FIT: SLIDING MECHANISM POSTOPERATIVE BREATHABLE TROM ADVANCE SUP-270000000 CDM 270 RC inpatient 196.14 192.22 All Payors / Plans All Payors / Plans 196.14 other 196.14 196.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRAIN LAB SPHERES 41773B SUP-270000000 CDM 270 RC inpatient 35.84 35.12 All Payors / Plans All Payors / Plans 35.84 other 35.84 35.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRUSH CYTOLOGY COMBO CATH L200 CM X W2.1 MM OD8 FR BILIARY RAPID EXCHANGE DISPOSABLE ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 187.36 183.61 All Payors / Plans All Payors / Plans 187.36 other 187.36 187.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRUSH CYTOLOGY CONMED L230 CM OD3 MM ODSEC2.1 MM GASTROINTESTINE SHEATH BRISTLE POSITIVE STOP THUMB RING STERILE LATEX FREE DISPOSABLE COLONOSCOPE SUP-270000000 CDM 270 RC inpatient 22.5 22.05 All Payors / Plans All Payors / Plans 22.5 other 22.5 22.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRUSH CYTOLOGY SUPERDIMENSION 115MM 10MM 1.9MM 3 NEEDLE SUP-270000000 CDM 270 RC inpatient 459.68 450.49 All Payors / Plans All Payors / Plans 459.68 other 459.68 459.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRUSH CYTOLOGY SUPERTRAX INREACH L120 CM L2 MM OD1.7 MM METAL TIPPED SHEATH STERILE DISPOSABLE TOOL SUP-270000000 CDM 270 RC inpatient 60.18 58.98 All Payors / Plans All Payors / Plans 60.18 other 60.18 60.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRUSH ERCP ENDOSCOPIC INFINITY NITINOL L200 CM OD3 MM DRIVE WIRE STIFFER SOFTER BRISTLE STERILE LATEX FREE DISPOSABLE LONG SHORT GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 294 288.12 All Payors / Plans All Payors / Plans 294 other 294 294 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BULKAMID URETHRAL BULKING SYSTEM SUP-270000000 CDM 270 RC inpatient 2205 2160.9 All Payors / Plans All Payors / Plans 2205 other 2205 2205 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BURR ROUND FLUTED SOFT TOUCH 2.0 MM SUP-270000000 CDM 270 RC inpatient 145.96 143.04 All Payors / Plans All Payors / Plans 145.96 other 145.96 145.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BURR SHAVER COOLCUT FLUSHCUT 12 FLUTE OVAL L13 CM OD5 MM SUP-270000000 CDM 270 RC inpatient 77.7 76.15 All Payors / Plans All Payors / Plans 77.7 other 77.7 77.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BURR SURGICAL MICROPOWER MICRO100 HALL CARBIDE 8 MM LONG L8 MM OD4 MM SMALL BONE OVAL FLUTED STERILE SUP-270000000 CDM 270 RC inpatient 38.25 37.49 All Payors / Plans All Payors / Plans 38.25 other 38.25 38.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUTTON GASTROSTOMY MIC-KEY SECUR-LOK 4CM 20FR 5ML SILICONE DISPOSABLE STERILE LF ENTERAL RADIOPAQUE LOW PROFILE TAPER SUP-270000000 CDM 270 RC inpatient 193.28 189.41 All Payors / Plans All Payors / Plans 193.28 other 193.28 193.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUTTON SUCTION BRONCHOSCOPE SUP-270000000 CDM 270 RC inpatient 19.95 19.55 All Payors / Plans All Payors / Plans 19.95 other 19.95 19.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CABLE BIPOLAR 12FT DISPOSABLE BIPOLAR BOVIE CONMED VALLEYLAB SUP-270000000 CDM 270 RC inpatient 10.66 10.45 All Payors / Plans All Payors / Plans 10.66 other 10.66 10.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CABLE CATHETER COAXIAL UMBILICAL DISPOSABLE SUP-270000000 CDM 270 RC inpatient 141.67 138.84 All Payors / Plans All Payors / Plans 141.67 other 141.67 141.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CABLE CRYOTHERAPY DISPOSABLE STERILE LF ELECTRICAL UMBILICAL SUP-270000000 CDM 270 RC inpatient 283.33 277.66 All Payors / Plans All Payors / Plans 283.33 other 283.33 283.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CABLE PACING SJM L 12FT TEMPORARY EXTENSION STERILE LAXTEX FREE DISPOSABLE SUP-275000000 CDM 270 RC inpatient 48.45 47.48 All Payors / Plans All Payors / Plans 48.45 other 48.45 48.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CABLE SILVERGLIDE BIPOLAR SUP-270000000 CDM 270 RC inpatient 4.89 4.79 All Payors / Plans All Payors / Plans 4.89 other 4.89 4.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CABLE/SLEEVE ORTHOPEDIC DALL-MILES VITALLIUM OD2 MM HIP SET SUP-270000000 CDM 270 RC inpatient 631.26 618.63 All Payors / Plans All Payors / Plans 631.26 other 631.26 631.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANISTER SUCTION BERKELEY SAFETOUCH BOTTLE SEAL CAP DISPOSABLE SUP-270000000 CDM 270 RC inpatient 9.42 9.23 All Payors / Plans All Payors / Plans 9.42 other 9.42 9.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANISTER SUCTION BERKELEY SAFETOUCH GAUZE SEAL CAP O RING STERILE SUP-270000000 CDM 270 RC inpatient 2.45 2.4 All Payors / Plans All Payors / Plans 2.45 other 2.45 2.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANISTER SUCTION MEDI-VAC GUARDIAN 90 D 2000 ML LOCK LID OVERFLOW SHUTOFF VALVE POUR SPOUT FILTER LATEX FREE DISPOSABLE SUP-270009176 CDM 270 RC inpatient 3 2.94 All Payors / Plans All Payors / Plans 3 other 3 3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANISTER SUCTION MEDI-VAC GUARDIAN 90D 3000ML DISPOSABLE LF SHUT OFF VALVE POUR SPOUT SUP-270009176 CDM 270 RC inpatient 3 2.94 All Payors / Plans All Payors / Plans 3 other 3 3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANISTER WOUND DRAIN INFOVAC C500 ML GEL TUBE CLAMP CONNECTOR CHARCOAL FILTER STERILE DISPOSABLE SUP-270009209 CDM 270 RC inpatient 35.92 35.2 All Payors / Plans All Payors / Plans 35.92 other 35.92 35.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANISTER WOUND DRAIN VAC ATS 500 ML TUBING CLAMP CONNECTOR GEL STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 146.9 143.96 All Payors / Plans All Payors / Plans 146.9 other 146.9 146.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA ARTHROSCOPIC POLYCARBONATE L75 MM ID7 MM 3 SEAL DAM THREAD OBTURATOR PRESSURE CONTROL STERILE LATEX FREE DISPOSABLE CLEAR SUP-270000000 CDM 270 RC inpatient 83.46 81.79 All Payors / Plans All Payors / Plans 83.46 other 83.46 83.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA ARTHROSCOPIC POLYCARBONATE L75 MM ID8.5 MM 3 SEAL DAM THREAD OBTURATOR STABILITY PRESSURE CONTROL STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 77.28 75.73 All Payors / Plans All Payors / Plans 77.28 other 77.28 77.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA BONE CEMENT VERTEPORT OD10 GA PRECISE CONTROL TACTILE FEEL STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 191.01 187.19 All Payors / Plans All Payors / Plans 191.01 other 191.01 191.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA BUTTON PASSPORT SILICONE CURVE LOW PROFILE L3 CM ID8 MM HIP 1 PIECE MOLD 2 DAM DESIGN 2 FLANGE FLEXIBLE SOFT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 67.2 65.86 All Payors / Plans All Payors / Plans 67.2 other 67.2 67.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA BUTTON PASSPORT SILICONE CURVE LOW PROFILE L4 CM ID8 MM HIP 1 PIECE MOLD 2 DAM DESIGN 2 FLANGE FLEXIBLE SOFT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 67.2 65.86 All Payors / Plans All Payors / Plans 67.2 other 67.2 67.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA ERCP CONTOUR TAPER L210 CM OD5 FR BILIARY DISPOSABLE ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 124.15 121.67 All Payors / Plans All Payors / Plans 124.15 other 124.15 124.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA OPHTHALMIC ANGLED L4 MM OD27 GA ANTERIOR CHAMBER IRRIGATION STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 13.71 13.44 All Payors / Plans All Payors / Plans 13.71 other 13.71 13.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA OPHTHALMIC ATKINSON L32 MM OD.5 MM RETROBULBAR PERIBULBAR ANESTHESIA SUP-270000000 CDM 270 RC inpatient 12.78 12.52 All Payors / Plans All Payors / Plans 12.78 other 12.78 12.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA OPHTHALMIC GRIESHABER SHORT OD25 GA ODSEC.8 MM SOFT TIP STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 21.89 21.45 All Payors / Plans All Payors / Plans 21.89 other 21.89 21.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA OPHTHALMIC OD25 GA CHANDELIER STERILE SUP-270000000 CDM 270 RC inpatient 174.83 171.33 All Payors / Plans All Payors / Plans 174.83 other 174.83 174.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA OPHTHALMIC SHORT OD23 GA SOFT TIP STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 21.89 21.45 All Payors / Plans All Payors / Plans 21.89 other 21.89 21.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA OPHTHALMIC SILICONE OD23 GA SOFT TIP DISPOSABLE SUP-270000000 CDM 270 RC inpatient 45.91 44.99 All Payors / Plans All Payors / Plans 45.91 other 45.91 45.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA PERFUSION VENOUS IRRIGATION BEVELED TIP SUP-270000000 CDM 270 RC inpatient 22.24 21.8 All Payors / Plans All Payors / Plans 22.24 other 22.24 22.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA SUCTION POLYTIP SUP-270000000 CDM 270 RC inpatient 100.8 98.78 All Payors / Plans All Payors / Plans 100.8 other 100.8 100.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAP DRAINAGE PLEURX THORACIC VALVE CAP KIT LATEX FREE DISPOSABLE PLEURAL EFFUSION SUP-270000000 CDM 270 RC inpatient 30.44 29.83 All Payors / Plans All Payors / Plans 30.44 other 30.44 30.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAP PROTECTIVE L1.1 MM OD.045 IN ORTHOPEDIC HEAD STERILE WHITE .045 IN PIN SUP-270000000 CDM 270 RC inpatient 5.79 5.67 All Payors / Plans All Payors / Plans 5.79 other 5.79 5.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAP SYRINGE COLEMAN LUER LOCK STERILE SUP-270000000 CDM 270 RC inpatient 2.31 2.26 All Payors / Plans All Payors / Plans 2.31 other 2.31 2.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAPSULE VIDEO PILLCAM SB 3 156D 434.1MHZ 26.2MM 11.4MM WHITE PLASTIC 3GM 4 LIGHT EMIT DIODE BATTERY SUP-270000000 CDM 270 RC inpatient 535.81 525.09 All Payors / Plans All Payors / Plans 535.81 other 535.81 535.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARDINALHEALTH MEDI-TRACE R2 PADS (GREEN) SUP-270000000 CDM 270 RC inpatient 40.6 39.79 All Payors / Plans All Payors / Plans 40.6 other 40.6 40.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARTRIDGE OIL MAESTRO CORE SUP-270000000 CDM 270 RC inpatient 23.56 23.09 All Payors / Plans All Payors / Plans 23.56 other 23.56 23.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION BARRX 360 L3 CM L85 CM L4 CM OD7 MM ODSEC28 MM ESOPHAGEAL BIPOLAR ELECTRODE BALLOON RADIOFREQUENCY SUP-270000000 CDM 270 RC inpatient 3281.27 3215.64 All Payors / Plans All Payors / Plans 3281.27 other 3281.27 3281.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION DECANAV 2MM 2-8-2 MM F CURVE L115CM OD 7 FR 10 POLE TIP SUP-270000000 CDM 270 RC inpatient 1938 1899.24 All Payors / Plans All Payors / Plans 1938 other 1938 1938 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION DECANAV CARTO 3 2 MM 2-8-2 MM D CURVE L115CM OD 7 FR 10 PLE SUP-270000000 CDM 270 RC inpatient 1162.8 1139.54 All Payors / Plans All Payors / Plans 1162.8 other 1162.8 1162.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION FLEXABILITY SENSOR ENABLED ENSITE PRECISION MEDIGUIDE 1-4-1 SPACE D-F CURVE L 115CM L 4MM OD 8FR BI-DIRECTIONAL HANDLE IRRIGATE SUP-481000000 CDM 270 RC inpatient 3885 3807.3 All Payors / Plans All Payors / Plans 3885 other 3885 3885 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION FLEXABILITY SENSOR ENABLED ENSITE PRECISION MEDIGUIDE 1-4-1 SPACE F-J CURVE L 115CM L 4MM OD 8FR BI-DIRECTIONAL HANDLE IRRIGATE SUP-481000000 CDM 270 RC inpatient 1887 1849.26 All Payors / Plans All Payors / Plans 1887 other 1887 1887 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION SMARTTOUCH THERMOCOOL SF D-F CURVE OD 8 FR BIODIRECTIONAL THERMOCOUPLE SUP-270000000 CDM 270 RC inpatient 3853.56 3776.49 All Payors / Plans All Payors / Plans 3853.56 other 3853.56 3853.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION SMARTTOUCH THERMOCOOL SF F CURVE UNIDIRECTIONAL THERMOCOUPLE SUP-270000000 CDM 270 RC inpatient 7518 7367.64 All Payors / Plans All Payors / Plans 7518 other 7518 7518 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION TACTICATH SENSOR ENABLED 2-2-2MM SPACE F-J CURVE L115CM L 3.5MM OD 8 FR IRRIGATE BIDIRECTIONAL SUP-270000000 CDM 270 RC inpatient 5670 5556.6 All Payors / Plans All Payors / Plans 5670 other 5670 5670 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION TACTIFLEX SE BIDIRECTIONAL CURVE D-F SENSOR ENABLED SUP-481000000 CDM 270 RC inpatient 6630 6497.4 All Payors / Plans All Payors / Plans 6630 other 6630 6630 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION TACTIFLEX SE BIDIRECTIONAL CURVE F-J SENSOR ENABLED SUP-481000000 CDM 270 RC inpatient 8190 8026.2 All Payors / Plans All Payors / Plans 8190 other 8190 8190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CATHETER ABLATION THERMOCOOLSF 2-5-2 SPACE 3.5MM D-F CURVE, L 115 CMOD 8 FR 6 ELECTRODE TIP BI-DIRECTIONAL NON-NAVIGATIONAL" SUP-481000000 CDM 270 RC inpatient 4029.9 3949.3 All Payors / Plans All Payors / Plans 4029.9 other 4029.9 4029.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC ARROW L60 CM OD5 FR ODSEC7 MM .75 CC 1 LUMEN BALLOON WEDGE PRESSURE TAPER TIP ACCEPTS .025 IN GUIDEWIRE 5 FR INTRODUCER SUP-270000000 CDM 270 RC inpatient 252 246.96 All Payors / Plans All Payors / Plans 252 other 252 252 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC EXPO FEMORAL LEFT 5 CURVE OD6 FR SUP-481000000 CDM 270 RC inpatient 15.8 15.48 All Payors / Plans All Payors / Plans 15.8 other 15.8 15.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC EXPO TRILON FEMORAL RIGHT 4 CURVE L100 CM OD5 FR ID.045 IN ROBUST SHAFT FULL LENGTH WIRE BRAID SUPER SOFT TIP VASCULAR ACCESS SUP-481000000 CDM 270 RC inpatient 18.82 18.44 All Payors / Plans All Payors / Plans 18.82 other 18.82 18.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC EXPO TRILON PIGTAIL CURVE FULL LENGTH L110 CM OD5 FR ID.041 IN VENTRICLE WIRE BRAIDING SUP-481000000 CDM 270 RC inpatient 15.8 15.48 All Payors / Plans All Payors / Plans 15.8 other 15.8 15.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC EXPO WILLIAMS RIGHT CURVE 100CM 6FR .056IN SUP-481000000 CDM 270 RC inpatient 15.8 15.48 All Payors / Plans All Payors / Plans 15.8 other 15.8 15.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC GLIDECATH GLIDE TECHNOLOGY STAINLESS STEEL HYDROPHILIC ANGLE L65 CM L15 CM OD4 FR ID.041 IN 2 BRAID SUP-270000000 CDM 270 RC inpatient 101.96 99.92 All Payors / Plans All Payors / Plans 101.96 other 101.96 101.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC GLIDECATH GLIDE TECHNOLOGY STAINLESS STEEL HYDROPHILIC ANGLE L65 CM L25 CM OD5 FR ID.047 IN 1 BRAID SUP-270000000 CDM 270 RC inpatient 49.57 48.58 All Payors / Plans All Payors / Plans 49.57 other 49.57 49.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC GLIDECATH GLIDE TECHNOLOGY STAINLESS STEEL HYDROPHILIC COBRA 2 CURVE L65 CM L25 CM OD5 FR ID.047 IN 1 BRAID SUP-270000000 CDM 270 RC inpatient 102.06 100.02 All Payors / Plans All Payors / Plans 102.06 other 102.06 102.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC GLIDECATH HYDROPHILIC NYLON SIM2 CURVE L100 CM L15 CM OD4 FR 2 STAINLESS STEEL BRAIDED POLYURETHANE JACKET ACCEPTS .038 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 102.06 100.02 All Payors / Plans All Payors / Plans 102.06 other 102.06 102.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC GLIDECATH STAINLESS STEEL HYDROPHILIC L100 CM L15 CM OD4 FR ID.041 IN 2 BRAID ANGLE TIP STERILE LATEX FREE ACCEPTS .038 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 82.54 80.89 All Payors / Plans All Payors / Plans 82.54 other 82.54 82.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC INFINITI THRULUMEN INTERNAL MAMMARY CURVE 100CM 5FR VESTAN RADIOPAQUE THIN WALL TORQUE CONTROL LG SUP-481000000 CDM 270 RC inpatient 17.54 17.19 All Payors / Plans All Payors / Plans 17.54 other 17.54 17.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC INFINITI VESTAN PIGTAIL CURVE STRAIGHT L110 CM OD6 FR VENTRICULAR 6 SIDEHOLE ACCEPTS .038 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 18.38 18.01 All Payors / Plans All Payors / Plans 18.38 other 18.38 18.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC PERFORMA .035 IN VERT CURVE L100 CM OD5 FR ID.046 IN SUP-270000000 CDM 270 RC inpatient 22.26 21.81 All Payors / Plans All Payors / Plans 22.26 other 22.26 22.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC PERFORMA PEBAX POLYCARBONATE NYLON STRAIGHT PIGTAIL CURVE L110 CM OD6 FR CARDIAC 5 SIDEHOLE RADIOPAQUE BRAID STERILE ACCEPTS .038 IN GUIDEWIRE SUP-481000000 CDM 270 RC inpatient 19.01 18.63 All Payors / Plans All Payors / Plans 19.01 other 19.01 19.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC SLIP-CATH HYDROPHILIC BEACON C2 CURVE L100 CM OD4 FR VISCERA ACCEPTS .038 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 87.2 85.46 All Payors / Plans All Payors / Plans 87.2 other 87.2 87.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC SOFT-VU KUMPE CURVE ANGLE L40 CM OD4 FR NONBRAIDED SOFT RADIOPAQUE TIP HIGH TORQUE SHAFT SELECTIVE STERILE DISPOSABLE .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 45.84 44.92 All Payors / Plans All Payors / Plans 45.84 other 45.84 45.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC SOFT-VU OMNI FLUSH 0 CURVE L90 CM OD5 FR HIGH TORQUE SHAFT SOFT RADIOPAQUE TIP ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 22.47 22.02 All Payors / Plans All Payors / Plans 22.47 other 22.47 22.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC SOFT-VU SOS OMNI 0 CURVE L80 CM OD4 FR VISCERAL BRAID ULTRA TORQUE SHAFT SOFT RADIOPAQUE TIP SELECTIVE ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 37.3 36.55 All Payors / Plans All Payors / Plans 37.3 other 37.3 37.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC SOFT-VU SOS OMNI2 CURVE 80CM 5FR DISPOSABLE STERILE VISCERA BRAID ULTRA TORQUE SHAFT RADIOPAQUE SUP-270000000 CDM 270 RC inpatient 48.38 47.41 All Payors / Plans All Payors / Plans 48.38 other 48.38 48.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC SOUNDSTAR OD 8 FR SUP-270000000 CDM 270 RC inpatient 2748.9 2693.92 All Payors / Plans All Payors / Plans 2748.9 other 2748.9 2748.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC TORCON NB ADVANTAGE BEACON TIP ANGLE SIMMONS 2 CURVE 100CM 5FR SS NYLON CEREBRAL MULTIPURPOSE SUP-270000000 CDM 270 RC inpatient 31.79 31.15 All Payors / Plans All Payors / Plans 31.79 other 31.79 31.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC TORCON NB ADVANTAGE BEACON TIP NYLON .035 IN RIM CURVE L65 CM OD4 FR LOW PROFILE HUB TO TIP TAPERED TIP OPTIMAL STEERABILITY SUP-270000000 CDM 270 RC inpatient 25.73 25.22 All Payors / Plans All Payors / Plans 25.73 other 25.73 25.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC TORCON NB ADVANTAGE NYLON STAINLESS STEEL .038 IN H1 CURVE L 100CM OD 5FR CEREBRAL FLEXIBLE ATRAUMATIC TIP SUP-270000000 CDM 270 RC inpatient 40.8 39.98 All Payors / Plans All Payors / Plans 40.8 other 40.8 40.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC TORCON NB ADVANTAGEBEACON TIP STAINLESS STEEL NYLON WEINBERG CEREBRAL CURVE LOW PROFILE TAPER L100CM OD 5FR RADIOPAQUE ACCEPTS .038 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 26.52 25.99 All Payors / Plans All Payors / Plans 26.52 other 26.52 26.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ARTERIAL LINE SWAN-GANZ HEPARIN POLYMER L110 CM OD5 FR PULMONARY 2 LUMEN SUP-270000000 CDM 270 RC inpatient 218.4 214.03 All Payors / Plans All Payors / Plans 218.4 other 218.4 218.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ASPIRATION AXS VECTA 71 L115 CM OD.082-.085 IN ID.071 IN SCOUT INTRODUCER STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 4302.7 4216.65 All Payors / Plans All Payors / Plans 4302.7 other 4302.7 4302.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ATHERECTOMY SHOCKWAVE C2 IVL 2.5 X 12 MM SUP-270000000 CDM 270 RC inpatient 19740 19345.2 All Payors / Plans All Payors / Plans 19740 other 19740 19740 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION COYOTE 150CM 220MM 3MM NYBAX LUBRICIOUS BIOSLIDE OTW ULTRA LOW PROFILE ACCEPTS .014IN SUP-270000000 CDM 270 RC inpatient 829.5 812.91 All Payors / Plans All Payors / Plans 829.5 other 829.5 829.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION COYOTE ES 145CM 40MM 6FR 4MM OTW LOW PROFILE ACCEPTS .014IN GUIDEWIRE 4FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC inpatient 467.5 458.15 All Payors / Plans All Payors / Plans 467.5 other 467.5 467.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA 142CM 12MM 3MM ULTRA-SLIM DURA-TRAC STERILE LF RAPID EXCHANGE RADIOPAQUE FEMALE LUER SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA POWERTRAC ULTRA-SLIM DURA-TRAC L142 CM L10 MM OD2.1-2.5 FR ODSEC2 MM RAPID EXCHANGE TAPER SHAFT RADIOPAQUE FEMALE LUER PTCA SUP-481000000 CDM 270 RC inpatient 76.5 74.97 All Payors / Plans All Payors / Plans 76.5 other 76.5 76.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA POWERTRAC ULTRA-SLIM DURA-TRAC L142 CM L10 MM OD2.1-2.5 FR ODSEC2.5 MM RAPID EXCHANGE TAPER SHAFT RADIOPAQUE FEMALE LUER PTCA SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA POWERTRAC ULTRA-SLIM DURA-TRAC L142 CM L12 MM OD2.1-2.5 FR ODSEC2 MM RAPID EXCHANGE TAPER SHAFT RADIOPAQUE FEMALE LUER PTCA SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA POWERTRAC ULTRA-SLIM DURA-TRAC L142 CM L12 MM OD2.1-2.5 FR ODSEC2.5 MM RAPID EXCHANGE TAPER SHAFT RADIOPAQUE FEMALE LUER PTCA SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA POWERTRAC ULTRA-SLIM DURA-TRAC L142 CM L15 MM OD2.1-2.5 FR ODSEC2 MM RAPID EXCHANGE TAPER SHAFT RADIOPAQUE FEMALE LUER PTCA SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA POWERTRAC ULTRA-SLIM DURA-TRAC L142 CM L15 MM OD2.1-2.5 FR ODSEC2.5 MM RAPID EXCHANGE TAPER SHAFT RADIOPAQUE FEMALE LUER PTCA SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA POWERTRAC ULTRA-SLIM DURA-TRAC L142 CM L15 MM OD2.1-2.5 FR ODSEC3 MM RAPID EXCHANGE TAPER SHAFT RADIOPAQUE FEMALE LUER PTCA SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA ULTRA SLIM DURA TRAC 142CM L 12 MM ODSEC 2.25 MM RAPID EXCHANGE TAPER SHAFT LOW PROFILE RADIOPAQUE LATEX FREE PTCA SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA ULTRA SLIM DURA TRAC 142CM L 20 MM ODSEC 3.0 MM RAPID EXCHANGE TAPER SHAFT LOW PROFILE RADIOPAQUE LATEX FREE PTCA SUP-481000000 CDM 270 RC inpatient 195 191.1 All Payors / Plans All Payors / Plans 195 other 195 195 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA ULTRA SLIM DURA TRAC 142CM L 20 MM ODSEC 3.5 MM RAPID EXCHANGE TAPER SHAFT LOW PROFILE RADIOPAQUE LATEX FREE PTCA SUP-481000000 CDM 270 RC inpatient 195 191.1 All Payors / Plans All Payors / Plans 195 other 195 195 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MINI TREK SLIM SEAL 8MM 2MM TUNGSTEN CORONARY RAPID EXCHANGE ULTRA LOW PROFILE RADIOPAQUE SUP-481000000 CDM 270 RC inpatient 235.2 230.5 All Payors / Plans All Payors / Plans 235.2 other 235.2 235.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG 135CM 20MM 4MM NYBAX HIGH PRESSURE ACCEPTS .035IN GUIDEWIRE 5FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC inpatient 346.5 339.57 All Payors / Plans All Payors / Plans 346.5 other 346.5 346.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG 135CM 20MM 8MM 6FR NYBAX MEDIGLIDE HIGH PRESSURE SUP-270000000 CDM 270 RC inpatient 346.5 339.57 All Payors / Plans All Payors / Plans 346.5 other 346.5 346.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG 75CM 40MM 6MM NYBAX HIGH PRESSURE ACCEPTS .035IN GUIDEWIRE 5FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC inpatient 323 316.54 All Payors / Plans All Payors / Plans 323 other 323 323 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG 75CM 40MM 7MM NYBAX HIGH PRESSURE ACCEPTS .035IN GUIDEWIRE 5FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC inpatient 323 316.54 All Payors / Plans All Payors / Plans 323 other 323 323 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG 75CM 40MM 8MM NYBAX HIGH PRESSURE ACCEPTS .035IN GUIDEWIRE 6FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC inpatient 399 391.02 All Payors / Plans All Payors / Plans 399 other 399 399 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG 75CM 40MM 9MM NYBAX HIGH PRESSURE ACCEPTS .035IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 323 316.54 All Payors / Plans All Payors / Plans 323 other 323 323 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG NYBAX .035 IN L135 CM L20 MM ODSEC8 MM HIGH PRESSURE SUP-270000000 CDM 270 RC inpatient 346.5 339.57 All Payors / Plans All Payors / Plans 346.5 other 346.5 346.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG NYBAX .035 IN L135 CM L40 MM ODSEC4 MM HIGH PRESSURE SUP-270000000 CDM 270 RC inpatient 399 391.02 All Payors / Plans All Payors / Plans 399 other 399 399 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG NYBAX .035 IN L40 CM L40 MM ODSEC7 MM HIGH PRESSURE SUP-270000000 CDM 270 RC inpatient 399 391.02 All Payors / Plans All Payors / Plans 399 other 399 399 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG NYBAX .035 IN L75 CM L20 MM ODSEC10 MM HIGH PRESSURE SUP-270000000 CDM 270 RC inpatient 346.5 339.57 All Payors / Plans All Payors / Plans 346.5 other 346.5 346.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG NYBAX .035 IN L75 CM L40 MM ODSEC10 MM HIGH PRESSURE SUP-270000000 CDM 270 RC inpatient 346.5 339.57 All Payors / Plans All Payors / Plans 346.5 other 346.5 346.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG NYBAX .035 IN L75 CM L40 MM ODSEC5 MM HIGH PRESSURE SUP-270000000 CDM 270 RC inpatient 399 391.02 All Payors / Plans All Payors / Plans 399 other 399 399 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 12MM 2.5MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 12MM 2MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 12MM 3.25MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 12MM 3.5MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 12MM 3MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 12MM 4MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC inpatient 127.5 124.95 All Payors / Plans All Payors / Plans 127.5 other 127.5 127.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 15MM 2MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 15MM 3.5MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC inpatient 195 191.1 All Payors / Plans All Payors / Plans 195 other 195 195 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 15MM 3MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 20MM 2.5MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 20MM 3.5MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC inpatient 195 191.1 All Payors / Plans All Payors / Plans 195 other 195 195 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 8MM 2.5MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 8MM 3.5MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 8MM 3.75MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 8MM 3MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC inpatient 127.5 124.95 All Payors / Plans All Payors / Plans 127.5 other 127.5 127.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION SAPPHIRE II PRO 3.0 X 10MM SEMICOMPLIANT SUP-481000000 CDM 270 RC inpatient 199.5 195.51 All Payors / Plans All Payors / Plans 199.5 other 199.5 199.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION STERLING .018 IN L135 MM L60 MM OD6 FR ODSEC6 MM OTW LOW PROFILE INFLATION PORT GUIDEWIRE ANGIOPLASTY ACCEPTS 4 FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC inpatient 467.5 458.15 All Payors / Plans All Payors / Plans 467.5 other 467.5 467.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION STERLING L135 CM L20 MM OD6 FR ODSEC6 MM OTW INFLATION PORT TAPER TIP ACCEPTS .018 IN GUIDEWIRE 5 FR SHEATH PTA SUP-270000000 CDM 270 RC inpatient 467.5 458.15 All Payors / Plans All Payors / Plans 467.5 other 467.5 467.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION STERLING MONORAIL PEBAX BIOSLIDE L80 CM L40 MM ODSEC5 MM PERIPHERAL TAPER TIP LOW PROFILE INFLATE PORT ACCEPTS .018 IN GUIDEWIRE 4 FR SHEATH 6 FR GUIDE CATHETER PTA SUP-270000000 CDM 270 RC inpatient 525 514.5 All Payors / Plans All Payors / Plans 525 other 525 525 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION STERLING MONORAIL PEBAX BIOSLIDE TAPER L135 CM L20 MM OD3.8-3.4 FR ODSEC5 MM RAPID EXCHANGE INFLATION PORT LOW PROFILE ACCEPTS .018 IN GUIDEWIRE 4 FR SHEATH PTA SUP-270000000 CDM 270 RC inpatient 577.5 565.95 All Payors / Plans All Payors / Plans 577.5 other 577.5 577.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION STERLING PEBAX BIOSLIDE L135 CM L40 MM OD6 FR ODSEC6 MM ID4 FR OTW LOW PROFILE INFLATION WIRE PORT ACCEPTS .018 IN GUIDEWIRE PTA SUP-270000000 CDM 270 RC inpatient 577.5 565.95 All Payors / Plans All Payors / Plans 577.5 other 577.5 577.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION STERLING PEBAX BIOSLIDE LOW PROFILE TAPER L135 CM L40 MM OD3.8 FR ODSEC7 MM OTW INFLATION PORT ACCEPTS .018 IN GUIDEWIRE 4 FR SHEATH PTA SUP-270000000 CDM 270 RC inpatient 577.5 565.95 All Payors / Plans All Payors / Plans 577.5 other 577.5 577.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION TAKERU L12MMOD SEC 1.5MM RAPID EXCHANGE LOW ENTRY PROFILE PTCA SUP-481000000 CDM 270 RC inpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION TREK SLIM SEAL 8MM 2.5MM CROSSFLEX2 TUNGSTEN CORONARY RAPID EXCHANGE ULTRA LOW PROFILE SUP-481000000 CDM 270 RC inpatient 235.2 230.5 All Payors / Plans All Payors / Plans 235.2 other 235.2 235.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION TRUE L110 CM L4.5 CM OD12 FR ODSEC22 MM AORTA 2 LUMEN 2 RADIOPAQUE OTW COAXIAL STERILE DISPOSABLE ACCEPTS .035 IN GUIDEWIRE VALVULOPLASTY SUP-481000000 CDM 270 RC inpatient 2725.38 2670.87 All Payors / Plans All Payors / Plans 2725.38 other 2725.38 2725.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION WOLVERINE CUTTING BALLOON MONORAIL Z-GLIDE L 10CM OD 2.75 MM BUMPER TIP ATHEROTOME RADIOPAQUE MIDSHAFT SUP-270000000 CDM 270 RC inpatient 1471.68 1442.25 All Payors / Plans All Payors / Plans 1471.68 other 1471.68 1471.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON OCCLUSION GORE 10-37 MM L90 CM L4 CM MOLD STENT GRAFT OPTIMIZE SEAL ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 1391 1363.18 All Payors / Plans All Payors / Plans 1391 other 1391 1391 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON OCCLUSION TRANSFORM L7 MM OD7 MM 1 LUMEN SUPER COMPLIANT STERILE LATEX FREE DISPOSABLE ACCEPTS .014 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 2949.5 2890.51 All Payors / Plans All Payors / Plans 2949.5 other 2949.5 2949.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER CENTRAL VENOUS 36CM 19FR HEPARIN TAL PALINDROME EMERALD SPORTPACK VENATRAC SUP-270000000 CDM 270 RC inpatient 362.5 355.25 All Payors / Plans All Payors / Plans 362.5 other 362.5 362.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER CENTRAL VENOUS TAL PALINDROME EMERALD HEPARIN L36 CM OD19 FR SPORTPACK VENATRAC SUP-270000000 CDM 270 RC inpatient 253.02 247.96 All Payors / Plans All Payors / Plans 253.02 other 253.02 253.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER CENTRAL VENOUS TAL PALINDROME EMERALD HEPARIN L40 CM OD23 FR SPORTPACK VENATRAC SUP-270000000 CDM 270 RC inpatient 421.69 413.26 All Payors / Plans All Payors / Plans 421.69 other 421.69 421.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER CRYOABLATION ARTIC FRONT ADVANCE PRO L23CM SUP-270000000 CDM 270 RC inpatient 9345 9158.1 All Payors / Plans All Payors / Plans 9345 other 9345 9345 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER CRYOABLATION ARTIC FRONT ADVANCE PRO L28CM SUP-270000000 CDM 270 RC inpatient 7565 7413.7 All Payors / Plans All Payors / Plans 7565 other 7565 7565 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DELIVERY SYSTEM NEURON SELECT STAINLESS STEEL POLYMER BERENSTEIN CURVE L130 CM L9 CM OD5 FR ID.04 IN LUMEN SOFT SHAFT RADIOPAQUE ACCEPTS .035/.038 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 262.5 257.25 All Payors / Plans All Payors / Plans 262.5 other 262.5 262.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DELIVERY SYSTEM NEURON SELECT STAINLESS STEEL POLYMER SIMMONS CURVE L125 CM L9 CM OD6 FR ODSEC5-5.6 FR ID.04 IN BRAID SOFT DISTAL SHAFT LATEX FREE ACCEPTS .035/.038 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 262.5 257.25 All Payors / Plans All Payors / Plans 262.5 other 262.5 262.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DELIVERY SYSTEM NEURON STAINLESS STEEL .038 IN SIMS CURVE L130 CM L9 CM OD5 FR ID.04 IN PROXIMAL DISTAL INTRACRANIAL LUMEN FULL LENGTHRADIOPAQUE MARKER SUP-270000000 CDM 270 RC inpatient 262.5 257.25 All Payors / Plans All Payors / Plans 262.5 other 262.5 262.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DIAGNOSTIC DXTERITY INSLIDE AMPLATZ LEFT 1 CURVE L100 CM OD 6 FR ID .056 IN LARGE LUMEN RADIOPAQUE 2 BRAID WIRE COLOR CODED HUB STERILE ACCEPTS .038 IN GUIDEWIRE SUP-481000000 CDM 270 RC inpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DIAGNOSTIC DXTERITY INSLIDE JUDKINS LEFT 5 CURVE L100 CM OD 6 FR ID .056 IN LARGE LUMEN RADIOPAQUE 2 BRAID WIRE COLOR CODED HUB STERILE ACCEPTS .038 IN GUIDEWIRE SUP-481000000 CDM 270 RC inpatient 15.3 14.99 All Payors / Plans All Payors / Plans 15.3 other 15.3 15.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DIAGNOSTIC DXTERITY INSLIDE LEFT CORONARY BYPASS CURVE L100 CM OD 6 FR ID .056 IN LARGE LUMEN RADIOPAQUE 2 BRAID WIRE COLOR CODED HUB STERILE ACCEPTS .038 IN GUIDEWIRE SUP-481000000 CDM 270 RC inpatient 9.18 9 All Payors / Plans All Payors / Plans 9.18 other 9.18 9.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DIAGNOSTIC DXTERITY INSLIDE MULTIPURPOSE A CURVE L100 CM OD 6 FR ID .056 IN LARGE LUMEN RADIOPAQUE 2 BRAID WIRE COLOR CODED HUB STERILE ACCEPTS .038 IN GUIDEWIRE SUP-481000000 CDM 270 RC inpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DRAINAGE AMPLATZ ULTRATHANE UNIVERSAL L50 CM OD10.2 FR 6 SIDEPORT STERILE DISPOSABLE ACCEPTS .038 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 482.96 473.3 All Payors / Plans All Payors / Plans 482.96 other 482.96 482.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DRAINAGE APD FLEXIMA LOOP 25CM 8FR METAL HYDROPHILIC DISPOSABLE STERILE REGULAR DUROMETER STIFF CANNULA LG SUP-270000000 CDM 270 RC inpatient 81.86 80.22 All Payors / Plans All Payors / Plans 81.86 other 81.86 81.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DRAINAGE APD FLEXIMA METAL HYDROPHILIC LOOP L25 CM OD10 FR REGULAR DUROMETER FLEXIBLE STIFF CANNULA LARGE LUMEN STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 81.86 80.22 All Payors / Plans All Payors / Plans 81.86 other 81.86 81.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DRAINAGE ARGYLE SENTINEL LINE SENTINEL EYE STRAIGHT 20IN 28FR CLEAR PVC DISPOSABLE STERILE LF THORACIC SMOOTH SUP-270009136 CDM 270 RC inpatient 6.47 6.34 All Payors / Plans All Payors / Plans 6.47 other 6.47 6.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DRAINAGE ARGYLE STRAIGHT 20IN 24FR CLEAR PVC DISPOSABLE STERILE THORACIC SMOOTH SIDE EYE RADIOPAQUE OPEN DISTAL SUP-270009136 CDM 270 RC inpatient 6.47 6.34 All Payors / Plans All Payors / Plans 6.47 other 6.47 6.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DRAINAGE FLEXIMA PIGTAIL CURVE L35 CM OD8 FR BILIARY FLEXIBLE STIFF CANNULA LOCK DUROMETER LARGE HOLE SUP-270000000 CDM 270 RC inpatient 168.53 165.16 All Payors / Plans All Payors / Plans 168.53 other 168.53 168.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DRAINAGE FLEXIMA PIGTAIL CURVE L35 CM OD8 FR BILIARY REGULAR DUROMETER FLEXIBLE STIFF CANNULA LOCK LARGE HOLE SUP-270000000 CDM 270 RC inpatient 232.73 228.08 All Payors / Plans All Payors / Plans 232.73 other 232.73 232.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DRAINAGE SILICONE STRAIGHT L20 IN OD20 FR THORACIC 5 EYELET KINK RESISTANT RADIOPAQUE STRIPE TAPERED TIP STERILE LATEX FREE DISPOSABLE CLEAR SUP-270000000 CDM 270 RC inpatient 21.51 21.08 All Payors / Plans All Payors / Plans 21.51 other 21.51 21.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROHEMOSTASIS GOLD PROBE 300CM 7FR HEMOGLIDE DISPOSABLE STERILE BIPOLAR ROUND DISTAL TIP FIRM SHAFT SUP-270000000 CDM 270 RC inpatient 302.82 296.76 All Payors / Plans All Payors / Plans 302.82 other 302.82 302.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROHEMOSTASIS GOLD PROBE HEMOGLIDE L300 CM OD10 FR BIPOLAR STANDARD PLUG CONNECTOR STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 168.51 165.14 All Payors / Plans All Payors / Plans 168.51 other 168.51 168.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY 2-5-2 MM SPACING LARGE L110 CM OD6 FR DECAPOLAR STEERABLE SUP-270000000 CDM 270 RC inpatient 346.8 339.86 All Payors / Plans All Payors / Plans 346.8 other 346.8 346.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY 2-8-2 MM SPACE P CURVE L 60CM L 1MM OD 5 FR DECAPOLAR FIX AUTO ID SUP-270000000 CDM 270 RC inpatient 304.98 298.88 All Payors / Plans All Payors / Plans 304.98 other 304.98 304.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY ACHIEVE 3D L20 MM MAPPING LOOP SUP-270000000 CDM 270 RC inpatient 1275 1249.5 All Payors / Plans All Payors / Plans 1275 other 1275 1275 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY CARTO 3 THERMOCOOL SF D-F CURVE OD 7.5 FR BIDRIECTIONAL DEFLECTABLE TIP STEERABLE MULTIELECTRODE STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 6961.5 6822.27 All Payors / Plans All Payors / Plans 6961.5 other 6961.5 6961.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY INQUIRY 2-5-2 MM SPACING LARGE CURVE L110 CM L2 MM OD6 FR MAPPING QUADRIPOLAR STEERABLE SUP-270000000 CDM 270 RC inpatient 295.8 289.88 All Payors / Plans All Payors / Plans 295.8 other 295.8 295.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY OCTARAY 3-3-3-3-3 MM SPCAE D CURVE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 2601 2548.98 All Payors / Plans All Payors / Plans 2601 other 2601 2601 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY OCTARAY 3-3-3-3-3 MM SPCAE F CURVE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 5355 5247.9 All Payors / Plans All Payors / Plans 5355 other 5355 5355 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY OD6 FR CSF10 PIN AUTO ID DODECAPOLAR SUP-270000000 CDM 270 RC inpatient 534.48 523.79 All Payors / Plans All Payors / Plans 534.48 other 534.48 534.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY PENTARRAY 2-6-2 MM D CURVE OD 7 FR NAVIGATION ELECTRODE SUP-270000000 CDM 270 RC inpatient 4363.8 4276.52 All Payors / Plans All Payors / Plans 4363.8 other 4363.8 4363.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY REDEL WEBSTER 10MM SPACE REGULAR D CURVE L 92CM L 1MM OD 6FR DEFLECTABLE QUADRAPOLAR AUTO ID SUP-270000000 CDM 270 RC inpatient 724.5 710.01 All Payors / Plans All Payors / Plans 724.5 other 724.5 724.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY RESPONSE 1 MM 5 MM SPACE JSN CURVE L120 CM OD6 FR QUADRIPOLAR SUPERB TORQUE CONTROL BAND ELECTRODE CONVENIENT CABLE SUP-270000000 CDM 270 RC inpatient 92.82 90.96 All Payors / Plans All Payors / Plans 92.82 other 92.82 92.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY RESPONSE 2-8-2 MM SPACING CSL CURVE L65 CM OD6 FR DECAPOLAR SUP-270000000 CDM 270 RC inpatient 367.2 359.86 All Payors / Plans All Payors / Plans 367.2 other 367.2 367.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER EMBOLECTOMY L60 CM OD2 FR ODSEC4.5 MM .5 ML 1 LUMEN BALLOON LATEX SUP-270000000 CDM 270 RC inpatient 144.9 142 All Payors / Plans All Payors / Plans 144.9 other 144.9 144.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER EMBOLECTOMY LEMAITRE L80 CM OD3 FR ODSEC8 MM .20 ML STERILE LATEX DISPOSABLE SUP-270000000 CDM 270 RC inpatient 144.9 142 All Payors / Plans All Payors / Plans 144.9 other 144.9 144.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER EMBOLECTOMY LEMAITRE L80 CM OD4 FR ODSEC10.5 MM 75 ML STERILE LATEX DISPOSABLE SUP-270000000 CDM 270 RC inpatient 144.9 142 All Payors / Plans All Payors / Plans 144.9 other 144.9 144.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER EXTERNAL DRAINAGE EDM SILICONE L80 CM LUMBAR CLOSED TIP BARIUM IMPREGNATED STERILE SUP-270000000 CDM 270 RC inpatient 252.63 247.58 All Payors / Plans All Payors / Plans 252.63 other 252.63 252.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER FLUSH PIGTAIL NO BRAIDED 4F .04X65CM SUP-270000000 CDM 270 RC inpatient 28.6 28.03 All Payors / Plans All Payors / Plans 28.6 other 28.6 28.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING CPS AIM CARDIAC VALVE BYPASS TOOL SUP-270000000 CDM 270 RC inpatient 73.5 72.03 All Payors / Plans All Payors / Plans 73.5 other 73.5 73.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING CXI 90CM 2.6FR SS HYDROPHILIC POLYMER DISPOSABLE STERILE LOW PROFILE ANGLE TIP BRAID RADIOPAQUE ACCEPTS SUP-270000000 CDM 270 RC inpatient 427.2 418.66 All Payors / Plans All Payors / Plans 427.2 other 427.2 427.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING CXI STAINLESS STEEL HYDROPHILIC STRAIGHT L65 CM OD2.3 FR MARKER BAND RADIOPAQUE BRAID KINK RESISTANT .018 IN ACCEPTS GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 427.2 418.66 All Payors / Plans All Payors / Plans 427.2 other 427.2 427.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER AR1 CURVE L100 CM OD6 FR CORONARY SIDEHOLE SUP-481000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER HS1 CURVE L100 CM OD6 FR CORONARY SUP-481000000 CDM 270 RC inpatient 71.4 69.97 All Payors / Plans All Payors / Plans 71.4 other 71.4 71.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER JL5 CURVE L100 CM OD8 FR ID.09 IN CORONARY SIDEHOLE SUP-481000000 CDM 270 RC inpatient 109.2 107.02 All Payors / Plans All Payors / Plans 109.2 other 109.2 109.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON AMPLATZ 1 LEFT CORONARY CURVE L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL SIDEHOLE STERILE DISPOSABLE SUP-481000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON AMPLATZ 1 RIGHT CORONARY CURVE L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON AMPLATZ 2 RIGHT CORONARY CURVE L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON EXTRA BACKUP 3 LEFT CURVE L100 CM OD6 FR ID.071 IN CORONARY LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC inpatient 71.4 69.97 All Payors / Plans All Payors / Plans 71.4 other 71.4 71.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON EXTRA BACKUP 3.5 LEFT CURVE L100 CM OD6 FR ID.071 IN CORONARY LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC inpatient 71.4 69.97 All Payors / Plans All Payors / Plans 71.4 other 71.4 71.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON EXTRA BACKUP 3.75 LEFT CURVE L100 CM OD6 FR ID.071 IN CORONARY LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON EXTRA BACKUP 4 LEFT CURVE L100 CM OD6 FR ID.071 IN CORONARY LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON EXTRA BACKUP 4.5 LEFT CURVE L100 CM OD6 FR ID.071 IN CORONARY LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON HS2 CURVE OD6 FR ID.071 IN CORONARY MULTIPURPOSE LARGE LUMEN FLEXIBLE DISTAL SEGMENT FULL WALL TECHNOLOGY RADIOPAQUE MARKER BAND STERILE DISPOSABLE SUP-481000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON JUDKINS CORONARY 3 LEFT CURVE STANDARD L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON JUDKINS CORONARY 3.5 LEFT CURVE STANDARD L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON JUDKINS CORONARY 4 LEFT CURVE STANDARD L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC inpatient 71.4 69.97 All Payors / Plans All Payors / Plans 71.4 other 71.4 71.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON JUDKINS CORONARY 4 RIGHT CURVE STANDARD L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON JUDKINS CORONARY 4 RIGHT CURVE STANDARD L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL SIDEHOLE STERILE DISPOSABLE SUP-481000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON LEFT CORONARY BYPASS CURVE L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC inpatient 42.84 41.98 All Payors / Plans All Payors / Plans 42.84 other 42.84 42.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON MULTIPURPOSE 1 CURVE L100 CM OD6 FR ID.071 IN CORONARY LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 71.4 69.97 All Payors / Plans All Payors / Plans 71.4 other 71.4 71.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON STANDARD FR4 CURVE L100CM OD 6 FR CORONARY LARGE LUMEN RADIOPAQUE FLEXIBLE DISTAL SEGMENT STERILE LATEX FREE SUP-481000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING VISTA BRITE TIP TRUELUMEN LONG EXTRA BACKUP 3.5 CURVE 100CM .62IN 5FR .056IN BLUE YELLOW SS NYLON PTFE SUP-270000000 CDM 270 RC inpatient 92.4 90.55 All Payors / Plans All Payors / Plans 92.4 other 92.4 92.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING VISTA BRITE TIP TRUELUMEN REGULAR XBLAD4 CURVE 100CM .1IN 6FR .07IN BLUE YELLOW SS NYLON PTFE SUP-481000000 CDM 270 RC inpatient 91.35 89.52 All Payors / Plans All Payors / Plans 91.35 other 91.35 91.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER HEMODIALYSIS GLIDEPATH POLYURETHANE STRAIGHT L55 CM L50 CM OD14.5 FR STANDARD KIT AIRGUARD VALVED INTRODUCER SYMMETRIC TIP PRELOADED LONG TERM NONSTERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 283.25 277.59 All Payors / Plans All Payors / Plans 283.25 other 283.25 283.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER HEMODIALYSIS PALINDROME VENATRAC L50 CM OD33 FR SPORTPACK SUP-270000000 CDM 270 RC inpatient 401.16 393.14 All Payors / Plans All Payors / Plans 401.16 other 401.16 401.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER IAB SENSATION PLUS L6 IN OD8 FR 50 ML CARDIOVASCULAR 2 STATLOCK DEVICE FIBER OPTIC INSERTION KIT INTRODUCER EXTENDER DATASCOPE SYSTEM SUP-270000000 CDM 270 RC inpatient 2350.53 2303.52 All Payors / Plans All Payors / Plans 2350.53 other 2350.53 2350.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ICE WITH 4 WAY STEERING SUP-270000000 CDM 270 RC inpatient 3570 3498.6 All Payors / Plans All Payors / Plans 3570 other 3570 3570 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER INFUSION CRAGG-MCNAMARA CRAGG-MICROVALVE L135 CM L20 CM OD4 FR 1 LUMEN RADIOPAQUE SIDEHOLE VALVE TIP ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 319.97 313.57 All Payors / Plans All Payors / Plans 319.97 other 319.97 319.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER INFUSION DIREXION FATHOM NITINOL .016 IN MICRO BERN L130 CM L180 CM OD2.4 FR TORQUEABLE FLEXIBLE GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 2088.66 2046.89 All Payors / Plans All Payors / Plans 2088.66 other 2088.66 2088.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER INFUSION MARKSMAN L160 CM SUP-270000000 CDM 270 RC inpatient 3076.5 3014.97 All Payors / Plans All Payors / Plans 3076.5 other 3076.5 3076.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER INFUSION MARKSMAN MICRO L160 CM L10 CM OD2.8-3.2 FR ID.027 IN ACCEPTS .021 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 3171 3107.58 All Payors / Plans All Payors / Plans 3171 other 3171 3171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER INFUSION PHENOM L120 CM OD.061 IN ODSEC.055 IN ID.044 IN ROUND DISTAL TIP SUP-270000000 CDM 270 RC inpatient 4305 4218.9 All Payors / Plans All Payors / Plans 4305 other 4305 4305 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER IV PROTECTIV PLUS STRAIGHT .75IN 24GA YELLOW POLYURETHANE DISPOSABLE STERILE LF PERIPHERAL RADIOPAQUE SAFETY SUP-270000000 CDM 270 RC inpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER IV PROTECTIV PLUS STRAIGHT 1.25IN 16GA GRAY POLYURETHANE DISPOSABLE STERILE LF PERIPHERAL RADIOPAQUE SUP-270000000 CDM 270 RC inpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER IV PROTECTIV PLUS STRAIGHT 1.25IN 20GA PINK POLYURETHANE DISPOSABLE STERILE LF PERIPHERAL RADIOPAQUE SAFETY SUP-270000000 CDM 270 RC inpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER IV PROTECTIV PLUS STRAIGHT 1IN 22GA BLUE POLYURETHANE DISPOSABLE STERILE LF PERIPHERAL RADIOPAQUE SAFETY SUP-270000000 CDM 270 RC inpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER KUMPE 5FR 65CM SUP-270000000 CDM 270 RC inpatient 56.1 54.98 All Payors / Plans All Payors / Plans 56.1 other 56.1 56.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER MAPPING ADVISOR HD GRID SENSOR ENABLED BI-D SUP-270000000 CDM 270 RC inpatient 1989 1949.22 All Payors / Plans All Payors / Plans 1989 other 1989 1989 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER MAPPING OPTRELL DF CURVE 36 ELECTRODE SUP-270000000 CDM 270 RC inpatient 7207.2 7063.06 All Payors / Plans All Payors / Plans 7207.2 other 7207.2 7207.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER PACING BARD 1CM PROXIMAL 110CM 5FR NATURAL RUBBER DISPOSABLE STERILE LATEX ELECTRODE BIPOLAR DISTAL TIP BALLOON SUP-270000000 CDM 270 RC inpatient 340.71 333.9 All Payors / Plans All Payors / Plans 340.71 other 340.71 340.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER PULMONARY ARTERY SWAN-GANZ 110CM 7FR DISPOSABLE STERILE PULMONARY 2 LUMEN MONITOR SUP-270000000 CDM 270 RC inpatient 106.08 103.96 All Payors / Plans All Payors / Plans 106.08 other 106.08 106.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER PULMONARY ARTERY SWAN-GANZ CCO VIP 110CM 7.5FR HEPARIN POLYMER PULMONARY SUP-270009130 CDM 270 RC inpatient 148.18 145.22 All Payors / Plans All Payors / Plans 148.18 other 148.18 148.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER PULMONARY ARTERY SWAN-GANZ VIP STANDARD L110 CM OD7.5 FR 5 LUMEN THERMODILUTION VOLUMETRIC LATEX SUP-270009129 CDM 270 RC inpatient 195.5 191.59 All Payors / Plans All Payors / Plans 195.5 other 195.5 195.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER REPERFUSION RED 43 .043 IN L160 CM OD1.52 MM SUP-270000000 CDM 270 RC inpatient 5187 5083.26 All Payors / Plans All Payors / Plans 5187 other 5187 5187 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER SPECIMEN RETRIEVAL TRI-EX .035IN 200CM 7-5FR 8.5MM 1.5ML PURPLE DISPOSABLE STERILE LATEX BILE DUCT 3 LUMEN SUP-270000000 CDM 270 RC inpatient 338.1 331.34 All Payors / Plans All Payors / Plans 338.1 other 338.1 338.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER SUCTION 71 L132 CM LARGE BORE SUP-270000000 CDM 270 RC inpatient 5250 5145 All Payors / Plans All Payors / Plans 5250 other 5250 5250 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER SUPPORT CXI 150CM 2.6FR SS POLYMER HYDROPHILIC DISPOSABLE STERILE LOW PROFILE ANGLE TIP BRAID RADIOPAQUE SUP-270000000 CDM 270 RC inpatient 373.98 366.5 All Payors / Plans All Payors / Plans 373.98 other 373.98 373.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER THROMBECTOMY RED 68 L132 CM REPERFUSION CATHETER PENUMBRA ASPIRATION TUBING NO CE STERILE SUP-270000000 CDM 270 RC inpatient 5953.5 5834.43 All Payors / Plans All Payors / Plans 5953.5 other 5953.5 5953.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER THROMBECTOMY RED 72 L132 CM REPERFUSION CATHETER PENUMBRA ASPIRATION TUBING NO CE STERILE SUP-270000000 CDM 270 RC inpatient 5953.5 5834.43 All Payors / Plans All Payors / Plans 5953.5 other 5953.5 5953.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ULTRASOUND SOUNDSTAR OD10 FR INTRACARDIAC STEERING HANDLE GE SUP-270000000 CDM 270 RC inpatient 2748.9 2693.92 All Payors / Plans All Payors / Plans 2748.9 other 2748.9 2748.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETERAL FLEXI-TIP AQ OD.05 IN L50 CM OD6/10 FR ODSEC.04 IN 2 LUMEN STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 133.14 130.48 All Payors / Plans All Payors / Plans 133.14 other 133.14 133.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETERAL FLEXI-TIP STANDARD L70 CM OD5 FR OPEN END LATEX FREE ACCEPTS .038 IN GUIDEWIRE RETROGRADE PYELOGRAM SUP-270000000 CDM 270 RC inpatient 30 29.4 All Payors / Plans All Payors / Plans 30 other 30 30 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETERAL PLASTIC WHISTLE L65 CM OD4 FR 2 STAGGER EYE LUER FIT ADAPTER COLOR CODED XRAY OPAQUE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 18.29 17.92 All Payors / Plans All Payors / Plans 18.29 other 18.29 18.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETERAL ROYAL FLUSH PLUS NYLON BEACON TIP VCF CURVE SPIRAL L65 CM OD4 FR 8 SIDEPORT HIGH FLOW RADIOPAQUE ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 31.21 30.59 All Payors / Plans All Payors / Plans 31.21 other 31.21 31.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX IC 12FR 5CC BACTI-GUARD NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 2 WAY FOLEY BALLOON SUP-270009003 CDM 270 RC inpatient 4.9 4.8 All Payors / Plans All Payors / Plans 4.9 other 4.9 4.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX IC 14FR 5CC BACTI-GUARD NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 2 WAY FOLEY BALLOON SUP-270009003 CDM 270 RC inpatient 4.9 4.8 All Payors / Plans All Payors / Plans 4.9 other 4.9 4.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX IC 16FR 5CC BACTI-GUARD NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 2 WAY FOLEY BALLOON SUP-270009003 CDM 270 RC inpatient 4.9 4.8 All Payors / Plans All Payors / Plans 4.9 other 4.9 4.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX IC 20FR 30CC BACTI-GUARD NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 2 WAY FOLEY BALLOON SUP-270009003 CDM 270 RC inpatient 4.9 4.8 All Payors / Plans All Payors / Plans 4.9 other 4.9 4.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX IC BACTI-GUARD NATURAL RUBBER HYDROGEL OD18 FR 5 CC 2 WAY FOLEY BALLOON ATRAUMATIC INSERTION STERILE LATEX DISPOSABLE SUP-270009003 CDM 270 RC inpatient 4.9 4.8 All Payors / Plans All Payors / Plans 4.9 other 4.9 4.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX LUBRICATH 14FR 5CC RED NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 2 WAY FOLEY 1 DRAINAGE SUP-270000000 CDM 270 RC inpatient 21.63 21.2 All Payors / Plans All Payors / Plans 21.63 other 21.63 21.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX LUBRICATH 16FR 5CC RED NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 2 WAY FOLEY 2 OPPOSING SUP-270000000 CDM 270 RC inpatient 25.28 24.77 All Payors / Plans All Payors / Plans 25.28 other 25.28 25.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX LUBRICATH 18FR 5CC RED NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 2 WAY FOLEY 1 DRAINAGE SUP-270000000 CDM 270 RC inpatient 21.42 20.99 All Payors / Plans All Payors / Plans 21.42 other 21.42 21.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX LUBRICATH STANDARD 20FR 5CC NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 3 WAY FOLEY 2 SUP-270009008 CDM 270 RC inpatient 11.33 11.1 All Payors / Plans All Payors / Plans 11.33 other 11.33 11.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX LUBRICATH STANDARD 22FR 30CC NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 3 WAY FOLEY 2 SUP-270000000 CDM 270 RC inpatient 19.71 19.32 All Payors / Plans All Payors / Plans 19.71 other 19.71 19.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX LUBRICATH STANDARD 24FR 30CC NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 3 WAY FOLEY 2 SUP-270000000 CDM 270 RC inpatient 17.82 17.46 All Payors / Plans All Payors / Plans 17.82 other 17.82 17.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL DOVER SILICONE L16 IN OD14 FR 5 CC 2 WAY FOLEY COLOR CODED INFLATION VALVE REINFORCE TIP LATEX FREE SUP-270009003 CDM 270 RC inpatient 4.9 4.8 All Payors / Plans All Payors / Plans 4.9 other 4.9 4.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL DOVER SILICONE NONPOROUS L16 IN OD16 FR 5 CC 2 WAY FOLEY COLOR CODED INFLATION VALVE REINFORCE TIP LATEX FREE SUP-270000000 CDM 270 RC inpatient 7.44 7.29 All Payors / Plans All Payors / Plans 7.44 other 7.44 7.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAUTERY BATTERY DIAGNOSTICK L2 IN OPHTHALMIC PENCIL CORDLESS HIGH TEMPERATURE LOOP STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 52.47 51.42 All Payors / Plans All Payors / Plans 52.47 other 52.47 52.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CELLSAVER CHARGE SUP-270010026 CDM 270 RC inpatient 362.9 355.64 All Payors / Plans All Payors / Plans 362.9 other 362.9 362.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEMENT BONE PALACOS R 40 GM GREEN SUP-270000000 CDM 270 RC inpatient 55.08 53.98 All Payors / Plans All Payors / Plans 55.08 other 55.08 55.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEMENT BONE SIMPLEX P RADIOPAQUE FULL DOSE STERILE SUP-270000000 CDM 270 RC inpatient 98.6 96.63 All Payors / Plans All Payors / Plans 98.6 other 98.6 98.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEMENT BONE SIMPLEX P SPEEDSET RADIOPAQUE STERILE SUP-270000000 CDM 270 RC inpatient 243.6 238.73 All Payors / Plans All Payors / Plans 243.6 other 243.6 243.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEMENT BONE SIMPLEX P TOBRAMYCIN FULL DOSE RADIOPAQUE PREBLEND STERILE SUP-270000000 CDM 270 RC inpatient 494.55 484.66 All Payors / Plans All Payors / Plans 494.55 other 494.55 494.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CF DELIVERY DEVICE CAPSULE BRAVO X 5 SUP-270000000 CDM 270 RC inpatient 672 658.56 All Payors / Plans All Payors / Plans 672 other 672 672 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHARGE NEUROMONITORING PROCEDURE-ALL SERVICES EXCEPT NEURO SUP-270010017 CDM 270 RC inpatient 336 329.28 All Payors / Plans All Payors / Plans 336 other 336 336 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHARGE NEUROMONITORING PROCEDURE-NEURO SUP-270010017 CDM 270 RC inpatient 326.4 319.87 All Payors / Plans All Payors / Plans 326.4 other 326.4 326.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHICAGO TIP 12FR SELFCLEANING DISP SUCTION SUP-270000000 CDM 270 RC inpatient 32.64 31.99 All Payors / Plans All Payors / Plans 32.64 other 32.64 32.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIRCUIT ANESTHESIA ADULT SUP-270000000 CDM 270 RC inpatient 8.16 8 All Payors / Plans All Payors / Plans 8.16 other 8.16 8.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLAMP ELECTROSURGICAL ISOLATOR TRANSPOLAR L6.3 MM ELECTRODE SUP-270000000 CDM 270 RC inpatient 2754 2698.92 All Payors / Plans All Payors / Plans 2754 other 2754 2754 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLAMP EXTERNAL FIXATION JET-X MINI 2 PIN BALL JOINT SUP-270000000 CDM 270 RC inpatient 2880.36 2822.75 All Payors / Plans All Payors / Plans 2880.36 other 2880.36 2880.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLEANER ELECTRO LUBE ROBOTIC SUP-270000000 CDM 270 RC inpatient 30.04 29.44 All Payors / Plans All Payors / Plans 30.04 other 30.04 30.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP ENDOSCOPIC MANTIS TRUGRIP L235 CM L2.8 MM 3 STEP ANCHOR PRONG CLOSURE MINIMAL SLIPPAG SUP-270000000 CDM 270 RC inpatient 827.4 810.85 All Payors / Plans All Payors / Plans 827.4 other 827.4 827.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP EXTERNAL DISPOSABLE STERILE SCALP 10 CLIP 20 CARTRIDGE SUP-270000000 CDM 270 RC inpatient 32.56 31.91 All Payors / Plans All Payors / Plans 32.56 other 32.56 32.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP HEMOSTATIC RESOLUTION 360 L235 CM BRAID TACTILE FEEDBACK SUP-270000000 CDM 270 RC inpatient 225.74 221.23 All Payors / Plans All Payors / Plans 225.74 other 225.74 225.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP INTERNAL LIGACLIP EXTRA LG 6.2MM YELLOW TITANIUM DISPOSABLE STERILE LF LIGATE OPEN SUP-270000000 CDM 270 RC inpatient 7.64 7.49 All Payors / Plans All Payors / Plans 7.64 other 7.64 7.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP INTERNAL LIGACLIP EXTRA SM BLUE TITANIUM DISPOSABLE STERILE LF LIGATE OPEN ENDOSCOPIC SUP-270000000 CDM 270 RC inpatient 7.14 7 All Payors / Plans All Payors / Plans 7.14 other 7.14 7.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP INTERNAL WECK HEM-O-LOK LG CHEVRON HEART PURPLE POLYMER DISPOSABLE STERILE LF LIGATE NONABSORBABLE CARTRIDGE SUP-270000000 CDM 270 RC inpatient 40 39.2 All Payors / Plans All Payors / Plans 40 other 40 40 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP INTERNAL WECK HEM-O-LOK XL CHEVRON HEART GOLD POLYMER DISPOSABLE STERILE LF LIGATE NONABSORBABLE CARTRIDGE SUP-270000000 CDM 270 RC inpatient 51.85 50.81 All Payors / Plans All Payors / Plans 51.85 other 51.85 51.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP LIGATING ENDOSCOPIC HEMOLOK POLYMER GREEN MEDIUM LARGE 5.0MM SUP-270000000 CDM 270 RC inpatient 54.9 53.8 All Payors / Plans All Payors / Plans 54.9 other 54.9 54.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP LIGATION RESOLUTION 360 ULTRA 17 MM OPEN L235 CM BRAID ROTATION CONTROL KNOB SUP-270000000 CDM 270 RC inpatient 505.1 495 All Payors / Plans All Payors / Plans 505.1 other 505.1 505.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP PADLOCK DEFECT CLOSURE SYSTEM SUP-270000000 CDM 270 RC inpatient 1375 1347.5 All Payors / Plans All Payors / Plans 1375 other 1375 1375 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP SURGICAL DLP L3 MM CORONARY ARTERY RETRACTION SUP-270000000 CDM 270 RC inpatient 98.81 96.83 All Payors / Plans All Payors / Plans 98.81 other 98.81 98.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP SURGICAL STEALTH 6MM STERILE ATRAUMATIC OCCLUSION FIBRA SPRING SUP-270000000 CDM 270 RC inpatient 46.2 45.28 All Payors / Plans All Payors / Plans 46.2 other 46.2 46.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COHEN-BENNER CONTACT LENS SUP-270000000 CDM 270 RC inpatient 102.9 100.84 All Payors / Plans All Payors / Plans 102.9 other 102.9 102.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COIL TARGET DETACHABLE 360 NANO 1.5MM X 3CM SUP-270000000 CDM 270 RC inpatient 5369.7 5262.31 All Payors / Plans All Payors / Plans 5369.7 other 5369.7 5369.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COLLAR CERVICAL LG 18.5INX3IN FOAM VELCRO FIRM DENSITY STOCKINETTE COVER SUP-270009109 CDM 270 RC inpatient 4.09 4.01 All Payors / Plans All Payors / Plans 4.09 other 4.09 4.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COLLAR CERVICAL MED LOW CONTOUR 17.5INX3IN FOAM VELCRO FIRM DENSITY STOCKINETTE COVER SUP-270009109 CDM 270 RC inpatient 4.09 4.01 All Payors / Plans All Payors / Plans 4.09 other 4.09 4.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COLLAR CERVICAL VISTA ADULT UNIVERSAL SET REPLACEMENT PAD LATEX FREE SUP-270009108 CDM 270 RC inpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COLLECTOR SPECIMEN VACUTAINER BD BBL ANAEROBIC SWAB NEEDLE SYRINGE STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 6.26 6.13 All Payors / Plans All Payors / Plans 6.26 other 6.26 6.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT FEMORAL ATTUNE SIZE 5 CEMENTED NARROW CRUCIATE RETAINING COBALT CHROMIUM RIGHT SUP-270010025 CDM 270 RC inpatient 6720 6585.6 All Payors / Plans All Payors / Plans 6720 other 6720 6720 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT FEMORAL GMK 23 KNEE RIGHT SPHERE CEMENTED SUP-270010025 CDM 270 RC inpatient 7035 6894.3 All Payors / Plans All Payors / Plans 7035 other 7035 7035 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT FEMORAL GMK SPHERIKA 5 KNEE LEFT CEMENT STERILE LATEX FREE SUP-270010025 CDM 270 RC inpatient 7560 7408.8 All Payors / Plans All Payors / Plans 7560 other 7560 7560 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT FEMORAL LPS-FLEX GENDER SOLUTIONS OPTION NEXGEN COCR G KNEE RIGHT SUP-270010025 CDM 270 RC inpatient 6090 5968.2 All Payors / Plans All Payors / Plans 6090 other 6090 6090 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT FEMORAL NEXGEN LCCK OPTION ZIMALOY F L72 MM X W65.5 MM KNEE RIGHT SET SCREW CEMENTED REVISION STERILE SUP-270010025 CDM 270 RC inpatient 14642.1 14349.26 All Payors / Plans All Payors / Plans 14642.1 other 14642.1 14642.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT FEMORAL NEXGEN LPS OPTION E KNEE RIGHT SUP-270010025 CDM 270 RC inpatient 7455 7305.9 All Payors / Plans All Payors / Plans 7455 other 7455 7455 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT FEMORAL NEXGEN LPS OPTION F KNEE RIGHT SUP-270010025 CDM 270 RC inpatient 6300 6174 All Payors / Plans All Payors / Plans 6300 other 6300 6300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT FEMORAL NEXGEN LPS OPTION G KNEE RIGHT SUP-270010025 CDM 270 RC inpatient 7540 7389.2 All Payors / Plans All Payors / Plans 7540 other 7540 7540 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT GLENOID UNIVERS REVERS +4 OD33 MM ODSEC24 MM SHOULDER LATERALIZE GLENOSPHERE TAPER BASEPLATE MODULAR SUP-270010030 CDM 270 RC inpatient 15540 15229.2 All Payors / Plans All Payors / Plans 15540 other 15540 15540 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT TIBIAL TRAY GMK 2 RIGHT CEMENTED FIXED PRIMARY SUP-270010025 CDM 270 RC inpatient 5695 5581.1 All Payors / Plans All Payors / Plans 5695 other 5695 5695 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT TIBIAL TRAY GMK 3 LEFT CEMENTED FIXED PRIMARY SUP-270010025 CDM 270 RC inpatient 9360 9172.8 All Payors / Plans All Payors / Plans 9360 other 9360 9360 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT TIBIAL TRAY GMK 4 RIGHT PRIMARY CEMENTED FIXED SUP-270010025 CDM 270 RC inpatient 9360 9172.8 All Payors / Plans All Payors / Plans 9360 other 9360 9360 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT TIBIAL TRAY GMK 5 LEFT PRIMARY CEMENTED FIXED SUP-270010025 CDM 270 RC inpatient 7560 7408.8 All Payors / Plans All Payors / Plans 7560 other 7560 7560 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT TIBIAL TRAY GMK 5 RIGHT PRIMARY CEMENTED FIXED SUP-270010025 CDM 270 RC inpatient 7035 6894.3 All Payors / Plans All Payors / Plans 7035 other 7035 7035 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT TIBIAL TRAY GMK 6 RIGHT PRIMARY CEMENTED FIXED SUP-270010025 CDM 270 RC inpatient 5695 5581.1 All Payors / Plans All Payors / Plans 5695 other 5695 5695 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CONNECTOR DRAINAGE BLAKE 2:1 3/8.5MMX3/16IN WHITE SILICONE DISPOSABLE STERILE LF CARDIAC 4 CHANNEL RADIOPAQUE SOLID CORE SUP-270000000 CDM 270 RC inpatient 35.12 34.42 All Payors / Plans All Payors / Plans 35.12 other 35.12 35.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CONNECTOR DRAINAGE BLAKE 3:1 3/8.5MMX3/16IN WHITE SILICONE DISPOSABLE STERILE LF CARDIAC 4 CHANNEL RADIOPAQUE SOLID CORE SUP-270000000 CDM 270 RC inpatient 17.06 16.72 All Payors / Plans All Payors / Plans 17.06 other 17.06 17.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CONNECTOR WOUND DRAIN TRAC Y DRESSING SYSTEM STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 1.73 1.7 All Payors / Plans All Payors / Plans 1.73 other 1.73 1.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CONQUEST PTA BALLOON DILATION CATHETER SUP-481000000 CDM 270 RC inpatient 1470 1440.6 All Payors / Plans All Payors / Plans 1470 other 1470 1470 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CONTAINER SPECIMEN 4OZ POLYPROPYLENE STERILE LF LEAK RESISTANT SCREW ON LID GRADUATED SUP-270000000 CDM 270 RC inpatient 1.18 1.16 All Payors / Plans All Payors / Plans 1.18 other 1.18 1.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COOK 16F CHECK-FLO PERFORMER SHEATH 30CM SUP-270000000 CDM 270 RC inpatient 123.65 121.18 All Payors / Plans All Payors / Plans 123.65 other 123.65 123.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COOK 8F DILATOR 20CM SUP-270000000 CDM 270 RC inpatient 8.25 8.09 All Payors / Plans All Payors / Plans 8.25 other 8.25 8.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CORETEMP FLUID WARMING DRAPE 56""X56""" SUP-270000000 CDM 270 RC inpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER BURR HOLE MATRIXNEURO TITANIUM H.4 MM OD15 MM CRANIOMAXILLOFACIAL NONSTERILE BLUE SUP-270010013 CDM 270 RC inpatient 2028.6 1988.03 All Payors / Plans All Payors / Plans 2028.6 other 2028.6 2028.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER BURR HOLE MATRIXNEURO TITANIUM H.4 MM OD17 MM CRANIOMAXILLOFACIAL BLUE SUP-270010013 CDM 270 RC inpatient 635 622.3 All Payors / Plans All Payors / Plans 635 other 635 635 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER BURR HOLE MATRIXNEURO TITANIUM H.4 MM OD24 MM CRANIOMAXILLOFACIAL NONSTERILE BLUE SHUNT SUP-270010013 CDM 270 RC inpatient 1066.8 1045.46 All Payors / Plans All Payors / Plans 1066.8 other 1066.8 1066.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER BURR HOLE MATRIXNEURO TITANIUM OD17 MM SHUNT NONSTERILE BLUE SUP-270010013 CDM 270 RC inpatient 603.75 591.68 All Payors / Plans All Payors / Plans 603.75 other 603.75 603.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER BURR HOLE MATRIXNEURO TITANIUM OD24 MM CRANIAL BLUE SUP-270010013 CDM 270 RC inpatient 1066.8 1045.46 All Payors / Plans All Payors / Plans 1066.8 other 1066.8 1066.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER ENDOSCOPE TIP HOT SHEARS DA VINCI ENDOWRIST 8 MM STANDARD CAUTERY MONOPOLAR DISPOSABLE SUP-270000000 CDM 270 RC inpatient 21.42 20.99 All Payors / Plans All Payors / Plans 21.42 other 21.42 21.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER INLINE CAMERA SUP-270000000 CDM 270 RC inpatient 114.02 111.74 All Payors / Plans All Payors / Plans 114.02 other 114.02 114.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER PROBE CIV-FLEX L58 IN X W5.5 IN EXTENDED LENGTH STERILE LATEX FREE SUP-481000000 CDM 270 RC inpatient 9.97 9.77 All Payors / Plans All Payors / Plans 9.97 other 9.97 9.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER PROBE SITE-RITE L48 IN PREGEL LATEX FREE SUP-270000000 CDM 270 RC inpatient 15.62 15.31 All Payors / Plans All Payors / Plans 15.62 other 15.62 15.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER TABLE SMS STANDARD L90 IN X W60 IN REINFORCE HEAVY DUTY STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 5.5 5.39 All Payors / Plans All Payors / Plans 5.5 other 5.5 5.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CPS DIRECT 10F SUP-270010030 CDM 270 RC inpatient 1155 1131.9 All Payors / Plans All Payors / Plans 1155 other 1155 1155 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRADLE POSITIONING FOAM L24IN X W5 IN XH3 IN ARM CONVOLUTE LATEX FREE LAMINECTOMY SUP-270000000 CDM 270 RC inpatient 3.09 3.03 All Payors / Plans All Payors / Plans 3.09 other 3.09 3.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRE PRO CATHETER BALLOON DILATATION CRE PEBAX 2.8 MM 3.2 MM L240 CM L5.5 CM OD10-11-12 MM ODSEC7.5 FR ESOPHAGEAL PYLORIC BILIARY LOW PROFILE GUIDEWIRE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 405.49 397.38 All Payors / Plans All Payors / Plans 405.49 other 405.49 405.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRE PRO CATHETER BALLOON DILATATION CRE PEBAX 2.8 MM 3.2 MM L240 CM L5.5 CM OD11-13.5-15 MM ODSEC7.5 FR ESOPHAGEAL PYLORIC BILIARY BALLOON LOW PROFILE GUIDEWIRE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 405.49 397.38 All Payors / Plans All Payors / Plans 405.49 other 405.49 405.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRE PRO CATHETER BALLOON DILATATION CRE PEBAX 2.8 MM 3.2 MM L240 CM L5.5 CM OD6-7-8 MM ESOPHAGEAL PYLORIC BILIARY LOW PROFILE RADIOPACQUE GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 299.39 293.4 All Payors / Plans All Payors / Plans 299.39 other 299.39 299.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRE PRO CATHETER BALLOON DILATION CRE PEBAX L240 CM L5.5 CM OD15-16.5-18 MM ODSEC7.5 FR ESOPHAGEAL PYLORIC BILIARY BALLOON LOW PROFILE GUIDEWIRE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 244.3 239.41 All Payors / Plans All Payors / Plans 244.3 other 244.3 244.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRE PRO DILATOR ENDOSCOPIC CRE PEBAX 2.8 MM 3.2 MM 3.7 MM 4.2 MM L240 CM L5.5 CM OD18-19-20 MM ODSEC7.5 FR ESOPHAGEAL PYLORIC BILIARY BALLOON LOW PROFILE GUIDEWIRE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 502.97 492.91 All Payors / Plans All Payors / Plans 502.97 other 502.97 502.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRE PRO DILATOR ENDOSCOPIC CRE PEBAX 2.8 MM 3.2 MM L240 CM L5.5 CM OD8-9-10 MM ODSEC7.5 FR ESOPHAGEAL PYLORIC BILIARY BALLOON LOW PROFILE GUIDEWIRE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 502.97 492.91 All Payors / Plans All Payors / Plans 502.97 other 502.97 502.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRT-P PERCEPTA MRI QUAD DEVICE SUP-275000000 CDM 270 RC inpatient 7237 7092.26 All Payors / Plans All Payors / Plans 7237 other 7237 7237 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUFF TOURNIQUET ATS 3000 CYLINDER L12 IN X W3.5 IN 2 PORT 1 BLADDER POSITIVE LOCK CONNECTOR CONTACT CLOSURE STERILE LATEX FREE DISPOSABLE BLACK SUP-270000000 CDM 270 RC inpatient 28.89 28.31 All Payors / Plans All Payors / Plans 28.89 other 28.89 28.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUFF TOURNIQUET ATS 3000 CYLINDER L18 IN X W4 IN 2 PORT 1 BLADDER POSITIVE LOCK CONNECTOR CONTACT CLOSURE STERILE LATEX FREE DISPOSABLE RED SUP-270000000 CDM 270 RC inpatient 28.89 28.31 All Payors / Plans All Payors / Plans 28.89 other 28.89 28.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUFF TOURNIQUET ATS 3000 CYLINDER L24 IN X W4 IN 2 PORT 1 BLADDER POSITIVE LOCK CONNECTOR CONTACT CLOSURE STERILE LATEX FREE DISPOSABLE GREEN SUP-270000000 CDM 270 RC inpatient 28.89 28.31 All Payors / Plans All Payors / Plans 28.89 other 28.89 28.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUFF TOURNIQUET ATS 3000 CYLINDER L30 IN X W4 IN 2 PORT 1 BLADDER POSITIVE LOCK CONNECTOR CONTACT CLOSURE STERILE LATEX FREE DISPOSABLE BLUE SUP-270000000 CDM 270 RC inpatient 16.83 16.49 All Payors / Plans All Payors / Plans 16.83 other 16.83 16.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUFF TOURNIQUET ATS 3000 CYLINDER L34 IN X W4 IN 2 PORT 1 BLADDER POSITIVE LOCK CONNECTOR CONTACT CLOSURE STERILE LATEX FREE DISPOSABLE BROWN SUP-270000000 CDM 270 RC inpatient 17.33 16.98 All Payors / Plans All Payors / Plans 17.33 other 17.33 17.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUFF TOURNIQUET ATS 3000 CYLINDER L42 IN X W4 IN 2 PORT 1 BLADDER POSITIVE LOCK CONNECTOR CONTACT CLOSURE STERILE LATEX FREE DISPOSABLE RUBY SUP-270000000 CDM 270 RC inpatient 35.69 34.98 All Payors / Plans All Payors / Plans 35.69 other 35.69 35.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUP ACETABULAR PINNACLE 52MM 3-HOLE PRIMARY SECTOR GRIPTION SUP-270010024 CDM 270 RC inpatient 8295 8129.1 All Payors / Plans All Payors / Plans 8295 other 8295 8295 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUP ARTHREX UNIVERSAL REVERSE SUTURE 39 +2 RIGHT SUP-270000000 CDM 270 RC inpatient 12650 12397 All Payors / Plans All Payors / Plans 12650 other 12650 12650 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CURETTE VACUUM CURVE 12MM CLEAR PLASTIC DISPOSABLE STERILE UTERINE OPEN TIP MOLD MARK FROST SOUND LINE SUP-270000000 CDM 270 RC inpatient 2.84 2.78 All Payors / Plans All Payors / Plans 2.84 other 2.84 2.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUSHION POSITIONING PRONEVIEW INSITE FOAM ADULT LARGE INSERT LATEX FREE OR SUP-270000000 CDM 270 RC inpatient 25.5 24.99 All Payors / Plans All Payors / Plans 25.5 other 25.5 25.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUTTER ENDARTERECTOMY MOLLRING L44 CM OD9 MM TRANSECTION DEVICE REMOTE SUP-270000000 CDM 270 RC inpatient 6297.9 6171.94 All Payors / Plans All Payors / Plans 6297.9 other 6297.9 6297.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEBRILLATOR CARDIAC COBALT XT CRT-D DF-1 PIN PLUG RADIOPAQUE STERILE RESYNCHRONIZATION SUP-275000000 CDM 270 RC inpatient 18065 17703.7 All Payors / Plans All Payors / Plans 18065 other 18065 18065 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DECANTER FLUID EMPTY BOTTLE NONSTERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 1.47 1.44 All Payors / Plans All Payors / Plans 1.47 other 1.47 1.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DECANTER FLUID L9 IN BAG LATEX SUP-270000000 CDM 270 RC inpatient 1.61 1.58 All Payors / Plans All Payors / Plans 1.61 other 1.61 1.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEFIBRILLATOR CARDIAC ACTICOR 7 HF-T SUP-270000000 CDM 270 RC inpatient 22950 22491 All Payors / Plans All Payors / Plans 22950 other 22950 22950 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEFIBRILLATOR CARDIAC COBALT XT CRT-D DF4 CONNECTOR RADIOPAQUE STERILE RESYNCHRONIZATION SUP-275000000 CDM 270 RC inpatient 27065 26523.7 All Payors / Plans All Payors / Plans 27065 other 27065 27065 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEFIBRILLATOR CARDIAC COBALT XT CRT-D QUAD DF4 CONNECTOR RADIOPAQUE STERILE RESYNCHRONIZATION SUP-275000000 CDM 270 RC inpatient 30103 29500.94 All Payors / Plans All Payors / Plans 30103 other 30103 30103 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEFIBRILLATOR CARDIAC GALLANT 2 CHAMBER IS-1 DF4 CONNECTOR SUP-275000000 CDM 270 RC inpatient 12118 11875.64 All Payors / Plans All Payors / Plans 12118 other 12118 12118 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEFIBRILLATOR VIGILANT EL DR DF4 DUAL CHAMBER SUP-275000000 CDM 270 RC inpatient 19256 18870.88 All Payors / Plans All Payors / Plans 19256 other 19256 19256 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DERMACARRIERS SUP-270000000 CDM 270 RC inpatient 44 43.12 All Payors / Plans All Payors / Plans 44 other 44 44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE AZURE XT DR MRI SURESCAN SUP-275000000 CDM 270 RC inpatient 3330 3263.4 All Payors / Plans All Payors / Plans 3330 other 3330 3330 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE BLOWER/MISTER ACCUMIST ATTACHED TUBING SET SUP-270000000 CDM 270 RC inpatient 94.5 92.61 All Payors / Plans All Payors / Plans 94.5 other 94.5 94.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CARDIAC ASSERT-IQ THK 4.4MM EL + L 9.4MM X H 49MM ICM SUP-270000000 CDM 270 RC inpatient 5079.6 4978.01 All Payors / Plans All Payors / Plans 5079.6 other 5079.6 5079.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE ANGIO-SEAL VIP BONDEK-PLUS POLYGLYD L70 CM OD8 FR ODSEC.038 IN VASCULAR HEMOSTATIC BIOABSORBABLE INSERTION SHEATH GUIDEWIRE STERILE LATEX FREE DISPOSABLE SUP-481000000 CDM 270 RC inpatient 430.5 421.89 All Payors / Plans All Payors / Plans 430.5 other 430.5 430.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE ANGIO-SEAL VIP COLLAGEN .035 IN L70 CM OD6 FR VASCULAR VALUELINK GUIDEWIRE INSERTION SHEATH J STRAIGHTENER SUP-481000000 CDM 270 RC inpatient 209.1 204.92 All Payors / Plans All Payors / Plans 209.1 other 209.1 209.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE ATRICLIP 45D 35MM 6CM NITINOL POLYESTER FLEXIBLE SHAFT PLUNGER GRIP LEFT ATRIAL APPENDAGE EXCLUSION SUP-270000000 CDM 270 RC inpatient 1224 1199.52 All Payors / Plans All Payors / Plans 1224 other 1224 1224 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE ATRICLIP 45D 40MM 6CM NITINOL POLYESTER FLEXIBLE SHAFT PLUNGER GRIP LEFT ATRIAL APPENDAGE EXCLUSION SUP-270000000 CDM 270 RC inpatient 1224 1199.52 All Payors / Plans All Payors / Plans 1224 other 1224 1224 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE ATRICLIP 45D 45MM 6CM NITINOL TITANIUM POLYESTER FLEXIBLE SHAFT PLUNGER GRIP LEFT ATRIAL APPENDAGE SUP-270000000 CDM 270 RC inpatient 2520 2469.6 All Payors / Plans All Payors / Plans 2520 other 2520 2520 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE ATRICLIP FLEXV L35 MM 1 HAND SMALL FOOTPRINT SUTURE LESS CLIP DEPLOYMENT STERILE LATEX FREE DISPOSABLE LEFT ATRIAL APPENDAGE EXCLUSION SYSTEM SUP-270000000 CDM 270 RC inpatient 3885 3807.3 All Payors / Plans All Payors / Plans 3885 other 3885 3885 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE ATRICLIP PRO2 GILLINOV-COSGROVE L35 MM STERILE LATEX FREE DISPOSABLE LEFT ATRIAL APPENDAGE EXCLUSION SYSTEM SUP-270000000 CDM 270 RC inpatient 9880 9682.4 All Payors / Plans All Payors / Plans 9880 other 9880 9880 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE ATRICLIP PRO2 GILLINOV-COSGROVE L45 MM STERILE LATEX FREE DISPOSABLE LEFT ATRIAL APPENDAGE EXCLUSION SYSTEM SUP-270000000 CDM 270 RC inpatient 6460 6330.8 All Payors / Plans All Payors / Plans 6460 other 6460 6460 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE CARTER-THOMASON XL PILOT GUIDES 5MM 10-12 MM SUP-270000000 CDM 270 RC inpatient 219.7 215.31 All Payors / Plans All Payors / Plans 219.7 other 219.7 219.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE EXOSEAL OD5 FR FEMORAL ARTERY ABSORBABLE PLUG APPLIER HANDLE DELIVERY SHAFT STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 153 149.94 All Payors / Plans All Payors / Plans 153 other 153 153 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE EXOSEAL OD6 FR FEMORAL ARTERY ABSORBABLE PLUG APPLIER HANDLE DELIVERY SHAFT STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 289 283.22 All Payors / Plans All Payors / Plans 289 other 289 289 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE MYNX 6FR7FR SUP-270000000 CDM 270 RC inpatient 246.84 241.9 All Payors / Plans All Payors / Plans 246.84 other 246.84 246.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE MYNX CONTROL VCD 6/7 FRENCH SUP-270000000 CDM 270 RC inpatient 391 383.18 All Payors / Plans All Payors / Plans 391 other 391 391 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE MYNXGRIP OD5 FR VASCULAR SUP-270000000 CDM 270 RC inpatient 508.2 498.04 All Payors / Plans All Payors / Plans 508.2 other 508.2 508.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE PERCLOSE OD6 FR VASCULAR SUTURE MEDIATE KNOT PUSH STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 256.02 250.9 All Payors / Plans All Payors / Plans 256.02 other 256.02 256.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE SYNETURE V-LOC 1 GS-21 L 9IN ABSORBABLE BLUE SUP-270000000 CDM 270 RC inpatient 76.67 75.14 All Payors / Plans All Payors / Plans 76.67 other 76.67 76.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE VASCULAR MANTA 14 FR SUP-481000000 CDM 270 RC inpatient 1995 1955.1 All Payors / Plans All Payors / Plans 1995 other 1995 1995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE VASCULAR MANTA 18 FR SUP-481000000 CDM 270 RC inpatient 1615 1582.7 All Payors / Plans All Payors / Plans 1615 other 1615 1615 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 180 0 GS-21 12IN GREEN ABSORBABLE TAPER POINT SUP-270000000 CDM 270 RC inpatient 22.13 21.69 All Payors / Plans All Payors / Plans 22.13 other 22.13 22.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 180 0 GS-21 L15 CM L37 MM ABSORBABLE GREEN SUP-270000000 CDM 270 RC inpatient 45.56 44.65 All Payors / Plans All Payors / Plans 45.56 other 45.56 45.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 180 2-0 GS-21 12IN GREEN ABSORBABLE TAPER POINT SUP-270000000 CDM 270 RC inpatient 45.56 44.65 All Payors / Plans All Payors / Plans 45.56 other 45.56 45.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 180 2-0 GS-22 1/2 CIRCLE L6 IN L27 MM TAPER POINT ABSORBABLE GREEN SUP-270000000 CDM 270 RC inpatient 35.34 34.63 All Payors / Plans All Payors / Plans 35.34 other 35.34 35.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 180 2-0 V-20 1/2 CIRCLE L18 IN L26 MM TAPER POINT ABSORBABLE GREEN SUP-270000000 CDM 270 RC inpatient 43.22 42.36 All Payors / Plans All Payors / Plans 43.22 other 43.22 43.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 180 3-0 P-14 18IN CLEAR ABSORBABLE PREMIUM REVERSE CUT SUP-270000000 CDM 270 RC inpatient 46.05 45.13 All Payors / Plans All Payors / Plans 46.05 other 46.05 46.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 180 SURGALLOY 3-0 V-20 1/2 CIRCLE L9 IN L26 MM TAPER POINT ABSORBABLE GREEN SUP-270000000 CDM 270 RC inpatient 43.65 42.78 All Payors / Plans All Payors / Plans 43.65 other 43.65 43.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 3-0 NON ABSORBABLE WOUND CLOSURE DEVICE SUP-270000000 CDM 270 RC inpatient 43.65 42.78 All Payors / Plans All Payors / Plans 43.65 other 43.65 43.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 90 3-0 SC-2 STRAIGHT L45 CM L60 MM 2 ANGLE CUT ABSORBABLE BARB UNDYED SUP-270000000 CDM 270 RC inpatient 67.7 66.35 All Payors / Plans All Payors / Plans 67.7 other 67.7 67.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 90 4-0 SC-2 STRAIGHT L45 CM L60 MM 2 ANGLE CUT ABSORBABLE BARB UNDYED SUP-270000000 CDM 270 RC inpatient 36.91 36.17 All Payors / Plans All Payors / Plans 36.91 other 36.91 36.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 90 SURGALLOY 2-0 P-12 3/8 CIRCLE L 12IN L19MM REVERSE CUT ABSORBABLE 2 ANGLE CUT BARB PATTERN UNDYED SUP-270000000 CDM 270 RC inpatient 138.14 135.38 All Payors / Plans All Payors / Plans 138.14 other 138.14 138.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 90 SURGALLOY 3-0 P-12 3/8 CIRCLE L12IN L19MM REVERSE CUT ABSORBABLE 2 ANGLE CUT BARB PATTERN UNDYED SUP-270000000 CDM 270 RC inpatient 46.05 45.13 All Payors / Plans All Payors / Plans 46.05 other 46.05 46.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE WATCHMAN FLX PRO L 20 MM LEFT ATRIAL APPENDAGE STERILE LATEX FREE DISPOSABLE DELIVERY SYSTEM SUP-481000000 CDM 270 RC inpatient 35700 34986 All Payors / Plans All Payors / Plans 35700 other 35700 35700 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE WATCHMAN FLX PRO L 24 MM LEFT ATRIAL APPENDAGE STERILE LATEX FREE DISPOSABLE DELIVERY SYSTEM SUP-481000000 CDM 270 RC inpatient 35700 34986 All Payors / Plans All Payors / Plans 35700 other 35700 35700 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE WATCHMAN FLX PRO L 35MM LEFT ATRIAL APPENDAGE STERILE LATEX FREE DISPOSABLE DELIVERY SYSTEM SUP-481000000 CDM 270 RC inpatient 35700 34986 All Payors / Plans All Payors / Plans 35700 other 35700 35700 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE WATCHMAN FXD CURVE OD 15 FR ID 12 FR 2 CURVE ACCESS SYSTEM LEFT ATRIAL APPENDAGE SUP-481000000 CDM 270 RC inpatient 1020 999.6 All Payors / Plans All Payors / Plans 1020 other 1020 1020 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE COAGULATION EPI-SENSE L3 CM GUIDE ELECTRODE IRRIGATION PERFUSION LUMEN SUCTION 6130 SUP-270000000 CDM 270 RC inpatient 29900 29302 All Payors / Plans All Payors / Plans 29900 other 29900 29900 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE COMPRESSION PRELUDESYNC L24 CM BAND STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 73.5 72.03 All Payors / Plans All Payors / Plans 73.5 other 73.5 73.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE DRAINAGE STAYFIX OD12-22 FR FIXATION FASTEN SHOWERCAP PERCUTANEOUS CATHETER SUP-270000000 CDM 270 RC inpatient 14.88 14.58 All Payors / Plans All Payors / Plans 14.88 other 14.88 14.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE ELECTROSURGICAL LIGASURE MARYLAND 350 D L23 CM OPEN SEALER DIVIDER 1 STEP SEAL FORCETRIAD SUP-270000000 CDM 270 RC inpatient 1760.41 1725.2 All Payors / Plans All Payors / Plans 1760.41 other 1760.41 1760.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE ELECTROSURGICAL PLASMABLADE X STERILE LATEX FREE DISPOSABLE PINK 3.0S LIGHT SUP-270000000 CDM 270 RC inpatient 448.8 439.82 All Payors / Plans All Payors / Plans 448.8 other 448.8 448.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE EMBOLIZATION SURPASS STREAMLINE L20MM OD 4MM SUP-270000000 CDM 270 RC inpatient 25245 24740.1 All Payors / Plans All Payors / Plans 25245 other 25245 25245 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE ENDOSCOPIC PLUNGE BOB POLY OD10 MM PORT CLEANER Q TIP ABSORBENT OBTURATOR SUP-270000000 CDM 270 RC inpatient 7.63 7.48 All Payors / Plans All Payors / Plans 7.63 other 7.63 7.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE ENDOSCOPIC PLUNGE BOB POLY OD5 MM PORT CLEANER Q TIP ABSORBENT OBTURATOR SUP-270000000 CDM 270 RC inpatient 54.39 53.3 All Payors / Plans All Payors / Plans 54.39 other 54.39 54.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE FIXATION SECURESTRAP 5MM DISPOSABLE 25 ABSORBABLE STRAP MESH HERNIA REPAIR SUP-270000000 CDM 270 RC inpatient 999.27 979.28 All Payors / Plans All Payors / Plans 999.27 other 999.27 999.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE FIXATION SECURESTRAP L5 MM ABSORBABLE STRAP HERNIA REPAIR SUP-270000000 CDM 270 RC inpatient 684.35 670.66 All Payors / Plans All Payors / Plans 684.35 other 684.35 684.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE FLOW CONTROL FLOSWITCH 1050 PSI 1 WAY HIGH PRESSURE SUP-270000000 CDM 270 RC inpatient 9.01 8.83 All Payors / Plans All Payors / Plans 9.01 other 9.01 9.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE INFLATION CADENCE PRECISION 1 ML SYRINGE INJECTOR THREAD PLUNGER SUP-270000000 CDM 270 RC inpatient 126.89 124.35 All Payors / Plans All Payors / Plans 126.89 other 126.89 126.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE INFLATION CRE STERI-FLATE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 46.99 46.05 All Payors / Plans All Payors / Plans 46.99 other 46.99 46.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE INFLATION ENCORE 26 L3 IN OD12 FR 20 ML PRESSURE GAUGE LATEX FREE SUP-270000000 CDM 270 RC inpatient 30.6 29.99 All Payors / Plans All Payors / Plans 30.6 other 30.6 30.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE INFLATION GATEWAY ENCORE 26 ADVANTAGE Y 20 ML KIT ADAPTER TORQUE GUIDEWIRE INTRODUCER SUP-270000000 CDM 270 RC inpatient 32.31 31.66 All Payors / Plans All Payors / Plans 32.31 other 32.31 32.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE INFLATION L10 IN 20 ML STERILE LATEX FREE DISPOSABLE ROYAL BLUE ANGIO SUP-270000000 CDM 270 RC inpatient 65.25 63.95 All Payors / Plans All Payors / Plans 65.25 other 65.25 65.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE SECUREMENT STAYFIX SMALL OD5-14 FR DRAIN CATHETER FASTENER FIXATION STERILE LATEX FREE PERCUTANEOUS CATHETER SUP-270000000 CDM 270 RC inpatient 8.93 8.75 All Payors / Plans All Payors / Plans 8.93 other 8.93 8.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE SPECIMEN RETRIEVAL RAPTOR L230 CM OD2.4 MM HYBRID JAW CONFIGURATION FLEXIBLE DISTAL WIRE GRASP STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 224.4 219.91 All Payors / Plans All Payors / Plans 224.4 other 224.4 224.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE SPECIMEN RETRIEVAL TALON STAINLESS STEEL L160CM OD2.5MM 4 PRONG GRASP INWARD FACE ATRAUMATIC HOOK SHEATH LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 132.6 129.95 All Payors / Plans All Payors / Plans 132.6 other 132.6 132.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE SUTURE STRATAFIX PDO 1 CTX L36 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM VIOLET BIDIRECTIONAL SUP-270000000 CDM 270 RC inpatient 31.31 30.68 All Payors / Plans All Payors / Plans 31.31 other 31.31 31.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE SUTURE V-LOC 180 SURGALLOY 3-0 V-20 TAPER POINT L 6IN ABSORBABLE GREEN SUP-270000000 CDM 270 RC inpatient 43.65 42.78 All Payors / Plans All Payors / Plans 43.65 other 43.65 43.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE SUTURING COR-KNOT QUICK LOAD TITANIUM BLUNT CURVE RELOAD WIRE SNARE LEVER STERILE PURPLE WHITE SUP-270000000 CDM 270 RC inpatient 283.5 277.83 All Payors / Plans All Payors / Plans 283.5 other 283.5 283.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE SUTURING ENDO STITCH L15 IN OD10 MM SOFT TISSUE PUSH BUTTON GRIP HANDLE STERILE LATEX FREE DISPOSABLE ENDOSCOPIC SUP-270000000 CDM 270 RC inpatient 441.65 432.82 All Payors / Plans All Payors / Plans 441.65 other 441.65 441.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE THROMBECTOMY EMBOTRAP OD 5MM X L 21MM RADIOPAQUE SUP-270000000 CDM 270 RC inpatient 14490 14200.2 All Payors / Plans All Payors / Plans 14490 other 14490 14490 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE THROMBECTOMY EMBOTRAP OD5MM X L 33MM RADIOPAQUE SUP-270000000 CDM 270 RC inpatient 14490 14200.2 All Payors / Plans All Payors / Plans 14490 other 14490 14490 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE TISSUE REMOVAL AVETA HYSTEROSCOPE PEARL STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 496.6 486.67 All Payors / Plans All Payors / Plans 496.6 other 496.6 496.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE TISSUE REMOVAL AVETA OD2.9 MM RESECT FLEX STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 1950 1911 All Payors / Plans All Payors / Plans 1950 other 1950 1950 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE TISSUE REMOVAL AVETA OD2.9 MM RESECT SMOL STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE TORQUE GLIDECATH .010-.038 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 6.06 5.94 All Payors / Plans All Payors / Plans 6.06 other 6.06 6.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE TORQUE OLCOTT HYDROPHILIC .014-.045 IN 1 HAND GUIDEWIRE STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 20.98 20.56 All Payors / Plans All Payors / Plans 20.98 other 20.98 20.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE VACUUM EXTRACTION PALMPUMP KIWI OMNICUP NEONATE FLEXIBLE STEM LOW PROFILE CUP TRACTION FORCE INDICATOR SUP-270000000 CDM 270 RC inpatient 61.15 59.93 All Payors / Plans All Payors / Plans 61.15 other 61.15 61.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIFFUSER MAESTRO CORE SUP-270000000 CDM 270 RC inpatient 13.09 12.83 All Payors / Plans All Payors / Plans 13.09 other 13.09 13.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILATOR ENDOSCOPIC CRE L3 CM L75 CM OD10-11-12 MM PULMONARY BALLOON RADIOPAQUE RECTILINEAR SHOULDER STERILE DISPOSABLE ACCEPTS .035 IN JAGWIRE SUP-270000000 CDM 270 RC inpatient 746.19 731.27 All Payors / Plans All Payors / Plans 746.19 other 746.19 746.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILATOR VASCULAR MAC-LOC COONS ULTRATHANE HYDROPHILIC TAPER L20CM OD 16FR PERCUTANEOUS LOCK LOOP STERILE DISPOSABLE ACCEPTS .038IN GUIDEWIRE CECOSTOMY SUP-270000000 CDM 270 RC inpatient 17.67 17.32 All Payors / Plans All Payors / Plans 17.67 other 17.67 17.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILATOR VASCULAR STANDARD JCD CURVE 20CM 5FR DISPOSABLE STERILE RADIOPAQUE ACCEPTS .035IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 18.88 18.5 All Payors / Plans All Payors / Plans 18.88 other 18.88 18.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILATOR VASCULAR STANDARD JCD CURVE 20CM 6FR DISPOSABLE STERILE VESSEL RADIOPAQUE ACCEPTS .038IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 9.17 8.99 All Payors / Plans All Payors / Plans 9.17 other 9.17 9.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILATOR VASCULAR STANDARD JCD CURVE 20CM 9FR DISPOSABLE STERILE VESSEL RADIOPAQUE ACCEPTS .038IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 18.88 18.5 All Payors / Plans All Payors / Plans 18.88 other 18.88 18.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIRECT SUCTION TUBING SET-UROLOGY SUP-270000000 CDM 270 RC inpatient 84.77 83.07 All Payors / Plans All Payors / Plans 84.77 other 84.77 84.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DISH PETRI STERILE SUP-270000000 CDM 270 RC inpatient 2.19 2.15 All Payors / Plans All Payors / Plans 2.19 other 2.19 2.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DISP KIT RESECTOSCOPE SUP-270000000 CDM 270 RC inpatient 60.38 59.17 All Payors / Plans All Payors / Plans 60.38 other 60.38 60.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DISSECTOR ENDOSCOPIC COOLCUT CURVE L13 CM OD4 MM SERRATE TOOTH STERILE DISPOSABLE ARTHROSCOPY SUP-270000000 CDM 270 RC inpatient 77.7 76.15 All Payors / Plans All Payors / Plans 77.7 other 77.7 77.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOPPLER PROBE VTI STERILE 8MHZ SUP-270000000 CDM 270 RC inpatient 468.04 458.68 All Payors / Plans All Payors / Plans 468.04 other 468.04 468.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAIN INCISION AXIOM SILICONE OD9 MM MEDIASTINAL EYE ON TOP NONSTERILE SUP-270009144 CDM 270 RC inpatient 14.3 14.01 All Payors / Plans All Payors / Plans 14.3 other 14.3 14.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAIN INCISION JACKSON-PRATT ROUND 10FR SILICONE DISPOSABLE STERILE LF PERFORATE END WITHOUT TROCAR RADIOPAQUE RESERVOIR SUP-270009031 CDM 270 RC inpatient 9.91 9.71 All Payors / Plans All Payors / Plans 9.91 other 9.91 9.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAIN INCISION JACKSON-PRATT SILICONE OD15 FR ROUND HUBLESS CHANNEL STERILE LATEX FREE DISPOSABLE WHITE SUP-270009031 CDM 270 RC inpatient 9.91 9.71 All Payors / Plans All Payors / Plans 9.91 other 9.91 9.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAIN INCISION JACKSON-PRATT SILICONE ROUND L3/16 IN OD15 FR END PERFORATE WITHOUT TROCAR RADIOPAQUE STERILE LATEX FREE DISPOSABLE SUP-270009031 CDM 270 RC inpatient 9.91 9.71 All Payors / Plans All Payors / Plans 9.91 other 9.91 9.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAIN INCISION JACKSON-PRATT SILICONE ROUND OD19 FR ROUND HUBLESS CHANNEL STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 20.45 20.04 All Payors / Plans All Payors / Plans 20.45 other 20.45 20.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAIN INCISION OASIS PLASTIC DISPOSABLE STERILE LF CHEST COLLECTION TUBE DRY SUCTION CONTROL CHAMBER SUP-270009127 CDM 270 RC inpatient 39.54 38.75 All Payors / Plans All Payors / Plans 39.54 other 39.54 39.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAIN WOUND JACKSON-PRATT SILICONE 3/4 FLUTE OD10 FR ODSEC19 FR ROUND HUBLESS CHANNEL TROCAR SUP-270009031 CDM 270 RC inpatient 9.91 9.71 All Payors / Plans All Payors / Plans 9.91 other 9.91 9.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAIN WOUND JACKSON-PRATT SILICONE FLAT L20 CM X W7 MM FULL PERFORATION WITHOUT TROCAR SUP-270009031 CDM 270 RC inpatient 9.91 9.71 All Payors / Plans All Payors / Plans 9.91 other 9.91 9.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE ARM SUP-270000000 CDM 270 RC inpatient 222.77 218.31 All Payors / Plans All Payors / Plans 222.77 other 222.77 222.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE COLUMN SUP-270000000 CDM 270 RC inpatient 38.56 37.79 All Payors / Plans All Payors / Plans 38.56 other 38.56 38.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE EQUIPMENT C-ARMOR EXPANDABLE COLLAPSIBLE STERILE C ARM FLUOROSCOPE SUP-270000000 CDM 270 RC inpatient 49.04 48.06 All Payors / Plans All Payors / Plans 49.04 other 49.04 49.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE EQUIPMENT PROXIMA SMS L53 IN X W24 IN MAYOSTAND COVER STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 1.31 1.28 All Payors / Plans All Payors / Plans 1.31 other 1.31 1.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE EQUIPMENT SMARTDRAPE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 39.37 38.58 All Payors / Plans All Payors / Plans 39.37 other 39.37 39.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE EQUIPMENT UNIVERSAL L96 IN X W7 IN VIDEO CAMERA TELESCOPIC FOLDED CUFF ADHESIVE CLOSURE STRIP NONSTERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 13.2 12.94 All Payors / Plans All Payors / Plans 13.2 other 13.2 13.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE EQUIPMENT VELYS SATELLITE STATION STERILE SUP-270000000 CDM 270 RC inpatient 49.67 48.68 All Payors / Plans All Payors / Plans 49.67 other 49.67 49.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE EQUIPMENT VELYS STERILE SUP-270000000 CDM 270 RC inpatient 76.04 74.52 All Payors / Plans All Payors / Plans 76.04 other 76.04 76.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE EQUIPMENT ZEISS CLEARLENS STANDARD L120 IN X W46 IN OD65 MM OCULAR COVER LENS PATENT GLARE REDUCE STEREO STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 38.51 37.74 All Payors / Plans All Payors / Plans 38.51 other 38.51 38.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE FAMILY FRIENDLY C-SECTION VIEWING SUP-270000000 CDM 270 RC inpatient 71.65 70.22 All Payors / Plans All Payors / Plans 71.65 other 71.65 71.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE MICRO SUP-270000000 CDM 270 RC inpatient 62.48 61.23 All Payors / Plans All Payors / Plans 62.48 other 62.48 62.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE PROBE ISOSILK STRAIGHT L96 IN X W5 IN FOLD TAPE STRIP GEL STERILE LATEX SUP-270000000 CDM 270 RC inpatient 18.91 18.53 All Payors / Plans All Payors / Plans 18.91 other 18.91 18.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SLUSH STERILE 44 X 66 SUP-270000000 CDM 270 RC inpatient 41.65 40.82 All Payors / Plans All Payors / Plans 41.65 other 41.65 41.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL 3M STERI-DRAPE 23X17IN CLEAR POLYETHYLENE DISPOSABLE STERILE LF ADHESIVE STRIP LG TOWEL MATTE FINISH SUP-270000000 CDM 270 RC inpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL 3M STERI-DRAPE 51X47IN CLEAR POLYETHYLENE DISPOSABLE STERILE LF ADHESIVE U DRAPE SUP-270000000 CDM 270 RC inpatient 3.55 3.48 All Payors / Plans All Payors / Plans 3.55 other 3.55 3.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL 3M STERI-DRAPE IOBAN PLASTIC LARGE L129 IN X W100 IN L27 IN X W12 IN 2 ANTIMICROBIAL INCISE FILM ISOLATION POUCH ADHESIVE STRIP STERILE CLEAR SUP-270000000 CDM 270 RC inpatient 26.41 25.88 All Payors / Plans All Payors / Plans 26.41 other 26.41 26.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL CONTROL PLUS L172 IN X W100 IN BEACH CHAIR ATTACHABLE FLUID COLLECTION POUCH SUCTION PORT STERILE SHOULDER ARTHROSCOPY SUP-270000000 CDM 270 RC inpatient 66.21 64.89 All Payors / Plans All Payors / Plans 66.21 other 66.21 66.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL CONTROL PLUS STANDARD L124 IN X W112 IN W30 IN FLUID COLLECTION POUCH HOOK LOOP TUBE ARMBOARD COVER LOW LINT STERILE LAPAROSCOPY SUP-270000000 CDM 270 RC inpatient 48.92 47.94 All Payors / Plans All Payors / Plans 48.92 other 48.92 48.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL CONVERTORS TIBURON L40 IN X W4 IN HIP REINFORCE EMERALD ADHESIVE STRIP SPLIT SHEET STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 24.81 24.31 All Payors / Plans All Payors / Plans 24.81 other 24.81 24.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL CONVERTORS TIBURON L55.5 IN X W28 IN OD8 IN HIP FENESTRATED ARMBOARD COVER TUBE HOLDER ABSORBENT IMPERVIOUS REINFORCEMENT PAD STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 11.82 11.58 All Payors / Plans All Payors / Plans 11.82 other 11.82 11.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL CONVERTORS TIBURON NEONATE L4 IN W3 IN L60 IN X W44 IN L19 IN X W18 1/2 IN REINFORCE FENESTRATE ABSORBENT ADHESIVE STRIP STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 2.94 2.88 All Payors / Plans All Payors / Plans 2.94 other 2.94 2.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL CONVERTORS TIBURON VELCRO L110 IN X W109 IN X H100 IN L18 IN X W16 IN FLUID CONTROL POUCH FENESTRATION ABSORBENT IMPERVIOUS REINFORCEMENT ARMBOARD COVER STERILE DISPOSABLE LAVH SUP-270000000 CDM 270 RC inpatient 22.01 21.57 All Payors / Plans All Payors / Plans 22.01 other 22.01 22.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL CVARTS CONTROL PLUS SMS L38 IN W84 IN L100 IN X W60 IN L76 IN X W60 IN HEAVY DUTY REINFORCEMENT STERILE LATEX UNIVERSAL SYSTEM SUP-270000000 CDM 270 RC inpatient 72.08 70.64 All Payors / Plans All Payors / Plans 72.08 other 72.08 72.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL PROXIMA SMS 3/4 L77 IN X W53 IN SHEET STERILE LATEX FREE DISPOSABLE BLUE SUP-270000000 CDM 270 RC inpatient 1.48 1.45 All Payors / Plans All Payors / Plans 1.48 other 1.48 1.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL PROXIMA SMS L122 IN X W102 IN X H78 IN ABDOMINAL ABSORBENT REINFORCE FENESTRATE MAJOR STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 13.1 12.84 All Payors / Plans All Payors / Plans 13.1 other 13.1 13.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL PROXIMA SMS L14 IN W4 IN CONTOUR L121 IN X W102 IN X H78 IN L29 IN X W29 IN FENESTRATE ABSORBENT REINFORCE HOOK LOOP CLOSURE STERILE LATEX FREE DISPOSABLE TRANSVERSE LAPAROTOMY SUP-270000000 CDM 270 RC inpatient 4.96 4.86 All Payors / Plans All Payors / Plans 4.96 other 4.96 4.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL PROXIMA SMS L5 IN W5 IN L121 IN X W78 IN L28 IN X W20 IN THYROID DIAMOND FENESTRATE ABSORBENT REINFORCE ADHESIVE CONTACT CLOSURE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 4.28 4.19 All Payors / Plans All Payors / Plans 4.28 other 4.28 4.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL PROXIMA SMS L76 IN X W54 IN L24 IN X W6 IN U DRAPE IMPERVIOUS SPLIT ADHESIVE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 2.31 2.26 All Payors / Plans All Payors / Plans 2.31 other 2.31 2.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL PROXIMA SMS L80 IN X W75 IN PERIGROIN PACK BILATERAL SPLIT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 4.99 4.89 All Payors / Plans All Payors / Plans 4.99 other 4.99 4.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL PROXIMA SMS PEDIATRIC L6 IN W6 IN L121 IN X W102 IN X H78 IN L20 IN X W18 IN FENESTRATE ABSORBENT REINFORCE T DRAPE ARMBOARD COVER STERILE LATEX FREE DISPOSABLE LAPAROTOMY SUP-270000000 CDM 270 RC inpatient 11.5 11.27 All Payors / Plans All Payors / Plans 11.5 other 11.5 11.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL SMS L108 IN X W77 IN L37 IN X W2.5 IN ADHESIVE IMPERVIOUS ULTRA LOW LINT PUNCTURE RESISTANT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 11.2 10.98 All Payors / Plans All Payors / Plans 11.2 other 11.2 11.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL SMS L128 IN X W121 IN X H90 IN EXTREMITY ABSORBENT REINFORCE CIRCULAR FENESTRATE ARMBOARD COVER HOOK LOOP LINE HOLDER STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 14.45 14.16 All Payors / Plans All Payors / Plans 14.45 other 14.45 14.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL SMS L44.5 IN X W40 IN L32 IN X W29 IN UNDER BUTTOCK POUCH BACK STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 2.15 2.11 All Payors / Plans All Payors / Plans 2.15 other 2.15 2.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL SMS T L121 IN X W102 IN X H78 IN L12 IN X W4 IN FENESTRATE ABSORBENT REINFORCE ARMBOARD COVER INSTRUMENT PAD STERILE LATEX FREE DISPOSABLE LAPAROTOMY T DRAPELAPAROTOMY T DRAPE SUP-270000000 CDM 270 RC inpatient 4.97 4.87 All Payors / Plans All Payors / Plans 4.97 other 4.97 4.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE TRANSPARENT 3M IOBAN 2 23X17IN FABRIC STERILE INCISE ANTIMICROBIAL SUP-270000000 CDM 270 RC inpatient 5.86 5.74 All Payors / Plans All Payors / Plans 5.86 other 5.86 5.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE TRANSPARENT 3M IOBAN 2 POLYETHYLENE XL L33 IN X W23 IN 2 ANTIMICROBIAL INCISE FILM IMPREGNATE SUP-270000000 CDM 270 RC inpatient 15.99 15.67 All Payors / Plans All Payors / Plans 15.99 other 15.99 15.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE TRANSPARENT 3M STERI-DRAPE POLYETHYLENE LARGE L23 IN X W17 IN INCISE ADHESIVE FLEXIBLE FILM STERILE LATEX FREE DISPOSABLE CLEAR SUP-270000000 CDM 270 RC inpatient 6.44 6.31 All Payors / Plans All Payors / Plans 6.44 other 6.44 6.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING ADHESIVE KENDALL TELFA 8X4IN POLYESTER COTTON STERILE LF ISLAND ABSORBENT NONADHERENT FILM NONWOVEN SUP-270000000 CDM 270 RC inpatient 1.24 1.22 All Payors / Plans All Payors / Plans 1.24 other 1.24 1.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING FOAM MEPILEX BORDER POLYURETHANE L10 IN X W4 IN SELF ADHERENT SHOWER PROOF BREATHABLE STERILE ASSORTED SUP-270000000 CDM 270 RC inpatient 5.44 5.33 All Payors / Plans All Payors / Plans 5.44 other 5.44 5.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING GERMICIDAL BIOPATCH DISC 1IN 4MM WHITE CHG STERILE LF PERCUTANEOUS ANTIMICROBIAL ADHERENT CENTER HOLE SLIT SUP-481000000 CDM 270 RC inpatient 13.92 13.64 All Payors / Plans All Payors / Plans 13.92 other 13.92 13.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING KIT CENTRAL LINE WITH BIOPATCH AND SORBAVIEW DRESSING - CUSTOM KIT SUP-270000000 CDM 270 RC inpatient 21.46 21.03 All Payors / Plans All Payors / Plans 21.46 other 21.46 21.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING PEEL AND PLACE PREVENA 13CM SUP-270000000 CDM 270 RC inpatient 625.57 613.06 All Payors / Plans All Payors / Plans 625.57 other 625.57 625.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING PETROLATUM XEROFORM 3% BISMUTH TRIBROMOPHENATE GAUZE L8 IN X W1 IN NONADHERENT OCCLUSIVE BACTERIOSTATIC LOW PROFILE STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING PRESSURE SAFEGUARD L24 CM HEMOSTASIS SUP-270000000 CDM 270 RC inpatient 61.2 59.98 All Payors / Plans All Payors / Plans 61.2 other 61.2 61.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING SILVER POST OP MEPILEX 10 X 25 CM (4 X 10 INCH) SUP-270000000 CDM 270 RC inpatient 66.87 65.53 All Payors / Plans All Payors / Plans 66.87 other 66.87 66.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING SILVER POST OP MEPILEX 10 X 30 CM (4 X 12 INCH) SUP-270000000 CDM 270 RC inpatient 76.4 74.87 All Payors / Plans All Payors / Plans 76.4 other 76.4 76.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING TRANSPARENT 3M TEGADERM 8X6IN STERILE LF FRAME STYLE ADHESIVE HYPOALLERGENIC WATERPROOF SUP-270009020 CDM 270 RC inpatient 4.14 4.06 All Payors / Plans All Payors / Plans 4.14 other 4.14 4.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING TRANSPARENT 3M TEGADERM OVAL 4.5X4IN POLYURETHANE STERILE LF ADHESIVE WATERPROOF SUP-270000000 CDM 270 RC inpatient 1.49 1.46 All Payors / Plans All Payors / Plans 1.49 other 1.49 1.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING TRANSPARENT OPSITE HYDROCELLULAR FOAM L25 CM X W10 CM POSTOPERATIVE VISIBLE BACTERIA PROOF ABSORBENT PAD ADHERENT SUP-270000000 CDM 270 RC inpatient 5.32 5.21 All Payors / Plans All Payors / Plans 5.32 other 5.32 5.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING WOUND ABTHERA FOAM OPEN ABDOMEN PAD STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 1014.28 993.99 All Payors / Plans All Payors / Plans 1014.28 other 1014.28 1014.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING WOUND JUMPSTART L8 IN OD1.5 IN ANTIMICROBIAL SUP-270000000 CDM 270 RC inpatient 39.9 39.1 All Payors / Plans All Payors / Plans 39.9 other 39.9 39.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING WOUND MEPILEX BORDER FLEX 3 IN X 3 IN SUP-270000000 CDM 270 RC inpatient 3.8 3.72 All Payors / Plans All Payors / Plans 3.8 other 3.8 3.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING WOUND MEPILEX BORDER FLEX 4 X 4 IN SUP-270000000 CDM 270 RC inpatient 5.18 5.08 All Payors / Plans All Payors / Plans 5.18 other 5.18 5.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING WOUND MEPILEX BORDER POST OP 4 X 12IN SUP-270000000 CDM 270 RC inpatient 12.34 12.09 All Payors / Plans All Payors / Plans 12.34 other 12.34 12.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING WOUND PRIMAPORE ACRYLIC POLYESTER L8 IN X W4 IN ADHESIVE NONWOVEN HIGH ABSORBENT PAD SOFT BREATHABLE COVER SUP-270000000 CDM 270 RC inpatient 1.27 1.24 All Payors / Plans All Payors / Plans 1.27 other 1.27 1.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL BONE 3.0 SUP-270000000 CDM 270 RC inpatient 474.6 465.11 All Payors / Plans All Payors / Plans 474.6 other 474.6 474.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS LARGE LONG OD 3.7MM AO QUICK CONNECTOR STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 680.4 666.79 All Payors / Plans All Payors / Plans 680.4 other 680.4 680.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS LARGE OD 3.7MM AO QUICK CONNECTOR TARGETER STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 880.95 863.33 All Payors / Plans All Payors / Plans 880.95 other 880.95 880.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS MINI OD 2MM AO QUICK CONNECT COUPLING DISPOSABLE SUP-270000000 CDM 270 RC inpatient 154.22 151.14 All Payors / Plans All Payors / Plans 154.22 other 154.22 154.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS OD 1.5MM AO QUICK CONNECT DISPOSABLE SUP-270000000 CDM 270 RC inpatient 154.22 151.14 All Payors / Plans All Payors / Plans 154.22 other 154.22 154.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS OD 2.4MM AO QUICK CONNECT DISPOSABLE SUP-270000000 CDM 270 RC inpatient 124.85 122.35 All Payors / Plans All Payors / Plans 124.85 other 124.85 124.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS SHORT OD 2MM AO QUICK CONNECT DISPOSABLE SUP-270000000 CDM 270 RC inpatient 154.22 151.14 All Payors / Plans All Payors / Plans 154.22 other 154.22 154.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS SMALL LONG OD 2.5MM AO QUICK CONNECT STERILE LATEX FREE REUSABLE SUP-270000000 CDM 270 RC inpatient 131.78 129.14 All Payors / Plans All Payors / Plans 131.78 other 131.78 131.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS SMALL SHORT OD 2MM AO QUICK CONNECT DISPOSABLE SUP-270000000 CDM 270 RC inpatient 162.79 159.53 All Payors / Plans All Payors / Plans 162.79 other 162.79 162.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS SMALL SHORT OD 3.5 MM AO QUICK CONNECT OVER STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 162.79 159.53 All Payors / Plans All Payors / Plans 162.79 other 162.79 162.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS SMALL SHORT OD2.5MM AO QUICK CONNECT DISPOSABLE SUP-270000000 CDM 270 RC inpatient 79.07 77.49 All Payors / Plans All Payors / Plans 79.07 other 79.07 79.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOSO SHORT OD1.8MM AO QUICK CONNECT DISPOSABLE SUP-270000000 CDM 270 RC inpatient 146.88 143.94 All Payors / Plans All Payors / Plans 146.88 other 146.88 146.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL JET-X MINI OD2 MM RADIUS DISTAL NONSTERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 647.89 634.93 All Payors / Plans All Payors / Plans 647.89 other 647.89 647.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL TRIGEN SHORT L 161MM OD 4MM TROCHANTER FEMUR AO PILOT STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 210 205.8 All Payors / Plans All Payors / Plans 210 other 210 210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL VLP MINI-MOD SHORT L 122 MM OD 1.8MM - LOG620156 SUP-270000000 CDM 270 RC inpatient 294.84 288.94 All Payors / Plans All Payors / Plans 294.84 other 294.84 294.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EAGLE EYE PTLATINUM ST IVUS CATHETER SUP-270000000 CDM 270 RC inpatient 1522.5 1492.05 All Payors / Plans All Payors / Plans 1522.5 other 1522.5 1522.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EBU 3.0 GUIDE SUP-270000000 CDM 270 RC inpatient 91.35 89.52 All Payors / Plans All Payors / Plans 91.35 other 91.35 91.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EBU 3.75 SUP-270000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE CUTTING 24FR SUP-270000000 CDM 270 RC inpatient 162.11 158.87 All Payors / Plans All Payors / Plans 162.11 other 162.11 162.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE CUTTING 26FR SUP-270000000 CDM 270 RC inpatient 165.42 162.11 All Payors / Plans All Payors / Plans 165.42 other 165.42 165.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE DEFIBRILLATOR MEDI-TRACE CADENCE ADULT MULTIFUNCTION RADIOLUCENT MEDTRONIC PAD SUP-270000000 CDM 270 RC inpatient 15.92 15.6 All Payors / Plans All Payors / Plans 15.92 other 15.92 15.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE DEFIBRILLATOR MEDITRACE CADENCE SILVER CHLORIDE ADULT OVAL L6.25IN X W4.5IN MULTIFUNCTION ADHESIVE RADIOTRANSPARENT CONNECTOR LATEX FREE ZOLL 8900-2100-01/8900-4005 SUP-270000000 CDM 270 RC inpatient 14.58 14.29 All Payors / Plans All Payors / Plans 14.58 other 14.58 14.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE ELECTROSURGICAL ARGON PLUS VALLEYLAB 10FT 1IN DISPOSABLE STERILE LF HANDSET RETRACTABLE BLADE HOLSTER SUP-270000000 CDM 270 RC inpatient 213.83 209.55 All Payors / Plans All Payors / Plans 213.83 other 213.83 213.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE ELECTROSURGICAL ARGONPLUS L11 IN FLEXIBLE LAPAROSCOPIC STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 179.66 176.07 All Payors / Plans All Payors / Plans 179.66 other 179.66 179.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE ELECTROSURGICAL SUREFIT L10 FT 2 DISPERSIVE ADHESIVE BORDER PULL TAB CABLE NONSTERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 2.33 2.28 All Payors / Plans All Payors / Plans 2.33 other 2.33 2.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE ELECTROSURGICAL ULTRACLEAN BLADE 1IN DISPOSABLE STERILE EXTEND INSULATE SUP-270000000 CDM 270 RC inpatient 3.55 3.48 All Payors / Plans All Payors / Plans 3.55 other 3.55 3.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE ELECTROSURGICAL ULTRACLEAN PTFE BLADE 90 D L1 IN L4 IN X W4 IN HEXAGONAL HUB STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 3.09 3.03 All Payors / Plans All Payors / Plans 3.09 other 3.09 3.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE ELECTROSURGICAL UTAHBALL STAINLESS STEEL BALL L11 CM OD5 MM ODSEC3/32 IN Y SHAFT STERILE DISPOSABLE RED LEEP SUP-270000000 CDM 270 RC inpatient 27.37 26.82 All Payors / Plans All Payors / Plans 27.37 other 27.37 27.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE ELECTROSURGICAL UTAHLOOP LETZ SAFE-T-GAUGE STAINLESS STEEL TUNGSTEN PLASTIC ROUND LOOP L12 MM X W20 MM L11 CM OD3/32 IN SHAFT WIRE STERILE DISPOSABLE WHITE SUP-270000000 CDM 270 RC inpatient 32.76 32.1 All Payors / Plans All Payors / Plans 32.76 other 32.76 32.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE ELECTROSURGICAL VAPR 90D 40MM DISPOSABLE STERILE LF SUCTION INTEGRATE HANDPIECE SUP-270000000 CDM 270 RC inpatient 567 555.66 All Payors / Plans All Payors / Plans 567 other 567 567 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE LOOP OD.3 MM ODSEC22 FR CUT DISPOSABLE SUP-270000000 CDM 270 RC inpatient 762.83 747.57 All Payors / Plans All Payors / Plans 762.83 other 762.83 762.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE PATIENT RETURN VALLEYLAB 9FT PVC DISPOSABLE NS LF ADULT CORD NONIRRITATE NONSENSITIZE ADHESIVE STRIP RECQM SUP-270000000 CDM 270 RC inpatient 5.49 5.38 All Payors / Plans All Payors / Plans 5.49 other 5.49 5.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENDOWRIST 12-8MM CANNULA REDUCER SUP-270000000 CDM 270 RC inpatient 44.77 43.87 All Payors / Plans All Payors / Plans 44.77 other 44.77 44.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENVELOPE ABSORBABLE TYRX LG 3.3X2.9IN POLYARYLATE MINOCYCLINE RIFAMPIN STERILE ICD SUP-270000000 CDM 270 RC inpatient 912.9 894.64 All Payors / Plans All Payors / Plans 912.9 other 912.9 912.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ESYSUIT MEDENVISION SUP-270000000 CDM 270 RC inpatient 132.6 129.95 All Payors / Plans All Payors / Plans 132.6 other 132.6 132.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EV3 AMPLATZ GOOSE NECK SNARE KIT 25MM SUP-481000000 CDM 270 RC inpatient 1303.93 1277.85 All Payors / Plans All Payors / Plans 1303.93 other 1303.93 1303.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EVACUATOR UROLOGY UROVAC BLADDER ADAPTER IRRIGATION LATEX DISPOSABLE SUP-270000000 CDM 270 RC inpatient 51.11 50.09 All Payors / Plans All Payors / Plans 51.11 other 51.11 51.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EVOLUT FX DELIVERY SYSTEM 23-29MM SUP-270000000 CDM 270 RC inpatient 4431 4342.38 All Payors / Plans All Payors / Plans 4431 other 4431 4431 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EVOLUT FX DELIVERY SYSTEM 34MM SUP-270000000 CDM 270 RC inpatient 5275 5169.5 All Payors / Plans All Payors / Plans 5275 other 5275 5275 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EVOLUT FX LOADING SYSTEM 23-29MM SUP-270000000 CDM 270 RC inpatient 819 802.62 All Payors / Plans All Payors / Plans 819 other 819 819 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EVOLUT FX LOADING SYSTEM 34MM SUP-270000000 CDM 270 RC inpatient 975 955.5 All Payors / Plans All Payors / Plans 975 other 975 975 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EVOS LARGE 3.7MM/5.5MM STEP DRILL W AO QC SUP-270000000 CDM 270 RC inpatient 1002.3 982.25 All Payors / Plans All Payors / Plans 1002.3 other 1002.3 1002.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EXPANDER TISSUE NATRELLE 14CM X 13CM 6CM 500ML SALINE-FILLED SMOOTH BREAST W/SUTURE TAB FOURTE FILL SYSTEM STYLE 133SMVT MRI-UNSAFE MODERATE HEIGHT VARIABLE PROJECTION SUP-270000000 CDM 270 RC inpatient 2835 2778.3 All Payors / Plans All Payors / Plans 2835 other 2835 2835 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FABRIC CARDIOVASCULAR HEMASHIELD 2 VELOUR COLLAGEN THK.76 MM L6 IN X W1 IN KNIT IMPREGNATE STERILE SUP-270000000 CDM 270 RC inpatient 252.08 247.04 All Payors / Plans All Payors / Plans 252.08 other 252.08 252.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FELT CARDIOVASCULAR THK1.65MM 4X4IN PTFE STERILE SUP-270000000 CDM 270 RC inpatient 367.71 360.36 All Payors / Plans All Payors / Plans 367.71 other 367.71 367.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FEMORAL STEM ACTIS COLLARD SIZE 3 SUP-270010025 CDM 270 RC inpatient 3876 3798.48 All Payors / Plans All Payors / Plans 3876 other 3876 3876 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FEMUR ACTIS COLLARD STEM STD SIZE 4 SUP-270010024 CDM 270 RC inpatient 7980 7820.4 All Payors / Plans All Payors / Plans 7980 other 7980 7980 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FIBER LASER FLEXIVA FLEXSHIELD 365 UM HIGH POWER POLISH OUTPUT TIP NONTAPER GUIDE CONNECTOR LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 684.56 670.87 All Payors / Plans All Payors / Plans 684.56 other 684.56 684.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FIBER LASER FLEXIVA TRAC TIP FLEXSHIELD HOLMIUM 200 UM FLEXIBLE CUSTOM GUIDE CONNECTOR LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 1016.15 995.83 All Payors / Plans All Payors / Plans 1016.15 other 1016.15 1016.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FIELDER XT STRAIGHT TIP GUIDEWIRE 190CM SUP-481000000 CDM 270 RC inpatient 273 267.54 All Payors / Plans All Payors / Plans 273 other 273 273 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FILIFORM CATH SUP-270000000 CDM 270 RC inpatient 121.72 119.29 All Payors / Plans All Payors / Plans 121.72 other 121.72 121.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FILLER BONE VOID .5CC DBX ALLOGRAFT PUTTY FREEZE DRIED SUP-270010031 CDM 270 RC inpatient 186.05 182.33 All Payors / Plans All Payors / Plans 186.05 other 186.05 186.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FILLER BONE VOID 1CC DBX ALLOGRAFT PUTTY FREEZE DRIED SUP-270010031 CDM 270 RC inpatient 406.73 398.6 All Payors / Plans All Payors / Plans 406.73 other 406.73 406.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FILTER EMBOLIZATION CELECT NAVALIGN 65CM 49MM 79CM 30MM 7FR PLATINUM HYDROPHILIC DISPOSABLE STERILE VENA CAVA RADIOPAQUE SUP-270000000 CDM 270 RC inpatient 1020 999.6 All Payors / Plans All Payors / Plans 1020 other 1020 1020 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FILTER INSUFFLATION HYDROPHOBIC BULB RECTUM HIGHLY VISIBLE LATEX FREE DISPOSABLE FLEX SIGMOIDOSCOPE SUP-270000000 CDM 270 RC inpatient 33.08 32.42 All Payors / Plans All Payors / Plans 33.08 other 33.08 33.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FILTER MILLEX-GS MIXED CELLULOSE ESTER .22 UM H26 MM OD33 MM 100 ML FEMALE LUER LOCK MALE LUER SLIP STERILE BLUE SUP-270000000 CDM 270 RC inpatient 11.3 11.07 All Payors / Plans All Payors / Plans 11.3 other 11.3 11.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLLOWER URETHRAL PHILLIPS 13.5IN 12FR PLASTIC REUSABLE STERILE LF DILATION CATHETER WOVEN SUP-270000000 CDM 270 RC inpatient 182.82 179.16 All Payors / Plans All Payors / Plans 182.82 other 182.82 182.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLLOWER URETHRAL PHILLIPS 13.5IN 14FR PLASTIC REUSABLE STERILE LF DILATION CATHETER WOVEN SUP-270000000 CDM 270 RC inpatient 100.18 98.18 All Payors / Plans All Payors / Plans 100.18 other 100.18 100.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLLOWER URETHRAL PHILLIPS 13.5IN 16FR PLASTIC REUSABLE STERILE LF DILATION CATHETER WOVEN SUP-270000000 CDM 270 RC inpatient 99.82 97.82 All Payors / Plans All Payors / Plans 99.82 other 99.82 99.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLLOWER URETHRAL PHILLIPS 13.5IN 18FR PLASTIC REUSABLE STERILE LF DILATION CATHETER WOVEN SUP-270000000 CDM 270 RC inpatient 104.07 101.99 All Payors / Plans All Payors / Plans 104.07 other 104.07 104.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLLOWER URETHRAL PHILLIPS 13.5IN 20FR PLASTIC REUSABLE STERILE LF DILATION CATHETER WOVEN SUP-270000000 CDM 270 RC inpatient 182.82 179.16 All Payors / Plans All Payors / Plans 182.82 other 182.82 182.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLLOWER URETHRAL PHILLIPS 13.5IN 8FR PLASTIC REUSABLE STERILE LF DILATION CATHETER WOVEN SUP-270000000 CDM 270 RC inpatient 105.59 103.48 All Payors / Plans All Payors / Plans 105.59 other 105.59 105.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS BIOPSY RADIAL JAW 4 2.8 MM LARGE CAPACITY L240 CM OD2.4 MM NEEDLE DISPOSABLE ORANGE SUP-270000000 CDM 270 RC inpatient 19.7 19.31 All Payors / Plans All Payors / Plans 19.7 other 19.7 19.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS BIOPSY RADIAL JAW 4 STAINLESS STEEL STANDARD CAPACITY L100 CM OD1.8 MM PULMONARY PRECISE BITE CONSISTENT SAMPLE RETENTION STREAMLINE CATHETER POSITION MARKER DISPOSABLE SUP-270000000 CDM 270 RC inpatient 57.38 56.23 All Payors / Plans All Payors / Plans 57.38 other 57.38 57.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS BIOPSY SPYBITE MAX L286 CM OD1.2 MM STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 1040.96 1020.14 All Payors / Plans All Payors / Plans 1040.96 other 1040.96 1040.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS BIOPSY SUPERTRAX L110 CM L2 MM OD1.7 MM SHAFT REINFORCED STACKED COIL DESIGN PROPRIETARY SHEATH SMOOTH BILATERAL CUP STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 188.02 184.26 All Payors / Plans All Payors / Plans 188.02 other 188.02 188.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS ENDOSCOPIC RADIAL JAW 4 JUMBO L240 CM OD2.8 MM NEEDLE STERILE DISPOSABLE ORANGE SUP-270000000 CDM 270 RC inpatient 89.3 87.51 All Payors / Plans All Payors / Plans 89.3 other 89.3 89.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS LENS GRIESHABER MAXGRIP OD25+ GA MICRO TEXTURE BROAD GRASP SURFACE BLUNT DISTAL END HEAVY MEMBRANE STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 176.29 172.76 All Payors / Plans All Payors / Plans 176.29 other 176.29 176.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS RADIAL JAW 4 HOT BIOPSY FORCEPS SUP-270000000 CDM 270 RC inpatient 85.12 83.42 All Payors / Plans All Payors / Plans 85.12 other 85.12 85.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS SURGICAL L25 CM END GRASPING TIP POSITIVE SUP-270000000 CDM 270 RC inpatient 325.4 318.89 All Payors / Plans All Payors / Plans 325.4 other 325.4 325.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS SURGICAL SHARKSKIN OD25+ GA ILLUMINATE STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 182.19 178.55 All Payors / Plans All Payors / Plans 182.19 other 182.19 182.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GEL ULTRASOUND AQUASONIC 100 .25 L PH 6.5-6.95 TRANSMISSION AQUEOUS DISPENSER CLEAR BLUE SLIGHT SUP-270000000 CDM 270 RC inpatient 4.2 4.12 All Payors / Plans All Payors / Plans 4.2 other 4.2 4.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GEL ULTRASOUND AQUASONIC 100 STERILE LF 20GM COMPLETE AQUEOUS TRANSMISSION FOIL POUCH SUP-270000000 CDM 270 RC inpatient 1.23 1.21 All Payors / Plans All Payors / Plans 1.23 other 1.23 1.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENERATOR NEUROSTIMULATOR PROCLAIM ELITE THK1.34 CM 25.5-MA 2-1200HZ 30.4 CU CM L1.95 IN X H2.19 IN 1.7 OZ 5 IMPLANTABLE PULSE TONIC STIMULATION MODE BATTERY SUP-270000000 CDM 270 RC inpatient 27500 26950 All Payors / Plans All Payors / Plans 27500 other 27500 27500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLENOSPHERE 36/24 SUP-270010030 CDM 270 RC inpatient 1710.07 1675.87 All Payors / Plans All Payors / Plans 1710.07 other 1710.07 1710.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIDE LENS THK6 MIL L30 MM X W5 MM L10 MM X W2.6 MM OD2.5 MM OPHTHALMIC PHACO STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 3.3 3.23 All Payors / Plans All Payors / Plans 3.3 other 3.3 3.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIDESHEATH SLENDER 7FR 10 CM DOUBLEWALL SUP-481000000 CDM 270 RC inpatient 127.5 124.95 All Payors / Plans All Payors / Plans 127.5 other 127.5 127.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIDEWIRE.038 X 150CM SUP-270000000 CDM 270 RC inpatient 29.58 28.99 All Payors / Plans All Payors / Plans 29.58 other 29.58 29.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL 7.5 285X96MM STRAW BIOGEL M NATURAL RUBBER STERILE LATEX POWDER FREE TEXTURE BEAD CUFF NONPYROGENIC SUP-270000000 CDM 270 RC inpatient 1.16 1.14 All Payors / Plans All Payors / Plans 1.16 other 1.16 1.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL 6 285X77MM STRAW NATURAL RUBBER STERILE LATEX POWDER FREE BEAD CUFF MICRO ROUGHENED NON PYROGENIC SUP-270000000 CDM 270 RC inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL 6.5 285X85MM STRAW NATURAL RUBBER STERILE LATEX POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL 7 STRAW NATURAL RUBBER STERILE LATEX POWDER FREE MICRO ROUGHENED BEAD CUFF NONPYROGENIC CURVE SUP-270000000 CDM 270 RC inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL 7.5 298X96MM STRAW NATURAL RUBBER STERILE LATEX POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL 8 299X103MM STRAW NATURAL RUBBER STERILE LATEX POWDER FREE BEAD CUFF MICRO ROUGHENED NON PYROGENIC SUP-270000000 CDM 270 RC inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL 8.5 301X109MM STRAW NATURAL RUBBER STERILE LATEX POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ECLIPSE NATURAL RUBBER 8 L299 MM X W103 MM POWDER FREE MICRO ROUGHEN SURFACE BEAD CUFF NONPYROGENIC STERILE LATEX STRAW CURVE FINGER SUP-270000000 CDM 270 RC inpatient 4.04 3.96 All Payors / Plans All Payors / Plans 4.04 other 4.04 4.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ORTHOPRO 7 298X91MM BROWN POLYISOPRENE STERILE LF POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC inpatient 137.44 134.69 All Payors / Plans All Payors / Plans 137.44 other 137.44 137.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ORTHOPRO POLYISOPRENE 7 1/2 SUP-270000000 CDM 270 RC inpatient 71.51 70.08 All Payors / Plans All Payors / Plans 71.51 other 71.51 71.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ORTHOPRO POLYISOPRENE 8 SUP-270000000 CDM 270 RC inpatient 196.65 192.72 All Payors / Plans All Payors / Plans 196.65 other 196.65 196.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ORTHOPRO POLYISOPRENE 8.5 SUP-270000000 CDM 270 RC inpatient 81.81 80.17 All Payors / Plans All Payors / Plans 81.81 other 81.81 81.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ULTRATOUCH 6 285X77MM STRAW POLYISOPRENE STERILE LF POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC inpatient 1.41 1.38 All Payors / Plans All Payors / Plans 1.41 other 1.41 1.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ULTRATOUCH 6.5 285X85MM STRAW POLYISOPRENE STERILE LF POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC inpatient 1.14 1.12 All Payors / Plans All Payors / Plans 1.14 other 1.14 1.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ULTRATOUCH 7 288X91MM STRAW POLYISOPRENE STERILE LF POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC inpatient 1.14 1.12 All Payors / Plans All Payors / Plans 1.14 other 1.14 1.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ULTRATOUCH 7.5 298X96MM STRAW POLYISOPRENE STERILE LF POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC inpatient 1.39 1.36 All Payors / Plans All Payors / Plans 1.39 other 1.39 1.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ULTRATOUCH 8 299X103MM STRAW POLYISOPRENE STERILE LF POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC inpatient 1.14 1.12 All Payors / Plans All Payors / Plans 1.14 other 1.14 1.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL PI INDICATOR 8 299X103MM BLUE BIOGEL POLYISOPRENE STERILE LF POWDER FREE SMOOTH BEAD CUFF UNDERGLOVE SUP-270000000 CDM 270 RC inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVER SURGICAL DERMA PRENE ULTRA NEOPRENE POLYURETHANE 8 L11.6 IN CHEMOTHERAPY POWDER FREE SMOOTH BEAD CUFF STERILE LATEX FREE DARK GREEN SUP-270000000 CDM 270 RC inpatient 1.36 1.33 All Payors / Plans All Payors / Plans 1.36 other 1.36 1.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GORE VIABAHN VBX BALLOON EXPANDABLE ENDOPROSTHESIS SUP-270000000 CDM 270 RC inpatient 9156 8972.88 All Payors / Plans All Payors / Plans 9156 other 9156 9156 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GORTEX SUTURE SUP-270000000 CDM 270 RC inpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GOWN SURGICAL 2XL XLONG 56IN BLUE PREVENTION PLUS DISPOSABLE STERILE LF AAMI LEVEL 4 IMPERVIOUS HOOK LOOP CLOSURE SUP-270000000 CDM 270 RC inpatient 5.08 4.98 All Payors / Plans All Payors / Plans 5.08 other 5.08 5.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GOWN SURGICAL SIRUS SMS POLYETHYLENE 2XL L49 IN AAMI LEVEL 4 IMPERVIOUS SLEEVE REINFORCE HOOK LOOP CLOSURE STERILE LATEX FREE DISPOSABLE BLUE SUP-270000000 CDM 270 RC inpatient 4.08 4 All Payors / Plans All Payors / Plans 4.08 other 4.08 4.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GOWN SURGICAL SIRUS SMS POLYETHYLENE LARGE L43 IN AAMI LEVEL 4 IMPERVIOUS SLEEVE REINFORCE HOOK LOOP CLOSURE STERILE LATEX FREE DISPOSABLE BLUE SUP-270000000 CDM 270 RC inpatient 3.04 2.98 All Payors / Plans All Payors / Plans 3.04 other 3.04 3.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GOWN SURGICAL SIRUS SMS POLYETHYLENE XL L47 IN AAMI LEVEL 4 IMPERVIOUS SLEEVE REINFORCE HOOK LOOP CLOSURE STERILE LATEX FREE DISPOSABLE BLUE SUP-270000000 CDM 270 RC inpatient 3.33 3.26 All Payors / Plans All Payors / Plans 3.33 other 3.33 3.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GOWN SURGICAL SIRUS SMS POLYETHYLENE XL XLONG L56 IN AAMI LEVEL 4 IMPERVIOUS REINFORCE HOOK LOOP CLOSURE STERILE LATEX FREE DISPOSABLE BLUE SUP-270000000 CDM 270 RC inpatient 7.88 7.72 All Payors / Plans All Payors / Plans 7.88 other 7.88 7.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT BONE 1-8MM 5CC CANCELLOUS ALLOGRAFT CHIP CRUSHED PRESERVON SUP-270010031 CDM 270 RC inpatient 266.99 261.65 All Payors / Plans All Payors / Plans 266.99 other 266.99 266.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT BONE CANCELLOUS H1-4 MM 15 ML FREEZE DRIED CHIPS SUP-270010031 CDM 270 RC inpatient 221.18 216.76 All Payors / Plans All Payors / Plans 221.18 other 221.18 221.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT BONE CANCELLOUS H1-4 MM 30 ML FREEZE DRIED CHIPS SUP-270010031 CDM 270 RC inpatient 381.84 374.2 All Payors / Plans All Payors / Plans 381.84 other 381.84 381.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT CARDIOVASCULAR HEMAGARD COLLAGEN POLYESTER STRAIGHT L40 CM X H.49 MM OD22 MM KNIT REVERSE LOCKNIT CROSS LINK EXCELLENT HEAL SUP-270000000 CDM 270 RC inpatient 783.41 767.74 All Payors / Plans All Payors / Plans 783.41 other 783.41 783.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT CARDIOVASCULAR HEMASHIELD PLATINUM 2 VELOUR COLLAGEN STRAIGHT L15 CM OD38 MM THORACIC 2 PASS SEWING WOVEN STERILE SUP-270000000 CDM 270 RC inpatient 905.45 887.34 All Payors / Plans All Payors / Plans 905.45 other 905.45 905.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT CARDIOVASCULAR INTERGARD POLYESTER VELOUR COLLAGEN 2 BRANCH L50 CM ID16 MM IDSEC8 MM THORAX ABDOMEN KNIT REVERSE LOCKNIT SUP-270000000 CDM 270 RC inpatient 1142.84 1119.98 All Payors / Plans All Payors / Plans 1142.84 other 1142.84 1142.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT CARDIOVASCULAR INTERGARD VELOUR COLLAGEN POLYESTER STRAIGHT L15 CM OD30 MM THORACIC AORTA WOVEN EXCLUSIVE WEAVE SUP-270000000 CDM 270 RC inpatient 808.4 792.23 All Payors / Plans All Payors / Plans 808.4 other 808.4 808.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT ENDOVASCULAR EXCLUDER GORE-TEX NITINOL FEP L12 CM OD27 MM SUP-270000000 CDM 270 RC inpatient 12942.8 12683.94 All Payors / Plans All Payors / Plans 12942.8 other 12942.8 12942.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT ENDOVASCULAR GORE EXCLUDER L14 CM OD14.5 MM ID12-13.5 MM CONTRALATERAL LEG AAA ACCEPTS 12 FR SHEATH SUP-270000000 CDM 270 RC inpatient 12942.8 12683.94 All Payors / Plans All Payors / Plans 12942.8 other 12942.8 12942.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT NET SUP-270000000 CDM 270 RC inpatient 654.5 641.41 All Payors / Plans All Payors / Plans 654.5 other 654.5 654.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT SOFT TISSUE ANGIOGRAFT SAPHENOUS VEIN L71-80 CM OD3 MM CRYOPRESERVE SUP-270000000 CDM 270 RC inpatient 15732.68 15418.03 All Payors / Plans All Payors / Plans 15732.68 other 15732.68 15732.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT SOFT TISSUE ARTHROFLEX THK2.5-3.5MM 70X40MM DECELLULARIZED DERMIS ALLOGRAFT SUP-270000000 CDM 270 RC inpatient 7991.32 7831.49 All Payors / Plans All Payors / Plans 7991.32 other 7991.32 7991.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT SOFT TISSUE DURAGEN BOVINE COLLAGEN MATRIX L3 IN X W1 IN CRANIAL DURA PATCH RESORBABLE SUTURABLE STERILE DURAPLASTY SUP-270010012 CDM 270 RC inpatient 1078.46 1056.89 All Payors / Plans All Payors / Plans 1078.46 other 1078.46 1078.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT SOFT TISSUE DURAGEN BOVINE COLLAGEN MATRIX L5 IN X W4 IN CRANIUM RESORBABLE SUTURABLE STERILE DURAPLASTY SUP-270010012 CDM 270 RC inpatient 3384.8 3317.1 All Payors / Plans All Payors / Plans 3384.8 other 3384.8 3384.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT SOFT TISSUE DURAMATRIX L5 IN X W4 IN SUTURABLE SUP-270000000 CDM 270 RC inpatient 2266.7 2221.37 All Payors / Plans All Payors / Plans 2266.7 other 2266.7 2266.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT SOFT TISSUE GEISTLICH BIO-GIDE PORCINE COLLAGEN MEMBRANE L50 MM X W40 MM 2 BLISTER 2 LAYER RESORBABLE STERILE SUP-270000000 CDM 270 RC inpatient 1096.2 1074.28 All Payors / Plans All Payors / Plans 1096.2 other 1096.2 1096.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT SOFT TISSUE STRAVIX PLACENTAL TISSUE L6 CM X W3 CM ALLOGRAFT SUP-270000000 CDM 270 RC inpatient 5613.3 5501.03 All Payors / Plans All Payors / Plans 5613.3 other 5613.3 5613.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT VASCULAR ARTEGRAFT 6MM 40CM WOVEN BOVINE COLLAGEN CAROTID ARTERY F/LOWER EXTREMITY BYPASS SUP-270000000 CDM 270 RC inpatient 4470.9 4381.48 All Payors / Plans All Payors / Plans 4470.9 other 4470.9 4470.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT VASCULAR GORE HEPARIN PROPATEN PTFE THIN WALL L80 CM L60 CM ID7 MM REMOVABLE RING STRETCH SUP-270000000 CDM 270 RC inpatient 4862 4764.76 All Payors / Plans All Payors / Plans 4862 other 4862 4862 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT VASCULAR GORE-TEX STANDARD WALL L40 CM ID6 MM PERIPHERAL STRETCH STERILE SUP-270000000 CDM 270 RC inpatient 1405 1376.9 All Payors / Plans All Payors / Plans 1405 other 1405 1405 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT VASCULAR GORE-TEX STANDARD WALL TAPER L45 CM ID4-7 MM PERIPHERAL STRETCH STERILE SUP-270000000 CDM 270 RC inpatient 1381.8 1354.16 All Payors / Plans All Payors / Plans 1381.8 other 1381.8 1381.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRIPPER MEDENVISION SUP-270000000 CDM 270 RC inpatient 280.5 274.89 All Payors / Plans All Payors / Plans 280.5 other 280.5 280.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUARDIAN HEMOSTASIS VALVE SUP-481000000 CDM 270 RC inpatient 37.74 36.99 All Payors / Plans All Payors / Plans 37.74 other 37.74 37.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDE CATHETER BOBBY L95 CM 8 F BALLOON GUIDE SUP-270000000 CDM 270 RC inpatient 5040 4939.2 All Payors / Plans All Payors / Plans 5040 other 5040 5040 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDE PIN ORTHOPEDIC BAYONET L 140MM OD 1.3MM STERILE DIPOSABLE 4MM 5MM CANNULATED SCREW SUP-270000000 CDM 270 RC inpatient 57.9 56.74 All Payors / Plans All Payors / Plans 57.9 other 57.9 57.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDE PIN ORTHOPEDIC L300 MM OD 3.2MM THREAD SUP-270000000 CDM 270 RC inpatient 322.37 315.92 All Payors / Plans All Payors / Plans 322.37 other 322.37 322.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDE PIN ORTHOPEDIC TRIGEN META-TAN L 343MM OD 3.2MM SUP-270000000 CDM 270 RC inpatient 210 205.8 All Payors / Plans All Payors / Plans 210 other 210 210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "GUIDE PIN, 3.0MM" SUP-270000000 CDM 270 RC inpatient 2574 2522.52 All Payors / Plans All Payors / Plans 2574 other 2574 2574 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDE ROD ORTHOPEDIC TRIGEN STAINLESS STEEL BALL L 1000MM OD 3MM BALL TIP STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 216.3 211.97 All Payors / Plans All Payors / Plans 216.3 other 216.3 216.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDE WIRE VASCULAR 1.5MM J TIP .035IN DIA 145CM LONG FIXED CORE SUP-270000000 CDM 270 RC inpatient 23.79 23.31 All Payors / Plans All Payors / Plans 23.79 other 23.79 23.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDELINER 5.5F CATHETER SUP-270000000 CDM 270 RC inpatient 835.8 819.08 All Payors / Plans All Payors / Plans 835.8 other 835.8 835.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE - GLIDEWIRE ADVANTAGE .035X260 ANGLED SUP-272C17691 CDM 270 RC inpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE CORONARY EXTRA FLOPPY 300CM SUP-481000000 CDM 270 RC inpatient 272 266.56 All Payors / Plans All Payors / Plans 272 other 272 272 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE CORONARY RUNTHROUGH EXTRA FLOPPY 180 CM SUP-481000000 CDM 270 RC inpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE ENDOSCOPIC ACROBAT 2 HYDROPHILIC L5.8 CM STRAIGHT L450 CM L4 CM OD.035 IN RADIOPAQUE CALIBRATED TIP SUP-270000000 CDM 270 RC inpatient 476.7 467.17 All Payors / Plans All Payors / Plans 476.7 other 476.7 476.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE ENDOSCOPIC HYDRA JAGWIRE PTFE HYDROPHILIC STRAIGHT L450 CM OD.035 IN BILIARY HIGH PERFORMANCE RAPID EXCHANGE RADIOPAQUE DISTAL STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 201.18 197.16 All Payors / Plans All Payors / Plans 201.18 other 201.18 201.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE ENDOSCOPIC JAGWIRE L180 CM OD.035 IN PULMONARY DISPOSABLE SUP-270000000 CDM 270 RC inpatient 286.92 281.18 All Payors / Plans All Payors / Plans 286.92 other 286.92 286.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE ORTHOPEDIC L100 MM OD.8 MM SUP-270000000 CDM 270 RC inpatient 140.4 137.59 All Payors / Plans All Payors / Plans 140.4 other 140.4 140.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE ORTHOPEDIC L150 MM OD1.1 MM SUP-270000000 CDM 270 RC inpatient 267.75 262.4 All Payors / Plans All Payors / Plans 267.75 other 267.75 267.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE ORTHOPEDIC OD.062 IN TROCAR TIP DISPOSABLE SUP-270000000 CDM 270 RC inpatient 31.5 30.87 All Payors / Plans All Payors / Plans 31.5 other 31.5 31.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE STRAIGHT AMPLATZ 180CM -- USE PMM 100541 SUP-270000000 CDM 270 RC inpatient 80.07 78.47 All Payors / Plans All Payors / Plans 80.07 other 80.07 80.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE UROLOGICAL SENSOR NITINOL STAINLESS STEEL HYDROPHILIC PTFE STRAIGHT L150 CM L3 CM OD.035 IN URETERAL FLEXIBLE TIP RADIOPAQUE LATEX FREE SUP-270000000 CDM 270 RC inpatient 89.41 87.62 All Payors / Plans All Payors / Plans 89.41 other 89.41 89.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR 1.5MM ROSEN CURVE J 260CM .035IN SS HEPARIN PTFE HEAVY DUTY MANDRIL FIX CORE EXCHANGE FLEXIBLE TIP SUP-270000000 CDM 270 RC inpatient 37.8 37.04 All Payors / Plans All Payors / Plans 37.8 other 37.8 37.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR AMPLATZ STAINLESS STEEL PTFE 3 MM RADIUS L3 CM CURVE TAPER L180 CM L7 CM OD.035 IN FLOPPY TIP EXTRA STIFF SUPPORT SUP-270000000 CDM 270 RC inpatient 87.95 86.19 All Payors / Plans All Payors / Plans 87.95 other 87.95 87.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR AMPLATZ SUPER STIFF STAINLESS STEEL PTFE 3 MM J L260 CM L7 CM OD.035 IN FLEXIBLE TIP SUP-270000000 CDM 270 RC inpatient 59.5 58.31 All Payors / Plans All Payors / Plans 59.5 other 59.5 59.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR AMPLATZ SUPER STIFF STAINLESS STEEL PTFE L3 MM SHORT FLAT TAPER L180 CM L7 CM OD.035 IN STRAIGHT TIP SUP-270000000 CDM 270 RC inpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR AMPLATZ SUPER STIFF STAINLESS STEEL PTFE SHORT TAPER L260 CM L1 CM OD.035 IN STRAIGHT TIP SUP-270000000 CDM 270 RC inpatient 52.5 51.45 All Payors / Plans All Payors / Plans 52.5 other 52.5 52.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR AMPLATZ SUPER STIFF STAINLESS STEEL PTFE STRAIGHT L260 CM L7 CM OD.035 IN FLEXIBLE TIP SUP-270000000 CDM 270 RC inpatient 73.5 72.03 All Payors / Plans All Payors / Plans 73.5 other 73.5 73.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR AMPLATZ SUPER STIFF STAINLESS STEEL PTFE TAPER L180 CM L7 CM OD.035 IN PERIPHERAL STRAIGHT TIP SUP-270000000 CDM 270 RC inpatient 73.5 72.03 All Payors / Plans All Payors / Plans 73.5 other 73.5 73.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ARISTOTLE L200CM L10 CM RADIOPAQUE OD 0.024 IN 24 GUIDEWIRE SUPPORT PROFILE WIRE HYCROPHILIC COATING L46CM SUP-270000000 CDM 270 RC inpatient 1554 1522.92 All Payors / Plans All Payors / Plans 1554 other 1554 1554 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ARISTOTLE NITINOL HYDROPHILIC L46 CM L35 CM L200 CM L10 CM OD.024 IN SOFT PROFILE RADIOPAQUE FLATTEN CORE TUBE SUP-270000000 CDM 270 RC inpatient 1554 1522.92 All Payors / Plans All Payors / Plans 1554 other 1554 1554 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR BENTSON STANDARD 145CM 6CM .035IN SS HEPARIN PTFE DISPOSABLE STERILE FIX CORE ATRAUMATIC TIP EXTRA SUP-270000000 CDM 270 RC inpatient 33.71 33.04 All Payors / Plans All Payors / Plans 33.71 other 33.71 33.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR BENTSON STANDARD 145CM 6CM .035IN SS PTFE DISPOSABLE STERILE FIX CORE ATRAUMATIC TIP EXTRA FLOPPY SUP-270000000 CDM 270 RC inpatient 28.03 27.47 All Payors / Plans All Payors / Plans 28.03 other 28.03 28.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR COONS STAINLESS STEEL PTFE 3.5 CM STRAIGHT TAPER FLOPPY L180 CM L15 CM OD.035 IN HEAVY DUTY FLEXIBLE TIP INTERVENTIONAL ATRAUMATIC SUP-270000000 CDM 270 RC inpatient 31.61 30.98 All Payors / Plans All Payors / Plans 31.61 other 31.61 31.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR COONS STAINLESS STEEL PTFE 3.5 CM STRAIGHT TAPER FLOPPY L260 CM L15 CM OD.035 IN HEAVY DUTY FLEXIBLE TIP INTERVENTIONAL ATRAUMATIC SUP-270000000 CDM 270 RC inpatient 75.58 74.07 All Payors / Plans All Payors / Plans 75.58 other 75.58 75.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR CORDIS EMERALD 3MM RADIUS J 150CM 7CM .025IN HEPARIN PTFE DISPOSABLE STERILE LF PERCUTANEOUS FLEXIBLE SUP-481000000 CDM 270 RC inpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR CORDIS EMERALD 3MM RADIUS J 260CM 7CM .025IN HEPARIN PTFE DISPOSABLE STERILE LF PERCUTANEOUS FLEXIBLE SUP-481000000 CDM 270 RC inpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR COUGAR XT HYDRO-TRACK J L190 CM OD.014 IN EXTRA SUPPORT SUP-481000000 CDM 270 RC inpatient 134.4 131.71 All Payors / Plans All Payors / Plans 134.4 other 134.4 134.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR COUGAR XT HYDRO-TRACK STRAIGHT L190 CM OD.014 IN EXTRA SUPPORT SUP-481000000 CDM 270 RC inpatient 65.28 63.97 All Payors / Plans All Payors / Plans 65.28 other 65.28 65.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ENROUTE PTFE HYDROPHILIC L5 CM L95 CM L15 CM OD .014 IN RADIOPAQUE SUP-270000000 CDM 270 RC inpatient 219.3 214.91 All Payors / Plans All Payors / Plans 219.3 other 219.3 219.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR FATHOM NITINOL STRAIGHT L200 CM L25 CM OD.016 IN STEERABLE SUP-27000000 CDM 270 RC inpatient 728.28 713.71 All Payors / Plans All Payors / Plans 728.28 other 728.28 728.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR GLIDEWIRE ADVANTAGE PTFE NITINOL HYDROPHILIC ANGLE L180 CM L25 CM OD.035 IN SUP-481000000 CDM 270 RC inpatient 272 266.56 All Payors / Plans All Payors / Plans 272 other 272 272 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR GLIDEWIRE ADVANTAGE PTFE NITINOL HYDROPHILIC ANGLED L260 CM L25 CM OD.035 IN SUP-481000000 CDM 270 RC inpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR GLIDEWIRE ANGLE STANDARD 150CM 3CM .035IN HYDROPHILIC JACKET CORE TO TIP ATRAUMATIC SUP-270000000 CDM 270 RC inpatient 29.58 28.99 All Payors / Plans All Payors / Plans 29.58 other 29.58 29.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR GLIDEWIRE HYDROPHILIC ANGLE L150 CM L3 CM OD.035 IN FLEXIBLE TIP STIFF SHAFT SUP-270000000 CDM 270 RC inpatient 46.05 45.13 All Payors / Plans All Payors / Plans 46.05 other 46.05 46.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR GLIDEWIRE NITINOL TUNGSTEN POLYURETHANE HYDROPHILIC STANDARD STRAIGHT L150 CM L3 CM OD.038 IN RADIOPAQUE FLEXIBLE SHAPEABLE KINK RESISTANCE SUP-270000000 CDM 270 RC inpatient 62.58 61.33 All Payors / Plans All Payors / Plans 62.58 other 62.58 62.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR GLIDEWIRE TUNGSTEN NITINOL POLYURETHANE HYDROPHILIC ANGLE STANDARD L180 CM L3 CM OD.035 IN PERIPHERAL JACKET CORE TO TIP ATRAUMATIC SUP-481000000 CDM 270 RC inpatient 40.49 39.68 All Payors / Plans All Payors / Plans 40.49 other 40.49 40.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR GLIDEWIRE TUNGSTEN NITINOL POLYURETHANE HYDROPHILIC ANGLE STANDARD L260 CM L3 CM OD.035 IN PERIPHERAL JACKET CORE TO TIP ATRAUMATIC SUP-481000000 CDM 270 RC inpatient 75.48 73.97 All Payors / Plans All Payors / Plans 75.48 other 75.48 75.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR HI-TORQUE BALANCE HEAVYWEIGHT J CURVE 190CM 4.5CM .014IN ELASTINITE HYDROPHILIC DISPOSABLE STERILE LF SUP-481000000 CDM 270 RC inpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR HI-TORQUE BALANCE MIDDLEWEIGHT J CURVE 190CM 3CM .014IN ELASTINITE HYDROPHILIC DISPOSABLE STERILE LF SUP-481000000 CDM 270 RC inpatient 168 164.64 All Payors / Plans All Payors / Plans 168 other 168 168 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR HI-TORQUE BALANCE MIDDLEWEIGHT STRAIGHT 190CM 3CM .014IN ELASTINITE HYDROPHILIC DISPOSABLE STERILE LF SUP-481000000 CDM 270 RC inpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR HI-TORQUE PILOT 150 J CURVE 190CM 3CM .014IN DURASTEEL POLYMER HYDROPHILIC DISPOSABLE STERILE LF CORE SUP-481000000 CDM 270 RC inpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR HI-TORQUE PILOT 50 J CURVE 190CM 3CM .014IN DURASTEEL POLYMER HYDROPHILIC DISPOSABLE STERILE LF CORE SUP-481000000 CDM 270 RC inpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR LUNDERQUIST STRAIGHT 260CM 15CM .035IN SS PTFE LF EXTRA STIFF FLEXIBLE TIP EXCHANGE SUP-270000000 CDM 270 RC inpatient 262.71 257.46 All Payors / Plans All Payors / Plans 262.71 other 262.71 262.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR MICROPUNCTURE NITINOL ANGLE L60 CM OD.018 IN SUP-270000000 CDM 270 RC inpatient 16.7 16.37 All Payors / Plans All Payors / Plans 16.7 other 16.7 16.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR MICROPUNCTURE NITINOL STRAIGHT L80 CM OD.018 IN SUP-270000000 CDM 270 RC inpatient 77.68 76.13 All Payors / Plans All Payors / Plans 77.68 other 77.68 77.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR NITINOL STAINLESS STEEL L215 CM L45 CM OD.014 IN SOFT ACCESS PRESHAPE SUP-270000000 CDM 270 RC inpatient 1264.8 1239.5 All Payors / Plans All Payors / Plans 1264.8 other 1264.8 1264.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR NITREX NITINOL 0 D STRAIGHT L60 CM L5 CM OD.018 IN PERIPHERAL CORONARY ATRAUMATIC RADIOPAQUE INTERMEDIATE TIP KINK RESISTANT SUP-270000000 CDM 270 RC inpatient 125.54 123.03 All Payors / Plans All Payors / Plans 125.54 other 125.54 125.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR OMNIWIRE NITINOL STRAIGHT L185 CM PRESSURE SUP-481000000 CDM 270 RC inpatient 1386 1358.28 All Payors / Plans All Payors / Plans 1386 other 1386 1386 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR PT2 POLYMER HYDROPHILIC L185 CM OD.014 IN MODERATE RAIL SUPPORT INTERMEDIATE J TIP SUP-481000000 CDM 270 RC inpatient 68.13 66.77 All Payors / Plans All Payors / Plans 68.13 other 68.13 68.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR PT2 STAINLESS STEEL NITINOL POLYMER HYDROPHILIC STRAIGHT L185 CM OD.014 IN MODERATE SUPPORT INTERMEDIATE TIP SUP-481000000 CDM 270 RC inpatient 140.27 137.46 All Payors / Plans All Payors / Plans 140.27 other 140.27 140.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR PUSH-PLUS MICROPUNCTURE 40CM 10CM .018IN 5FR SS 1 PART NEEDLE STIFFENED CANNULA COAXIAL CATHETER SUP-270000000 CDM 270 RC inpatient 44.56 43.67 All Payors / Plans All Payors / Plans 44.56 other 44.56 44.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ROADRUNNER HYDROPHILIC NITINOL PLATINUM TAPER L260 CM OD.035 IN RADIOPAQUE FLEXIBLE TIP SUP-270000000 CDM 270 RC inpatient 44.88 43.98 All Payors / Plans All Payors / Plans 44.88 other 44.88 44.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ROADRUNNER PC HYDROPHILIC NITINOL PLATINUM ANGLE TAPER STANDARD L260 CM OD.035 IN RADIOPAQUE STIFF SHAFT SUP-270000000 CDM 270 RC inpatient 67.52 66.17 All Payors / Plans All Payors / Plans 67.52 other 67.52 67.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ROADRUNNER PC NIMBLE NITINOL PLATINUM HYDROPHILIC L145 CM OD.035 IN ANGLE SHORT TAPER FLEXIBLE SHAFT SUP-270000000 CDM 270 RC inpatient 65.43 64.12 All Payors / Plans All Payors / Plans 65.43 other 65.43 65.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ROADRUNNER TAPER FLOPPY ANGLE SPRING COIL 300CM 8.5CM .014IN PLATINUM NITINOL PTFE DISPOSABLE STERILE SUP-270000000 CDM 270 RC inpatient 130.04 127.44 All Payors / Plans All Payors / Plans 130.04 other 130.04 130.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ROSEN J CURVE 180CM 1.5MM .035IN SS PTFE DISPOSABLE STERILE FIX CORE HEAVY DUTY EXCHANGE SUP-270000000 CDM 270 RC inpatient 16.25 15.93 All Payors / Plans All Payors / Plans 16.25 other 16.25 16.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR SAFE-T-J STANDARD CURVE TAPER 145CM 1.5CM .035IN SS PTFE DISPOSABLE STERILE FIX CORE FLEXIBLE TIP SUP-270000000 CDM 270 RC inpatient 27.28 26.73 All Payors / Plans All Payors / Plans 27.28 other 27.28 27.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR SYNCHRO SELECT NITINOL STAINLESS STEEL STANDARD L300 CM L35 CM OD.014 IN EXCHANGE SUP-270000000 CDM 270 RC inpatient 1816.5 1780.17 All Payors / Plans All Payors / Plans 1816.5 other 1816.5 1816.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR SYNCHRO SELECT NITINOL STAINLESS STEEL STRAIGHT L215 CM L35 CM OD.014 IN SOFT ACCESS LENGTH SUP-270000000 CDM 270 RC inpatient 1264.8 1239.5 All Payors / Plans All Payors / Plans 1264.8 other 1264.8 1264.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR SYNCHRO SELECT NITINOL STAINLESS STEEL STRAIGHT L300 CM L35 CM OD.014 IN SOFT EXCHANGE LENGTH SUP-270000000 CDM 270 RC inpatient 1470.5 1441.09 All Payors / Plans All Payors / Plans 1470.5 other 1470.5 1470.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR V-18 CONTROLWIRE SCITANIUM ICE STRAIGHT L110 CM L8 CM OD.018 IN RADIOPAQUE SUP-270000000 CDM 270 RC inpatient 238 233.24 All Payors / Plans All Payors / Plans 238 other 238 238 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR V-18 CONTROLWIRE SCITANIUM ICE TAPER L300 CM L8 CM OD.018 IN PERIPHERAL RADIOPAQUE STRAIGHT TIP SUP-270000000 CDM 270 RC inpatient 294 288.12 All Payors / Plans All Payors / Plans 294 other 294 294 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR VICTORY STAINLESS STEEL PTFE HYDROPHILIC STRAIGHT L300 CM OD.014 IN ODSEC12 GA BROAD MATRIX PUSHABILITY EXCELLENT CROSS ENHANCE TORQUE RADIOPAQUE SUP-270000000 CDM 270 RC inpatient 251.77 246.73 All Payors / Plans All Payors / Plans 251.77 other 251.77 251.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ZIPWIRE HYDROPHILIC L150 CM L3 CM OD.035 IN STANDARD SHAFT TAPER ANGLE TIP SUP-270000000 CDM 270 RC inpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ZIPWIRE NITINOL POLYMER HYDROPHILIC STANDARD STRAIGHT L150 CM L3 CM OD.035 IN SUPER ELASTIC CORE PRECISE TORQUE CONTROL SUPERIOR VISIBILITY SUP-270000000 CDM 270 RC inpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "GUIDEWIRE, PTFE 035 X 180CM FC 3MM J" SUP-481000000 CDM 270 RC inpatient 9.49 9.3 All Payors / Plans All Payors / Plans 9.49 other 9.49 9.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDING LAUNCHER 7F EBU 3.5 SUP-270000000 CDM 270 RC inpatient 72.25 70.81 All Payors / Plans All Payors / Plans 72.25 other 72.25 72.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDING LAUNCHER 7F EBU 4.0 SUP-270000000 CDM 270 RC inpatient 72.25 70.81 All Payors / Plans All Payors / Plans 72.25 other 72.25 72.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GW VSI TRU-TORQUE WIRE 260CM SUP-481000000 CDM 270 RC inpatient 132.6 129.95 All Payors / Plans All Payors / Plans 132.6 other 132.6 132.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC .9% NACL 500 ML SUP-270002114 CDM 270 RC inpatient 6.4 6.27 All Payors / Plans All Payors / Plans 6.4 other 6.4 6.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APHERESIS SUPPLIES SUP-27000000 CDM 270 RC inpatient 811.78 795.54 All Payors / Plans All Payors / Plans 811.78 other 811.78 811.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARDIAC CATH LAB SUPPLIES SUP-481000000 CDM 270 RC inpatient 35700 34986 All Payors / Plans All Payors / Plans 35700 other 35700 35700 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COVERSITE 4X4 PLUS SUP-270041318 CDM 270 RC inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COVERSITE PLUS 6X6 SUP-270041323 CDM 270 RC inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DAVINCI PACK SUP-270010034 CDM 270 RC inpatient 280.8 275.18 All Payors / Plans All Payors / Plans 280.8 other 280.8 280.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DENTAL CROWN CHARGE SUP-270009241 CDM 270 RC inpatient 41.24 40.42 All Payors / Plans All Payors / Plans 41.24 other 41.24 41.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIALYSIS SUPPLIES SUP-270001000 CDM 270 RC inpatient 102 99.96 All Payors / Plans All Payors / Plans 102 other 102 102 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDOFORM 2X2 FENESTRATED COLLAGEN SUP-270041333 CDM 270 RC inpatient 12.97 12.71 All Payors / Plans All Payors / Plans 12.97 other 12.97 12.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HIP SUPPLIES SUP-270010024 CDM 270 RC inpatient 550 539 All Payors / Plans All Payors / Plans 550 other 550 550 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HYDROFERA BLUE BACTERIO DRESS 4X4 SUP-270041330 CDM 270 RC inpatient 7.62 7.47 All Payors / Plans All Payors / Plans 7.62 other 7.62 7.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INSTRUMENT TRAY SUP-270009300 CDM 270 RC inpatient 58 56.84 All Payors / Plans All Payors / Plans 58 other 58 58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IODOFLEX 5 GRAM SUP-270041319 CDM 270 RC inpatient 5.72 5.61 All Payors / Plans All Payors / Plans 5.72 other 5.72 5.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KNEE SUPPLIES SUP-270010025 CDM 270 RC inpatient 3264 3198.72 All Payors / Plans All Payors / Plans 3264 other 3264 3264 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LYOFOAM 3X3.4 SUP-270041374 CDM 270 RC inpatient 2.64 2.59 All Payors / Plans All Payors / Plans 2.64 other 2.64 2.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MED SURG SUPPLIES SUP-270000000 CDM 270 RC inpatient 54.6 53.51 All Payors / Plans All Payors / Plans 54.6 other 54.6 54.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEDIHONEY CALC ALG 4X5 SUP-270041327 CDM 270 RC inpatient 10.19 9.99 All Payors / Plans All Payors / Plans 10.19 other 10.19 10.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEDIHONEY HCS 4.3X4.3 SUP-270041386 CDM 270 RC inpatient 10.62 10.41 All Payors / Plans All Payors / Plans 10.62 other 10.62 10.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEDIHONEY HCS NON-AD 4.3X4.3 SUP-270041328 CDM 270 RC inpatient 10.52 10.31 All Payors / Plans All Payors / Plans 10.52 other 10.52 10.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX 3X3 BORDERED FOAM SUP-270041377 CDM 270 RC inpatient 2.58 2.53 All Payors / Plans All Payors / Plans 2.58 other 2.58 2.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX BORDERED SACRUM SUP-270041379 CDM 270 RC inpatient 7.6 7.45 All Payors / Plans All Payors / Plans 7.6 other 7.6 7.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX TRANSFER 6X8 SUP-270041315 CDM 270 RC inpatient 8.74 8.57 All Payors / Plans All Payors / Plans 8.74 other 8.74 8.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX TRANSFER 8X20 SUP-270041316 CDM 270 RC inpatient 23.8 23.32 All Payors / Plans All Payors / Plans 23.8 other 23.8 23.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPTILOCK NON-ADHESIVE 8X12 SUP-270041405 CDM 270 RC inpatient 6.58 6.45 All Payors / Plans All Payors / Plans 6.58 other 6.58 6.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PACEMAKER SUP-275000000 CDM 270 RC inpatient 402.9 394.84 All Payors / Plans All Payors / Plans 402.9 other 402.9 402.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PEDIATRIC DENTAL CHARGE SUP-270009240 CDM 270 RC inpatient 84.8 83.1 All Payors / Plans All Payors / Plans 84.8 other 84.8 84.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERITONEAL DIALYSIS SUPPLY SUP-270001050 CDM 270 RC inpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POLYMEM 4X12.5 SUP-270041404 CDM 270 RC inpatient 22.1 21.66 All Payors / Plans All Payors / Plans 22.1 other 22.1 22.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POLYMEM 4X4 SUP-270041403 CDM 270 RC inpatient 7 6.86 All Payors / Plans All Payors / Plans 7 other 7 7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROFORE BANDAGE COMPRESSION PAD SUP-270041406 CDM 270 RC inpatient 8.8 8.62 All Payors / Plans All Payors / Plans 8.8 other 8.8 8.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROFORE WRAPS SUP-270041320 CDM 270 RC inpatient 13.52 13.25 All Payors / Plans All Payors / Plans 13.52 other 13.52 13.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROMOGRAN/PRISMA 4.34 SQ IN SUP-270041384 CDM 270 RC inpatient 9.8 9.6 All Payors / Plans All Payors / Plans 9.8 other 9.8 9.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPINAL FUSION FIXATION SUPPLY SUP-270010020 CDM 270 RC inpatient 503.57 493.5 All Payors / Plans All Payors / Plans 503.57 other 503.57 503.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST 3 IN W/1 BOOT REGULAR SUP-270041335 CDM 270 RC inpatient 136.2 133.48 All Payors / Plans All Payors / Plans 136.2 other 136.2 136.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST 3 INCH NO BOOT SUP-270041334 CDM 270 RC inpatient 122.96 120.5 All Payors / Plans All Payors / Plans 122.96 other 122.96 122.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VAGAL NERVE PACKAGE SUP-270010003 CDM 270 RC inpatient 1393.08 1365.22 All Payors / Plans All Payors / Plans 1393.08 other 1393.08 1393.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VISCOPASTE SUP-270041322 CDM 270 RC inpatient 6.77 6.63 All Payors / Plans All Payors / Plans 6.77 other 6.77 6.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD43 MM ID26 MM HIP SUP-270010023 CDM 270 RC inpatient 6195.02 6071.12 All Payors / Plans All Payors / Plans 6195.02 other 6195.02 6195.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP SUP-270010024 CDM 270 RC inpatient 950 931 All Payors / Plans All Payors / Plans 950 other 950 950 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP SUP-270010023 CDM 270 RC inpatient 6195.02 6071.12 All Payors / Plans All Payors / Plans 6195.02 other 6195.02 6195.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP SUP-270010023 CDM 270 RC inpatient 6195.02 6071.12 All Payors / Plans All Payors / Plans 6195.02 other 6195.02 6195.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP SUP-270010023 CDM 270 RC inpatient 6195.02 6071.12 All Payors / Plans All Payors / Plans 6195.02 other 6195.02 6195.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP SUP-270010023 CDM 270 RC inpatient 6195.02 6071.12 All Payors / Plans All Payors / Plans 6195.02 other 6195.02 6195.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP SUP-270010023 CDM 270 RC inpatient 1365 1337.7 All Payors / Plans All Payors / Plans 1365 other 1365 1365 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL -4MM OFFSET TAPER 28MM HIP BIOLOX DELTA V40 SUP-270010024 CDM 270 RC inpatient 500 490 All Payors / Plans All Payors / Plans 500 other 500 500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL ARTICUL/EZE +1.5MM 12/14 TAPER 36MM BIOLOX DELTA TITANIUM STERILE LF HIP CEMENTLESS SUP-270010024 CDM 270 RC inpatient 4029 3948.42 All Payors / Plans All Payors / Plans 4029 other 4029 4029 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL ARTICUL/EZE +5MM 12/14 TAPER 32MM BIOLOX DELTA STERILE LF HIP SUP-270010024 CDM 270 RC inpatient 3876 3798.48 All Payors / Plans All Payors / Plans 3876 other 3876 3876 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL ARTICUL/EZE +5MM 12/14 TAPER 36MM BIOLOX DELTA TITANIUM STERILE LF HIP CEMENTLESS SUP-270010024 CDM 270 RC inpatient 3876 3798.48 All Payors / Plans All Payors / Plans 3876 other 3876 3876 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL ARTICUL/EZE +8.5MM 12/14 TAPER 36MM BIOLOX DELTA TITANIUM STERILE LF HIP CEMENTLESS SUP-270010024 CDM 270 RC inpatient 7980 7820.4 All Payors / Plans All Payors / Plans 7980 other 7980 7980 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL BIOLOX DELTA +7.5 MM OD36 MM HIP C TAPER SUP-270010024 CDM 270 RC inpatient 500 490 All Payors / Plans All Payors / Plans 500 other 500 500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL BIOLOX DELTA -3.5 MM 12/14 SMALL OD36 MM HIP ACETABULAR STERILE SUP-270010025 CDM 270 RC inpatient 3876 3798.48 All Payors / Plans All Payors / Plans 3876 other 3876 3876 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL V40 BIOLOX DELTA +2.5 MM OFFSET TAPER OD36 MM HIP SUP-270010024 CDM 270 RC inpatient 7665.06 7511.76 All Payors / Plans All Payors / Plans 7665.06 other 7665.06 7665.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL V40 BIOLOX DELTA 0 MM OFFSET TAPER OD36 MM HIP SUP-270010024 CDM 270 RC inpatient 7665.02 7511.72 All Payors / Plans All Payors / Plans 7665.02 other 7665.02 7665.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL V40 LFIT COCR -4 MM OFFSET TAPER OD28 MM HIP PRIMARY SUP-270010024 CDM 270 RC inpatient 500 490 All Payors / Plans All Payors / Plans 500 other 500 500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD HUMERAL UNIVERS II H18 MM OD46 MM SHOULDER ANATOMIC RESTORATION VARIABLE ADJUSTMENT STERILE SUP-270010030 CDM 270 RC inpatient 5670 5556.6 All Payors / Plans All Payors / Plans 5670 other 5670 5670 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD MARINER POLYAXIAL SUP-270000000 CDM 270 RC inpatient 1836 1799.28 All Payors / Plans All Payors / Plans 1836 other 1836 1836 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD MATCH 3.0MM PRECISION NEURO SUP-270000000 CDM 270 RC inpatient 145.96 143.04 All Payors / Plans All Payors / Plans 145.96 other 145.96 145.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEMOSPRAY 7 SUP-270000000 CDM 270 RC inpatient 5250 5145 All Payors / Plans All Payors / Plans 5250 other 5250 5250 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEMOSTAT ABSORBABLE FIBRILLAR SURGICEL L4 IN X W2 IN LIGHTWEIGHT LAYER STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 100.96 98.94 All Payors / Plans All Payors / Plans 100.96 other 100.96 100.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEMOSTAT ABSORBABLE L14 IN X W2 IN SUP-270009023 CDM 270 RC inpatient 21 20.58 All Payors / Plans All Payors / Plans 21 other 21 21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEMOSTAT ABSORBABLE SURGICEL 3X2IN STERILE FLEXIBLE SUP-270009023 CDM 270 RC inpatient 21 20.58 All Payors / Plans All Payors / Plans 21 other 21 21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEMOSTAT ABSORBABLE SURGICEL FIBRILLAR 2X1IN STERILE LIGHTWEIGHT LAYER TUFT SUP-270000000 CDM 270 RC inpatient 92.34 90.49 All Payors / Plans All Payors / Plans 92.34 other 92.34 92.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEMOSTAT ABSORBABLE SURGICEL L8 IN X W4 IN SHEER WEAVE STERILE DISPOSABLE SUP-270009023 CDM 270 RC inpatient 21 20.58 All Payors / Plans All Payors / Plans 21 other 21 21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HOLDER LIMB QUICK RELEASE 60 INCH STRAP SUP-270009040 CDM 270 RC inpatient 3.42 3.35 All Payors / Plans All Payors / Plans 3.42 other 3.42 3.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HOOD FLYTE SURGICOOL SUP-270000000 CDM 270 RC inpatient 40.4 39.59 All Payors / Plans All Payors / Plans 40.4 other 40.4 40.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HOOD SURGEON FLYTE STERI-SHIELD PEELAWAY FACE SHIELD LATEX FREE PERSONAL PROTECTION SYSTEM SUP-270000000 CDM 270 RC inpatient 84.2 82.52 All Payors / Plans All Payors / Plans 84.2 other 84.2 84.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HOOK RETRACTION 5 MM BLUNT ELASTIC STAY DISPOSABLE SUP-270000000 CDM 270 RC inpatient 28.3 27.73 All Payors / Plans All Payors / Plans 28.3 other 28.3 28.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HOOK RETRACTION LONE STAR 12 MM BLUNT ELASTIC STAY STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 131.87 129.23 All Payors / Plans All Payors / Plans 131.87 other 131.87 131.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HOOK RETRACTION LONE STAR STAINLESS STEEL 5 MM SHARP ELASTIC STAY STERILE LATEX FREE DISPOSABLE INDIVIDUALLY WRAPPED SUP-270000000 CDM 270 RC inpatient 91.43 89.6 All Payors / Plans All Payors / Plans 91.43 other 91.43 91.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HOOK RETRACTOR LONE STAR STAINLESS STEEL 5 MM SHARP ELASTIC STAY STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 990.7 970.89 All Payors / Plans All Payors / Plans 990.7 other 990.7 990.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROGEN PEROXIDE 4OZ SUP-270000000 CDM 270 RC inpatient 1.24 1.22 All Payors / Plans All Payors / Plans 1.24 other 1.24 1.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ICD COBALT XT MRI DR SURESCAN DEVICE SUP-275000000 CDM 270 RC inpatient 11772 11536.56 All Payors / Plans All Payors / Plans 11772 other 11772 11772 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ICD QUADRA ASSURA MP CRT-D DR4 CONNECTOR SUP-275000000 CDM 270 RC inpatient 18090 17728.2 All Payors / Plans All Payors / Plans 18090 other 18090 18090 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMOBILIZER ORTHOPEDIC ALUMINUM FOAM 26 IN OD 20.5 IN ODSEC 22 IN L KNEE 3 PANEL LOOP LOCK CLOSURE POSTERIOR STAY ADJUSTABLE LATEX FREE SUP-270009016 CDM 270 RC inpatient 32.05 31.41 All Payors / Plans All Payors / Plans 32.05 other 32.05 32.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMOBILIZER ORTHOPEDIC ALUMINUM FOAM NYLON CONTOUR L22 IN OD29 IN KNEE ELASTIC PATELLA STRAP PERFORATE BREATHABLE SUP-270009016 CDM 270 RC inpatient 18.25 17.89 All Payors / Plans All Payors / Plans 18.25 other 18.25 18.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMOBILIZER ORTHOPEDIC ALUMINUM TRICOT UNIVERSAL L12 IN KNEE POSTERIOR STAY HOOK LOOP CLOSURE 3 PANEL LATEX FREE SUP-270009016 CDM 270 RC inpatient 28.5 27.93 All Payors / Plans All Payors / Plans 28.5 other 28.5 28.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMPELLA CP WITH SMARTASSIST SUP-481000000 CDM 270 RC inpatient 38500 37730 All Payors / Plans All Payors / Plans 38500 other 38500 38500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMPLANT CORNERSTONE L-SR 7X14X11 SUP-270010020 CDM 270 RC inpatient 1995 1955.1 All Payors / Plans All Payors / Plans 1995 other 1995 1995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMPLANT HIP INSIGNIA 5 STEM 105 MM NK 38.5 MM HIGH STEM HIGH OFFSET STERILE SUP-270010024 CDM 270 RC inpatient 1800 1764 All Payors / Plans All Payors / Plans 1800 other 1800 1800 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMPLANT PUTTY OSTEOSTRUX 10CC SUP-270010031 CDM 270 RC inpatient 1424.08 1395.6 All Payors / Plans All Payors / Plans 1424.08 other 1424.08 1424.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMPLANT STRIP POCKET DBM 20CC SUP-270010031 CDM 270 RC inpatient 3168.61 3105.24 All Payors / Plans All Payors / Plans 3168.61 other 3168.61 3168.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INBONE STEINMANN PIN 2.4MM SUP-270000000 CDM 270 RC inpatient 655.2 642.1 All Payors / Plans All Payors / Plans 655.2 other 655.2 655.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSERT ACETABULAR ADM MOBILE BEARING HIP RESTORATION X3 POLYETHYLENE H9.9 MM OD48 MM ODSEC54 MM ID28 MM HIP SUP-270010024 CDM 270 RC inpatient 775 759.5 All Payors / Plans All Payors / Plans 775 other 775 775 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSERT CLAMP EVERCLIP FOGARTY HYDRAGRIP L33 MM ATRAUMATIC OCCLUSION SOFT COMPLIANT TRACTION GENTLE SURROUND VESSEL SET STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 46.33 45.4 All Payors / Plans All Payors / Plans 46.33 other 46.33 46.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSERT CLAMP EVERCLIP FOGARTY HYDRAGRIP L61 MM ATRAUMATIC OCCLUSION SOFT COMPLIANT TRACTION GENTLE SURROUND VESSEL RUBBER PYRAMID SET STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 39.33 38.54 All Payors / Plans All Payors / Plans 39.33 other 39.33 39.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSERT CLAMP FOGARTY HYDRAGRIP L86 MM SOFTJAW SET ATRAUMATIC OCCLUSION HIGH FLOW STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 3.88 3.8 All Payors / Plans All Payors / Plans 3.88 other 3.88 3.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSERT NEEDLE HOLDER SUTURE RETENTION SLOT DISPOSABLE OCTOBASE RETRACTOR SUP-270000000 CDM 270 RC inpatient 98.6 96.63 All Payors / Plans All Payors / Plans 98.6 other 98.6 98.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSERT TIBIAL ATTUNE 5 H5 MM KNEE RIGHT CRUCIATE RETAIN MEDIAL STABILIZE SUP-270010025 CDM 270 RC inpatient 6720 6585.6 All Payors / Plans All Payors / Plans 6720 other 6720 6720 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSERT TIBIAL GMK 5 H11 MM RIGHT FIXED SPHERE FLEX SUP-270010024 CDM 270 RC inpatient 3366 3298.68 All Payors / Plans All Payors / Plans 3366 other 3366 3366 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSTRUMENT BIOPSY BARD MAX-CORE ANGLE 22MM 20CM 13.8CM 18GA PINK DISPOSABLE STERILE LF PROSTATIC 2 TRIGGER ULTRA SHARP SUP-270000000 CDM 270 RC inpatient 51.46 50.43 All Payors / Plans All Payors / Plans 51.46 other 51.46 51.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSTRUMENT BIOPSY BARD MAX-CORE L16 CM OD14 GA 2 TRIGGER ULTRA SHARP TIP BEVEL TROCAR ANGLE NOTCH STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 570.47 559.06 All Payors / Plans All Payors / Plans 570.47 other 570.47 570.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSTRUMENT ELECTROSURGICAL LIGASURE FORCETRIAD TISSUEFECT 28D 3.4V 14.7MM CURVE 18.8CM 16.5X1-4MM DISPOSABLE STERILE LF SUP-270000000 CDM 270 RC inpatient 1927.54 1888.99 All Payors / Plans All Payors / Plans 1927.54 other 1927.54 1927.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSTRUMENT ENDOSCOPIC SIGMOID 30CM 6FT 18FR DISPOSABLE STERILE PREATTACH TUBE ON OFF CONTROL SIGMOIDOSCOPY COLONOSCOPY SUP-270000000 CDM 270 RC inpatient 7.46 7.31 All Payors / Plans All Payors / Plans 7.46 other 7.46 7.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTERTAN 10MM X 18CM 130DEG SUP-270000000 CDM 270 RC inpatient 1687.5 1653.75 All Payors / Plans All Payors / Plans 1687.5 other 1687.5 1687.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTERTAN 11.5MM X 18CM 125DEG SUP-270000000 CDM 270 RC inpatient 2835 2778.3 All Payors / Plans All Payors / Plans 2835 other 2835 2835 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTERTAN LAG/COMP KIT 100/95 SUP-270000000 CDM 270 RC inpatient 769.25 753.87 All Payors / Plans All Payors / Plans 769.25 other 769.25 769.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTERTAN LAG/COMP KIT 85/80 SUP-270000000 CDM 270 RC inpatient 1600.04 1568.04 All Payors / Plans All Payors / Plans 1600.04 other 1600.04 1600.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTERTAN LAG/COMP KIT 90/85 SUP-270000000 CDM 270 RC inpatient 1292.34 1266.49 All Payors / Plans All Payors / Plans 1292.34 other 1292.34 1292.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER HEMOSTASIS FAST CATH LUER LOCK GUIDEWIRE AND REPOSITIONING SLEEVE 7 FR 12CM 0.038 IN SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER HEMOSTATSIS FAST CATH LUER LOCK GUIDEWIRE AND REPOSITIONING SLEEVE 8.5 FR 12 CM 0.038 IN SUP-481000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER MICRO STIFFEN 5FR SUP-270000000 CDM 270 RC inpatient 38.18 37.42 All Payors / Plans All Payors / Plans 38.18 other 38.18 38.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH AGILIS NXT DUAL REACH .032 IN LARGE CURL CURVE L50 MM L71 CM OD8.5 FR STEERABLE ERGONOMIC HANDLE ATRAUMATIC TIP INTEGRATE HEMOSTASIS VALVE RADIOPAQUE TIP MARKER SUP-270000000 CDM 270 RC inpatient 1785 1749.3 All Payors / Plans All Payors / Plans 1785 other 1785 1785 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH CHECK-FLO FLEXOR .035 IN L70 CM OD7 FR ID.1 IN ANL0 CURVE STRAIGHT TIP ANSEL MODIFICATION HIGH FLEX DILATOR GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 162.83 159.57 All Payors / Plans All Payors / Plans 162.83 other 162.83 162.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH CHECK-FLO FLEXOR 6 FR 1 CURVE MULTIPURPOSE TIP ANSEL MODIFICATION HIGH FLEX DILATOR GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 110.16 107.96 All Payors / Plans All Payors / Plans 110.16 other 110.16 110.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH CORDIS BRITE TIP 35CM 35MM 6FR GREEN SILICONE DISPOSABLE STERILE LF ENDOVASCULAR KINK RESISTANT SUP-270000000 CDM 270 RC inpatient 21.42 20.99 All Payors / Plans All Payors / Plans 21.42 other 21.42 21.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH CORDIS BRITE TIP 35CM 35MM 7FR ORANGE SILICONE DISPOSABLE STERILE LF ENDOVASCULAR KINK RESISTANT SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH FAST-CATH STRAIGHT J L12 CM OD12 FR INTRACARDIAC LARGE LUMEN HEMOSTASIS VALVE SIDEPORT DILATOR ACCEPTS .038 IN GUIDEWIRE SUP-481000000 CDM 270 RC inpatient 45.9 44.98 All Payors / Plans All Payors / Plans 45.9 other 45.9 45.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH FAST-CATH SWARTZ SR .038 IN J SR0 CURVE L63 CM L145 CM OD8 FR TRANSSEPTAL GUIDE HEMOSTASIS VALVE SIDEPORT DILATOR RADIOPAQUE TIP MARKER SUP-270000000 CDM 270 RC inpatient 181.56 177.93 All Payors / Plans All Payors / Plans 181.56 other 181.56 181.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC L10 CM L2.5 CM OD4 FR PERIPHERAL KINK RESISTANT DESIGN CROSS CUT VALVE SMOOTH TRANSITION DILATOR SUP-270000000 CDM 270 RC inpatient 14.88 14.58 All Payors / Plans All Payors / Plans 14.88 other 14.88 14.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE .035 IN L10 CM L2.5 CM ID8 FR PERIPHERAL DILATOR KINK RESISTANT SUP-270000000 CDM 270 RC inpatient 14.88 14.58 All Payors / Plans All Payors / Plans 14.88 other 14.88 14.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE .035 IN L10 CM L2.5 CM OD6 FR MINI GUIDEWIRE DILATOR SUP-270000000 CDM 270 RC inpatient 18.38 18.01 All Payors / Plans All Payors / Plans 18.38 other 18.38 18.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE .038 IN L10 CM L2.5 CM ID10 FR PERIPHERAL GUIDEWIRE DILATOR KINK RESISTANT SUP-481000000 CDM 270 RC inpatient 8.67 8.5 All Payors / Plans All Payors / Plans 8.67 other 8.67 8.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE .038 IN L10 CM L2.5 CM ID6 FR CORONARY GUIDEWIRE DILATOR KINK RESISTANT SUP-270009215 CDM 270 RC inpatient 8.67 8.5 All Payors / Plans All Payors / Plans 8.67 other 8.67 8.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE .038 IN L10 CM L2.5 CM ID7 FR CORONARY GUIDEWIRE DILATOR KINK RESISTANT SUP-481000000 CDM 270 RC inpatient 8.67 8.5 All Payors / Plans All Payors / Plans 8.67 other 8.67 8.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE .038 IN L10 CM L2.5 CM ID8 FR CORONARY GUIDEWIRE DILATOR KINK RESISTANT SUP-270009215 CDM 270 RC inpatient 8.67 8.5 All Payors / Plans All Payors / Plans 8.67 other 8.67 8.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE .038 IN L10 CM L2.5 CM ID9 FR CORONARY GUIDEWIRE DILATOR KINK RESISTANT SUP-481000000 CDM 270 RC inpatient 8.67 8.5 All Payors / Plans All Payors / Plans 8.67 other 8.67 8.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE L25 CM L2.5 CM ID10 FR PERIPHERAL DILATOR KINK RESISTANT SUP-270000000 CDM 270 RC inpatient 29.16 28.58 All Payors / Plans All Payors / Plans 29.16 other 29.16 29.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE L25 CM L2.5 CM ID6 FR CORONARY DILATOR KINK RESISTANT SUP-270000000 CDM 270 RC inpatient 17.49 17.14 All Payors / Plans All Payors / Plans 17.49 other 17.49 17.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE L25 CM L2.5 CM ID8 FR CORONARY DILATOR KINK RESISTANT SMOOTH TRANSITION SNAP ON SUP-270009215 CDM 270 RC inpatient 36.02 35.3 All Payors / Plans All Payors / Plans 36.02 other 36.02 36.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE L25 CM L2.5 CM ID9 FR CORONARY DILATOR KINK RESISTANT SUP-270000000 CDM 270 RC inpatient 29.16 28.58 All Payors / Plans All Payors / Plans 29.16 other 29.16 29.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE R/O II L6 CM L2.5 CM ID6 FR DILATOR RADIOPAQUE MARKER SUP-270000000 CDM 270 RC inpatient 39.38 38.59 All Payors / Plans All Payors / Plans 39.38 other 39.38 39.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE STAINLESS STEEL HYDROPHILIC PTFE L10 CM L2.5 CM ID5 FR CORONARY DILATOR KINK RESISTANT SMOOTH TRANSITION SNAP ON ACCEPTS .038 IN GUIDEWIRE SUP-481000000 CDM 270 RC inpatient 14.45 14.16 All Payors / Plans All Payors / Plans 14.45 other 14.45 14.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PRELUDE SNAP L13 CM OD8 FR ROBUST VALVE SPLITTABLE SIDEPORT HUB BLUE SUP-275000000 CDM 270 RC inpatient 178.5 174.93 All Payors / Plans All Payors / Plans 178.5 other 178.5 178.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRRIGATOR ENDOSCOPIC PATHFINDER PLUS BULB L10 IN UROLOGICAL TUBE LUER LOCK STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 83.27 81.6 All Payors / Plans All Payors / Plans 83.27 other 83.27 83.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRRIGATOR SUCTION SUP-270000000 CDM 270 RC inpatient 584.5 572.81 All Payors / Plans All Payors / Plans 584.5 other 584.5 584.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility JELLY LUBRICANT E-Z 2 OZ WATER SOLUBLE FLIP TOP TUBE GREASELESS STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 3.52 3.45 All Payors / Plans All Payors / Plans 3.52 other 3.52 3.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT 13.5FR X 16CM MAHURKAR SUP-270000000 CDM 270 RC inpatient 1229.68 1205.09 All Payors / Plans All Payors / Plans 1229.68 other 1229.68 1229.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT 13.5FR X 24CM MAHURKAR SUP-270000000 CDM 270 RC inpatient 155.93 152.81 All Payors / Plans All Payors / Plans 155.93 other 155.93 155.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT ARTERIAL LINE QUICKFLASH POLYURETHANE L1 1/2 IN OD20 GA ODSEC.018 IN RADIAL ARTERY CATHETER RADIOPAQUE SPRING GUIDEWIRE NEEDLE LATEX FREE SUP-270000000 CDM 270 RC inpatient 25.37 24.86 All Payors / Plans All Payors / Plans 25.37 other 25.37 25.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT ARTERIAL PTFE .028 IN 40 CM MINI L6 IN L2.25 IN OD18 GA ODSEC19 GA RADIOPAQUE FEMALE LUER HUB GUIDEWIRE NEEDLE SUP-270009171 CDM 270 RC inpatient 29.86 29.26 All Payors / Plans All Payors / Plans 29.86 other 29.86 29.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT ARTHROSCOPIC FIXATION INTERNALBRACE SWIVELOCK BIOCOMPOSITE STANDARD OD4.75 MM ODSEC3.5 MM RADIOPAQUE SUP-270000000 CDM 270 RC inpatient 3139.5 3076.71 All Payors / Plans All Payors / Plans 3139.5 other 3139.5 3139.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT BONE CEMENT AUTOPLEX VERTAPLEX WITHOUT NEEDLE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 2185.93 2142.21 All Payors / Plans All Payors / Plans 2185.93 other 2185.93 2185.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT BONE CEMENT FEMUR 2 RESTRICTOR PRESSURIZER SPONGE BRUSH 2 CURETTES INSERTER STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 816.9 800.56 All Payors / Plans All Payors / Plans 816.9 other 816.9 816.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT BONE GRAFT OSTEOSET 25ML CALCIUM SULFATE RESORBABLE BEAD SUP-270000000 CDM 270 RC inpatient 2618.75 2566.38 All Payors / Plans All Payors / Plans 2618.75 other 2618.75 2618.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT CATHETER L4.5 IN OD9 FR CENTRAL VENOUS 2 LUMEN SUP-270000000 CDM 270 RC inpatient 182.96 179.3 All Payors / Plans All Payors / Plans 182.96 other 182.96 182.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT CATHETER MAHURKAR ELITE L20 CM OD13.5 FR STRAIGHT EXTENSION SUP-270000000 CDM 270 RC inpatient 55.66 54.55 All Payors / Plans All Payors / Plans 55.66 other 55.66 55.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT CATHETER MAHURKAR POLYURETHANE .038 IN STRAIGHT J L19.5 CM L70 CM OD13.5 FR 1.7 ML 2 LUMEN HIGH FLOW CURVE EXTENSION GUIDEWIRE STERILE HEMODIALYSIS SUP-270000000 CDM 270 RC inpatient 161.42 158.19 All Payors / Plans All Payors / Plans 161.42 other 161.42 161.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT CATHETER PALINDROME L19 CM OD 14.5 FR TWO LUMEN LATEX FREE SUP-270000000 CDM 270 RC inpatient 454.41 445.32 All Payors / Plans All Payors / Plans 454.41 other 454.41 454.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT CATHETER THROMBECTOMY RED 62 REPERFUSION 0.076IN 0.062IN LUMEN 138CM LOW-PROFILE W/PENUMBRA ASPIRATION TUBING SUP-270000000 CDM 270 RC inpatient 5953.5 5834.43 All Payors / Plans All Payors / Plans 5953.5 other 5953.5 5953.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT CATHETER UROMAX ULTRA QUADRA-FOLD ENCORE HYDROPLUS POLYMER L75 CM L4 CM OD5.8 FR ODSEC15 FR URINARY TRACT HIGH PRESSURE KINK RESISTANT SHAFT RADIOPAQUE TAPER DISTAL END LATEX FREE ACCEPTS .038 IN GUIDEWIRE RADIAL DILATATION SUP-270009094 CDM 270 RC inpatient 199.49 195.5 All Payors / Plans All Payors / Plans 199.49 other 199.49 199.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT CATHETER UROMAX ULTRA QUADRA-FOLD ENCORE HYDROPLUS POLYMER L75 CM L4 CM OD5.8 FR ODSEC18 FR URINARY TRACT HIGH PRESSURE KINK RESISTANT SHAFT RADIOPAQUE TAPER DISTAL END LATEX FREE ACCEPTS .038 IN GUIDEWIRE RADIAL DILATATION SUP-270000000 CDM 270 RC inpatient 562.91 551.65 All Payors / Plans All Payors / Plans 562.91 other 562.91 562.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRAINAGE JACKSON-PRATT PVC 1/8 IN ROUND OD10 FR 400 ML 3 SPRING RESERVOIR TROCAR Y CONNECTOR STERILE LATEX FREE DISPOSABLE SUP-270009033 CDM 270 RC inpatient 18.83 18.45 All Payors / Plans All Payors / Plans 18.83 other 18.83 18.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRAINAGE PLEURAGUIDE THORACIC ALL IN ONE CHEST TUBE STERILE LATEX FREE DISPOSABLE SUP-270009127 CDM 270 RC inpatient 206.33 202.2 All Payors / Plans All Payors / Plans 206.33 other 206.33 206.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRAINAGE PLEURX 1000 ML STARTER CATHETER SUP-270000000 CDM 270 RC inpatient 661.5 648.27 All Payors / Plans All Payors / Plans 661.5 other 661.5 661.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRAINAGE PLEURX ALCOHOL PLASTIC GAUZE FOAM L4 IN X W4 IN 1000 ML THORACIC CATHETER VACUUM BOTTLE SELF ADHESIVE DRESSING VALVE CAP STERILE LATEX FREE DISPOSABLE BLUE PLEURAL EFFUSION SUP-270000000 CDM 270 RC inpatient 202.27 198.22 All Payors / Plans All Payors / Plans 202.27 other 202.27 202.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRAINAGE PLEURX POLYESTER OD15.5 FR PLEURAL CATHETER ACTIVE VACCUM TECHNOLOGY PROPRIETARY SAFETY VALVE CUFF STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 1419.6 1391.21 All Payors / Plans All Payors / Plans 1419.6 other 1419.6 1419.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRAINAGE PVC ROUND L12 IN OD1/4 IN 400 ML 3 SPRING EVACUATOR TROCAR Y CONNECTOR TUBE HOLE PATTERN STERILE LATEX FREE DISPOSABLE SUP-270009033 CDM 270 RC inpatient 18.83 18.45 All Payors / Plans All Payors / Plans 18.83 other 18.83 18.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRAPE SPY-PHI DRUG SUP-270000000 CDM 270 RC inpatient 639.32 626.53 All Payors / Plans All Payors / Plans 639.32 other 639.32 639.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRESSING GRANUFOAM SENSAT.R.A.C. V.A.C. POLYURETHANE FOAM THK3.3 CM SMALL STANDARD L10 CM X W7.5 CM 1 ADHESIVE DRAPE PAD HYDROPHOBIC FLEXIBLE DISPOSABLE SUP-270009205 CDM 270 RC inpatient 27.53 26.98 All Payors / Plans All Payors / Plans 27.53 other 27.53 27.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRESSING GRANUFOAM SENSATRAC VAC POLYURETHANE FOAM THK3.3 CM MEDIUM STANDARD L18 CM X W12.5 CM 2 ADHESIVE DRAPE PAD HARD TO REACH FLEXIBLE HYDROPHOBIC SUP-270009207 CDM 270 RC inpatient 34.72 34.03 All Payors / Plans All Payors / Plans 34.72 other 34.72 34.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRESSING GRANUFOAM VAC POLYURETHANE FOAM HYDROPHOBIC THK3.3 CM LARGE STANDARD L26 CM X W15 CM 2 ADHESIVE DRAPE SENSATRAC PAD HARD TO REACH FLEXIBLE BLACK SUP-270009208 CDM 270 RC inpatient 95.78 93.86 All Payors / Plans All Payors / Plans 95.78 other 95.78 95.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRESSING NEGATIVE PRESSURE VACUUM PEEL AND PLACE PREVENA 20CM SUP-270000000 CDM 270 RC inpatient 1070.69 1049.28 All Payors / Plans All Payors / Plans 1070.69 other 1070.69 1070.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRESSING WITH VACUUM PEEL AND PLACE PREVENA 13CM SUP-270000000 CDM 270 RC inpatient 866.75 849.42 All Payors / Plans All Payors / Plans 866.75 other 866.75 866.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT ELECTRODE SURFACE ENSITE X SUP-270000000 CDM 270 RC inpatient 1428 1399.44 All Payors / Plans All Payors / Plans 1428 other 1428 1428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT EXTERNAL DRAINAGE ACCUDRAIN SPECIAL LATEX FREE INS8400 SUP-270009150 CDM 270 RC inpatient 251.78 246.74 All Payors / Plans All Payors / Plans 251.78 other 251.78 251.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT EYE MEROCEL WIPE EYE DRAIN CORNEAL LIGHT SHIELD STERILE SUP-270000000 CDM 270 RC inpatient 8.32 8.15 All Payors / Plans All Payors / Plans 8.32 other 8.32 8.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT FIRST FRACTURE STABILIT SUP-270000000 CDM 270 RC inpatient 5617.5 5505.15 All Payors / Plans All Payors / Plans 5617.5 other 5617.5 5617.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INJECTION RS PENINSULA REGIONAL MEDICAL SUP-270000000 CDM 270 RC inpatient 30.15 29.55 All Payors / Plans All Payors / Plans 30.15 other 30.15 30.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INSERTION FOR IABP SUP-270000000 CDM 270 RC inpatient 331.67 325.04 All Payors / Plans All Payors / Plans 331.67 other 331.67 331.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INTERVENTIONAL ENROUTE TRANSCAROTID NEUROPROTECTION SUP-270000000 CDM 270 RC inpatient 3825 3748.5 All Payors / Plans All Payors / Plans 3825 other 3825 3825 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INTRODUCER AVEIR HYDROPHILIC COATED L 50 CM OD 8.9 MM 25 FR INTRODUCER STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 1260 1234.8 All Payors / Plans All Payors / Plans 1260 other 1260 1260 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INTRODUCER GLIDESHEATH SLENDER .021IN 35MM 10CM 45CM 5FR 21GA SS HYDROPHILIC DISPOSABLE STERILE NEEDLE DILATOR SUP-270000000 CDM 270 RC inpatient 105 102.9 All Payors / Plans All Payors / Plans 105 other 105 105 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INTRODUCER GLIDESHEATH SLENDER .021IN 35MM 10CM 45CM 6FR 21GA SS HYDROPHILIC DISPOSABLE STERILE NEEDLE DILATOR SUP-270000000 CDM 270 RC inpatient 62.5 61.25 All Payors / Plans All Payors / Plans 62.5 other 62.5 62.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INTRODUCER SAFESHEATH II L13CM OD 9 FR PEEL AWAY SUP-481000000 CDM 270 RC inpatient 165.75 162.44 All Payors / Plans All Payors / Plans 165.75 other 165.75 165.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INTRODUCER SAFESHEATH II LONG L23CM L 28.5CM OD 9 FR VASCULAR SIDEPORT TEAR AWAY DILATOR HEMOSTATIC VALVE ORANGE SUP-275000000 CDM 270 RC inpatient 383.25 375.59 All Payors / Plans All Payors / Plans 383.25 other 383.25 383.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INTRODUCER SILK ROAD .018 IN L50 CM L15 CM OD 4 FR MICROWIRE EXTENSION TUBE NEEDLE STIFF DILATOR SUP-270000000 CDM 270 RC inpatient 204 199.92 All Payors / Plans All Payors / Plans 204 other 204 204 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT IV CHLORAPREP TEGADERM L2 IN X W2 IN .67 ML IV START STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 1.16 1.14 All Payors / Plans All Payors / Plans 1.16 other 1.16 1.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT LEFT HEART SUP-481000000 CDM 270 RC inpatient 43.3 42.43 All Payors / Plans All Payors / Plans 43.3 other 43.3 43.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT LIVER ACCESS BIOPSY SUP-270000000 CDM 270 RC inpatient 1568.7 1537.33 All Payors / Plans All Payors / Plans 1568.7 other 1568.7 1568.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT MICROINTRODUCER STAINLESS STEEL SILICONE NITINOL .018 IN REGULAR TAPER L40 CM L7 CM OD5 FR ODSEC21 GA DILATOR SMOOTH NEEDLE SOFT TIP WIRE MANDREL SUP-481000000 CDM 270 RC inpatient 36.66 35.93 All Payors / Plans All Payors / Plans 36.66 other 36.66 36.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT NEEDLE GUIDE CIV FLEX SONOSITE OD21 GA COVER BAND GEL STERILE TEAL L25 SUP-270000000 CDM 270 RC inpatient 48.3 47.33 All Payors / Plans All Payors / Plans 48.3 other 48.3 48.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PEG ENDOVIVE SAFETYGLIDE CHLORAPREP XYLOCAINE SILICONE 11 L1 1/2 IN OD20 FR ODSEC22 GA PUSH METHOD AMPULE 2 EXTERNAL BOLSTER SPRING LOAD BLADE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 227.49 222.94 All Payors / Plans All Payors / Plans 227.49 other 227.49 227.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PEG ENDOVIVE SILICONE STANDARD UNIVERSAL OD20 FR 5 ML PULL FENESTRATE DRAPE CLAMP STERILE DISPOSABLE ENTERAL ACCESS DEVICE SUP-270000000 CDM 270 RC inpatient 146.6 143.67 All Payors / Plans All Payors / Plans 146.6 other 146.6 146.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PERICARDIOCENTESIS PIGTAIL CURVE L40 CM OD8 FR CATHETER SUP-481000000 CDM 270 RC inpatient 197.2 193.26 All Payors / Plans All Payors / Plans 197.2 other 197.2 197.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PILLCAM SENSOR BELT 2 DISPOSABLE SUP-270000000 CDM 270 RC inpatient 31.62 30.99 All Payors / Plans All Payors / Plans 31.62 other 31.62 31.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT POSITIONING COBAN S SHOULDER STABILIZATION ARM DRAPE HOOK SUSPENSION STERILE LATEX FREE DISPOSABLE ARTHROSCOPY SUP-270000000 CDM 270 RC inpatient 195.97 192.05 All Payors / Plans All Payors / Plans 195.97 other 195.97 195.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT POSITIONING JACKSON L7 IN PILLOW COVER ARM CRADLE 4 HIP THIGH PAD COVER JACKSON TABLE SUP-270000000 CDM 270 RC inpatient 27.17 26.63 All Payors / Plans All Payors / Plans 27.17 other 27.17 27.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT POSITIONING PROAXIS PRONEVIEW SUP-270000000 CDM 270 RC inpatient 72.38 70.93 All Payors / Plans All Payors / Plans 72.38 other 72.38 72.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT POSITIONING TRIMANO BEACH CHAIR ARM HOLDER DRAPE LIGHTWEIGHT DISPOSABLE SUP-270000000 CDM 270 RC inpatient 76.5 74.97 All Payors / Plans All Payors / Plans 76.5 other 76.5 76.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT POSITIONING WILSON L7 IN PATIENT CARE FRAME SUP-270000000 CDM 270 RC inpatient 22.92 22.46 All Payors / Plans All Payors / Plans 22.92 other 22.92 22.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PREP QUIK USE FEMORAL BONE CEMENT SUP-270000000 CDM 270 RC inpatient 151.01 147.99 All Payors / Plans All Payors / Plans 151.01 other 151.01 151.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PRESSURE MONITOR TRUWAVE L60 IN L12 IN 3 WAY STOPCOCK TRANSDUCER FLUSH DEVICE MACRODRIP TUBE STERILE DISPOSABLE MODEL PX600F SUP-270009140 CDM 270 RC inpatient 13.5 13.23 All Payors / Plans All Payors / Plans 13.5 other 13.5 13.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PROCEDURE EDGE 180 D LOCATABLE GUIDE FIRM TIP EXTEND WORK CHANNEL CATHETER SUP-270000000 CDM 270 RC inpatient 3271.8 3206.36 All Payors / Plans All Payors / Plans 3271.8 other 3271.8 3271.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PROCEDURE EDGE 90D LOCATABLE GUIDE FIRM TIP EXTEND WORK CHANNEL CATHETER SUP-270000000 CDM 270 RC inpatient 3271.8 3206.36 All Payors / Plans All Payors / Plans 3271.8 other 3271.8 3271.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PULSED LAVAGE PULSAVAC PLUS FAN SPRAY TIP RETAIN MECHANISM ROCKER SWITCH TEXTURE PISTOL GRIP HANDLE SUP-270000000 CDM 270 RC inpatient 30.91 30.29 All Payors / Plans All Payors / Plans 30.91 other 30.91 30.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT RIGHT HEART SUP-481000000 CDM 270 RC inpatient 40.57 39.76 All Payors / Plans All Payors / Plans 40.57 other 40.57 40.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT SCREW INTERTAN L 95MM L 90MM OD 11.5 ODSEC 7MM TROCHANTERIC LAG COMPRESSION INTEGRATE INTERLOCK SUP-270000000 CDM 270 RC inpatient 1292.34 1266.49 All Payors / Plans All Payors / Plans 1292.34 other 1292.34 1292.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT SUCTION AXS UNIVERSAL LINER NONSTERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 58.1 56.94 All Payors / Plans All Payors / Plans 58.1 other 58.1 58.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT SUTURE COR-KNOT MINI STERILE COMBO SUP-270000000 CDM 270 RC inpatient 1606.5 1574.37 All Payors / Plans All Payors / Plans 1606.5 other 1606.5 1606.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT SUTURE HEART IN-HOUSE CUSTOM SUP-270000000 CDM 270 RC inpatient 131.05 128.43 All Payors / Plans All Payors / Plans 131.05 other 131.05 131.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT SUTURE VALVE IN-HOUSE CUSTOM SUP-270000000 CDM 270 RC inpatient 194.27 190.38 All Payors / Plans All Payors / Plans 194.27 other 194.27 194.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT SYRINGE ORISE INTERJECT OD23 GA 10 ML 1 PACK GEL PREFILL PREDYE CLEAR SUP-270000000 CDM 270 RC inpatient 216.24 211.92 All Payors / Plans All Payors / Plans 216.24 other 216.24 216.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT THORACENTESIS ARROW-CLARKE PLEURA-SEAL SHARPSAWAY II CHLORAPREP HI-LITE ORANGE POLYURETHANE L7 1/2 IN L1 1/2 IN OD8 FR ODSEC18 GA 5 ML 3 WAY STOPCOCK NEEDLE CATHETER SELF SEAL VALVE LUER LOCK SYRINGE STERILE LATEX SUP-270009223 CDM 270 RC inpatient 129.2 126.62 All Payors / Plans All Payors / Plans 129.2 other 129.2 129.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT THROMBECTOMY POWER PULSE ANGIOJET ULTRA CONSOLE SUP-270000000 CDM 270 RC inpatient 75.14 73.64 All Payors / Plans All Payors / Plans 75.14 other 75.14 75.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT TRANSSEPTAL NRG RADIOFREQUENCY PTW-25-230 SUP-481000000 CDM 270 RC inpatient 1827 1790.46 All Payors / Plans All Payors / Plans 1827 other 1827 1827 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT VESSEL HARVESTING VASOVIEW HEMOPRO 2 ENDOSCOPIC SUP-270000000 CDM 270 RC inpatient 1071 1049.58 All Payors / Plans All Payors / Plans 1071 other 1071 1071 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT VITRECTOMY PERFLUORON PERFLUORO-N-OCTANE 7 ML PROCEDURAL LIQUID PURIFY LATEX FREE SUP-270000000 CDM 270 RC inpatient 1183.67 1160 All Payors / Plans All Payors / Plans 1183.67 other 1183.67 1183.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KNIFE CRESCENT SUP-270000000 CDM 270 RC inpatient 23.1 22.64 All Payors / Plans All Payors / Plans 23.1 other 23.1 23.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KNIFE OPHTHALMIC ALCON A-OK 15 D STANDARD W1.52 MM BLADE FULL HANDLE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 14.22 13.94 All Payors / Plans All Payors / Plans 14.22 other 14.22 14.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KNIFE OPHTHALMIC A-OK 30 D W1.85 MM FULL HANDLE ANGLE BLADE STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 14.22 13.94 All Payors / Plans All Payors / Plans 14.22 other 14.22 14.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KNIFE OPHTHALMIC BD EDGEAHEAD STRAIGHT W1.1 MM OD20 GA MVR SIDEPORT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 66.42 65.09 All Payors / Plans All Payors / Plans 66.42 other 66.42 66.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KNIFE OPHTHALMIC CLEARCUT ANGLE FULL W1 MM 2 BEVEL SIDEPORT SATIN FINISH STERILE LATEX DISPOSABLE FLUORESCENT PINK SUP-270000000 CDM 270 RC inpatient 34.15 33.47 All Payors / Plans All Payors / Plans 34.15 other 34.15 34.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KNIFE OPHTHALMIC CLEARCUT SATINSLIT ANGLE W3.2 MM SLIT STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 71.06 69.64 All Payors / Plans All Payors / Plans 71.06 other 71.06 71.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility K-WIRE1.4MMX228MM SUP-270000000 CDM 270 RC inpatient 62.4 61.15 All Payors / Plans All Payors / Plans 62.4 other 62.4 62.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LANGSTON 6F 145 PIGTAIL DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC inpatient 267.92 262.56 All Payors / Plans All Payors / Plans 267.92 other 267.92 267.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LAUNCHER 7 F GUIDING CATHETER 3.75 SUP-270000000 CDM 270 RC inpatient 72.25 70.81 All Payors / Plans All Payors / Plans 72.25 other 72.25 72.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD 0672 ICD RELIANCE 4-FRONT SINGLE COIL SUP-275000000 CDM 270 RC inpatient 6537.3 6406.55 All Payors / Plans All Payors / Plans 6537.3 other 6537.3 6537.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD ATTAIN SUP-275000000 CDM 270 RC inpatient 2060.4 2019.19 All Payors / Plans All Payors / Plans 2060.4 other 2060.4 2060.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD INGEVITY PLUS PACING 52CM SUP-275000000 CDM 270 RC inpatient 680 666.4 All Payors / Plans All Payors / Plans 680 other 680 680 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD NEUROSTIMULATOR VNS THERAPY PERENNIAFLEX 2MM STERILE LF MODEL 304 SUP-270010003 CDM 270 RC inpatient 22212.71 21768.46 All Payors / Plans All Payors / Plans 22212.71 other 22212.71 22212.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING ATTAIN STARFIX LEFT VENTRICLE SUP-275000000 CDM 270 RC inpatient 1734 1699.32 All Payors / Plans All Payors / Plans 1734 other 1734 1734 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING CAPSUREFIX NOVUS STEROID ELUTING PLATINUM SILICONE 10 MM SPACE SMALL STRAIGHT L45 CM L20-110 CM OD6.2 FR ODSEC2 MM ATRIUM VENTRICLE BIPOLAR SCREW IN IMPLANTABLE ACTIVE FIXATION SUP-275000000 CDM 270 RC inpatient 402.9 394.84 All Payors / Plans All Payors / Plans 402.9 other 402.9 402.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING CAPSUREFIX NOVUS STEROID ELUTING PLATINUM SILICONE 10 MM SPACE SMALL STRAIGHT L52 CM L20-110 CM OD6.2 FR ODSEC2 MM ATRIUM VENTRICLE BIPOLAR SCREW IN IMPLANTABLE ACTIVE FIXATION SUP-275000000 CDM 270 RC inpatient 402.9 394.84 All Payors / Plans All Payors / Plans 402.9 other 402.9 402.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING CAPSUREFIX NOVUS STEROID ELUTING PLATINUM SILICONE 10 MM SPACE SMALL STRAIGHT L58 CM L20-110 CM OD6.2 FR ODSEC2 MM ATRIUM VENTRICLE BIPOLAR SCREW IN IMPLANTABLE ACTIVE FIXATION SUP-275000000 CDM 270 RC inpatient 829.5 812.91 All Payors / Plans All Payors / Plans 829.5 other 829.5 829.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING DURATA SJ4 STEROID ELUTING SILICONE 11 MM SPACING L58 CM OD6.8 FR ENDOCARDIUM 1 COIL SUP-275000000 CDM 270 RC inpatient 4495 4405.1 All Payors / Plans All Payors / Plans 4495 other 4495 4495 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING QUARTET OPTIM LOW PROFILE S CURVE NARROW L86 CM X H16 MM OD5 FR LEFT HEART 4 ELECTRODE IS-4 CONNECTOR SUP-275000000 CDM 270 RC inpatient 1860 1822.8 All Payors / Plans All Payors / Plans 1860 other 1860 1860 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING SELECTSECURE L69 CM ATRIUM VENTRICLE BIPOLAR FIXED SCREW IN CATHETER DELIVER SUP-275000000 CDM 270 RC inpatient 829.5 812.91 All Payors / Plans All Payors / Plans 829.5 other 829.5 829.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING SILICONE L53 CM OD6.6 FR MYOCARDIUM UNIPOLAR FIXED SCREW IS-1 SUP-275000000 CDM 270 RC inpatient 840 823.2 All Payors / Plans All Payors / Plans 840 other 840 840 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING SPRINT QUATTRO SECURE DEXAMETHASONE SODIUM PHOSPHATE STEROID ELUTING L62 CM SUP-275000000 CDM 270 RC inpatient 3169.14 3105.76 All Payors / Plans All Payors / Plans 3169.14 other 3169.14 3169.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING STREAMLINE L3 MM OD.48 MM ATRIUM UNIPOLAR TEMPORARY PURPLE SUP-270000000 CDM 270 RC inpatient 67.16 65.82 All Payors / Plans All Payors / Plans 67.16 other 67.16 67.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING TENDRIL MRI L58 CM SUP-275000000 CDM 270 RC inpatient 630 617.4 All Payors / Plans All Payors / Plans 630 other 630 630 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING TENDRIL STS STEROID ELUTING SILICONE HELIX L46 CM OD6 FR ENDOCARDIUM IS-1 CONNECTOR SUP-275000000 CDM 270 RC inpatient 480.5 470.89 All Payors / Plans All Payors / Plans 480.5 other 480.5 480.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING TENDRIL STS STEROID ELUTING SILICONE HELIX L52 CM OD6 FR ENDOCARDIUM IS-1 CONNECTOR SUP-275000000 CDM 270 RC inpatient 510 499.8 All Payors / Plans All Payors / Plans 510 other 510 510 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD TENDRIL MRI 52CM SUP-275000000 CDM 270 RC inpatient 630 617.4 All Payors / Plans All Payors / Plans 630 other 630 630 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEGGINGS SURGICAL PROXIMA SMS L48 IN X W31 IN L6 IN CUFF STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 3.71 3.64 All Payors / Plans All Payors / Plans 3.71 other 3.71 3.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LENS INTRAOCULAR AKRESO AO 17.5 DIOIPTER POSTERIOR CHAMBER SUP-270000000 CDM 270 RC inpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LENS INTRAOCULAR AKRESO AO 18.5 DIOIPTER POSTERIOR CHAMBER SUP-270000000 CDM 270 RC inpatient 273 267.54 All Payors / Plans All Payors / Plans 273 other 273 273 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIGATOR 18IN ENDOLOOP MONOFILAMENT TIES LOOP SUTURE ENDOSCOPIC PDS II 12 LF VIOLET SUP-270000000 CDM 270 RC inpatient 87.12 85.38 All Payors / Plans All Payors / Plans 87.12 other 87.12 87.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIGATOR ENDOSCOPIC ENDOLOOP 12 18IN VIOLET PDS II LF MONOFILAMENT TIE LOOP SUTURE SUP-270009006 CDM 270 RC inpatient 12.49 12.24 All Payors / Plans All Payors / Plans 12.49 other 12.49 12.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIGATOR ENDOSCOPIC SPEEDBAND SUPERVIEW SUPER 7 2.8 MM L2.8 MM OD8.6-11.5 MM ESOPHAGEAL 1 STRING MULTIPLE BAND ERGONOMIC HANDLE AUDIBLE CLICK STERILE LATEX FREE DISPOSABLE HEMOSTASIS SUP-270000000 CDM 270 RC inpatient 272.07 266.63 All Payors / Plans All Payors / Plans 272.07 other 272.07 272.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIGHT RETRACTOR WAVEGUIDE WIDE FLAT FIBER OPTIC STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 419.02 410.64 All Payors / Plans All Payors / Plans 419.02 other 419.02 419.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINER ACETABULAR MDM COCR G OD48 MM HIP 28 MM FEMORAL HEAD SUP-270010024 CDM 270 RC inpatient 775 759.5 All Payors / Plans All Payors / Plans 775 other 775 775 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINER ACETABULAR PINNACLE NEUTRAL 52MM 36MM ALTRX STERILE LF HIP SUP-270010024 CDM 270 RC inpatient 6715 6580.7 All Payors / Plans All Payors / Plans 6715 other 6715 6715 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINER GLOVE BIOGEL INDICATOR NATURAL RUBBER 6 1/2 L285 MM X W85 MM POWDER FREE BEAD CUFF SMOOTH SURFACE NONPYROGENIC STERILE LATEX GREEN CURVE FINGER SUP-270000000 CDM 270 RC inpatient 1.49 1.46 All Payors / Plans All Payors / Plans 1.49 other 1.49 1.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINER GLOVE BIOGEL INDICATOR NATURAL RUBBER 7 L288 MM X W91 MM POWDER FREE BEAD CUFF SMOOTH SURFACE NONPYROGENIC STERILE LATEX GREEN CURVE FINGER SUP-270000000 CDM 270 RC inpatient 1.36 1.33 All Payors / Plans All Payors / Plans 1.36 other 1.36 1.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINER GLOVE BIOGEL INDICATOR NATURAL RUBBER 8 1/2 L301 MM X W109 MM POWDER FREE SMOOTH BEAD CUFF NONPYROGENIC STERILE LATEX DISPOSABLE GREEN CURVE SUP-270000000 CDM 270 RC inpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINER GLOVE BIOGEL INDICATOR NATURAL RUBBER 8 L299 MM X W103 MM POWDER FREE BEAD CUFF SMOOTH SURFACE NONPYROGENIC STERILE LATEX GREEN CURVE FINGER SUP-270000000 CDM 270 RC inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOOP VESSEL RETRACT-O-TAPE STAINLESS STEEL SILICONE MAXI ROUND L12 IN OD18 GA VASCULAR AIR CUSHION CURVE BLUNT TIP THIN WALL NEEDLE LATEX FREE WHITE SUP-270000000 CDM 270 RC inpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAHURKAR 20CM SUP-270000000 CDM 270 RC inpatient 185.63 181.92 All Payors / Plans All Payors / Plans 185.63 other 185.63 185.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANIFOLD SUCTION NEPTUNE 2 4 PORT SPECIMEN COLLECTION SUP-270000000 CDM 270 RC inpatient 45.31 44.4 All Payors / Plans All Payors / Plans 45.31 other 45.31 45.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANIFOLD SUCTION NEPTUNE 2 STANDARD 1 PORT WASTE MANAGEMENT SYSTEM SUP-270000000 CDM 270 RC inpatient 14.18 13.9 All Payors / Plans All Payors / Plans 14.18 other 14.18 14.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANIPULATOR ENDOSCOPIC HUMI UTERINE ADJUSTABLE SUP-270000000 CDM 270 RC inpatient 49.44 48.45 All Payors / Plans All Payors / Plans 49.44 other 49.44 49.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANIPULATOR ENDOSCOPIC VCARE DX CURVE UTERINE GRADUATED SHAFT LUER CHANNEL LOCK SCREW LAPAROSCOPIC HYSTERECTOMY SUP-270000000 CDM 270 RC inpatient 129.15 126.57 All Payors / Plans All Payors / Plans 129.15 other 129.15 129.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANIPULATOR ENDOSCOPIC VCARE SM 32MM DISPOSABLE STERILE LF CERVIX UTERUS 2 CUP LOCK SCREW HOLE INFLATE BALLOON SUP-270000000 CDM 270 RC inpatient 149.52 146.53 All Payors / Plans All Payors / Plans 149.52 other 149.52 149.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAPPING CATHETER WITH TRUEREF TECHNOLOGY D-F SUP-270000000 CDM 270 RC inpatient 5355 5247.9 All Payors / Plans All Payors / Plans 5355 other 5355 5355 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MARKER ENDOSCOPIC SPOT STERILE 5 ML GI TRACT SYRINGE PREFILL SUP-270000000 CDM 270 RC inpatient 79.8 78.2 All Payors / Plans All Payors / Plans 79.8 other 79.8 79.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MARKER SURGICAL DEVON GENTIAN VIOLET DISPOSABLE STERILE LF SKIN 2 TIP RULER CAP LABEL NONTOXIC SUP-270000000 CDM 270 RC inpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MASK O2/CO2 CAPNOMASK ADULT TRANSPARENT GAS SAMPLING LINE DEHP PVC FREE LATEX FREE SUP-270000000 CDM 270 RC inpatient 5.5 5.39 All Payors / Plans All Payors / Plans 5.5 other 5.5 5.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MASK OXYGEN POM ADULT MALE TO MALE MEDIUM CONCENTRATION CO2 MONITOR NONSTERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 8.33 8.16 All Payors / Plans All Payors / Plans 8.33 other 8.33 8.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MASK OXYGEN POM ELITE MSA ADULT HIGH CONCENTRATION CO2 MONITOR LATEX FREE MICROSTREAM SUP-270000000 CDM 270 RC inpatient 13.8 13.52 All Payors / Plans All Payors / Plans 13.8 other 13.8 13.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAT OPERATING ROOM SURGISAFE L40 IN X W28 IN HIGH ABSORBENT FLUID BARRIER BACKING NONSTERILE LATEX FREE GREEN SUP-270000000 CDM 270 RC inpatient 9.26 9.07 All Payors / Plans All Payors / Plans 9.26 other 9.26 9.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MATRIX TISSUE ALLODERM SELECT THK.4-1.6 MM MEDIUM CONTOUR L19.3 CM X W9.6 CM ALLOGRAFT REGENERATIVE PERFORATE SUP-270000000 CDM 270 RC inpatient 5051.04 4950.02 All Payors / Plans All Payors / Plans 5051.04 other 5051.04 5051.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MATTRESS TRANSFER HOVERMATT W34 IN BREATHABLE NONSTERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 143.85 140.97 All Payors / Plans All Payors / Plans 143.85 other 143.85 143.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH BARD PERFIX BARD POLYPROPYLENE EXTRA LARGE L1.6 IN X W 2 IN PLUG MONOFILAMENT STERILE PREPERITONEAL REPAIR 3D KNITTED TRIMMABLE SUP-270000000 CDM 270 RC inpatient 349.86 342.86 All Payors / Plans All Payors / Plans 349.86 other 349.86 349.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH BARD PERFIX BARD POLYPROPYLENE LARGE L1.6 IN X W 1.9 IN PLUG MONOFILAMENT STERILE PREPERITONEAL REPAIR SUP-270000000 CDM 270 RC inpatient 141.88 139.04 All Payors / Plans All Payors / Plans 141.88 other 141.88 141.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH BARD PERFIX BARD POLYPROPYLENE MEDIUM L1.55 IN X W 1.3 IN PLUG MONOFILAMENT STERILE PREPERITONEAL REPAIR SUP-270000000 CDM 270 RC inpatient 287.91 282.15 All Payors / Plans All Payors / Plans 287.91 other 287.91 287.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH BARD PERFIX BARD POLYPROPYLENE SMALL L1 IN X W 1.35 IN PLUG MONOFILAMENT STERILE PREPERITONEAL REPAIR SUP-270000000 CDM 270 RC inpatient 282.24 276.6 All Payors / Plans All Payors / Plans 282.24 other 282.24 282.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH CRANIAL LORENZ L85 MM X W53 MM X H.6 MM NEURO PANEL 1.5 MM SCREW SUP-270000000 CDM 270 RC inpatient 2547.3 2496.35 All Payors / Plans All Payors / Plans 2547.3 other 2547.3 2547.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH GYNECARE Y SUP-270000000 CDM 270 RC inpatient 1868.52 1831.15 All Payors / Plans All Payors / Plans 1868.52 other 1868.52 1868.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH HERNIA OVITEX POLYGLYCOLIC ACID THK 1.1MM 6MM L 10CM X W 6CM RESORBABLE GRID 1 SMOOTH SIDE VISCERA CONTACT SUP-270000000 CDM 270 RC inpatient 2041.2 2000.38 All Payors / Plans All Payors / Plans 2041.2 other 2041.2 2041.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL 3DMAX POLYPROPYLENE XL 3D CURVE L7 IN X W5 IN GROIN LEFT CONTOUR SEAL EDGE STERILE LAPAROSCOPIC INGUINAL HERNIA REPAIR SUP-270000000 CDM 270 RC inpatient 432.18 423.54 All Payors / Plans All Payors / Plans 432.18 other 432.18 432.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL 3DMAX POLYPROPYLENE XL 3D CURVE L7 IN X W5 IN GROIN RIGHT CONTOUR SEAL EDGE STERILE LAPAROSCOPIC INGUINAL HERNIA REPAIR SUP-270000000 CDM 270 RC inpatient 432.18 423.54 All Payors / Plans All Payors / Plans 432.18 other 432.18 432.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL ABSORBABLE PATCH 1.7 IN DIAMETER SUP-270000000 CDM 270 RC inpatient 829.92 813.32 All Payors / Plans All Payors / Plans 829.92 other 829.92 829.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL ABSORBABLE PATCH 2.5 IN DIAMETER SUP-270000000 CDM 270 RC inpatient 1004.64 984.55 All Payors / Plans All Payors / Plans 1004.64 other 1004.64 1004.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL BARD 3DMAX LG 3D CURVE CONTOUR 6X4IN POLYPROPYLENE STERILE GROIN LEFT SEAL EDGE LAPAROSCOPIC INGUINAL SUP-270000000 CDM 270 RC inpatient 360.15 352.95 All Payors / Plans All Payors / Plans 360.15 other 360.15 360.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL BARD 3DMAX LG 3D CURVE CONTOUR 6X4IN POLYPROPYLENE STERILE GROIN RIGHT SEAL EDGE LAPAROSCOPIC INGUINAL SUP-270000000 CDM 270 RC inpatient 360.15 352.95 All Payors / Plans All Payors / Plans 360.15 other 360.15 360.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL BARD 3DMAX MED 3D CURVE CONTOUR 5X3IN POLYPROPYLENE STERILE GROIN LEFT SEAL EDGE LAPAROSCOPIC INGUINAL SUP-270000000 CDM 270 RC inpatient 329.28 322.69 All Payors / Plans All Payors / Plans 329.28 other 329.28 329.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL BARD 3DMAX MED 3D CURVE CONTOUR 5X3IN POLYPROPYLENE STERILE GROIN RIGHT SEAL EDGE LAPAROSCOPIC INGUINAL SUP-270000000 CDM 270 RC inpatient 329.28 322.69 All Payors / Plans All Payors / Plans 329.28 other 329.28 329.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL BARD POLYPROPYLENE L14IN X W10 IN GROIN MONOFILAMENT VENTRAL INGUINAL HERNIA REPAIR SUP-270000000 CDM 270 RC inpatient 388.5 380.73 All Payors / Plans All Payors / Plans 388.5 other 388.5 388.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL BARD POLYPROPYLENE L6IN X W3 IN GROIN MONOFILAMENT VENTRAL INGUINAL HERNIA REPAIR SUP-270000000 CDM 270 RC inpatient 64.43 63.14 All Payors / Plans All Payors / Plans 64.43 other 64.43 64.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL BARD POLYPROPYLENE L6IN X W6 IN GROIN MONOFILAMENT VENTRAL INGUINAL HERNIA REPAIR SUP-270000000 CDM 270 RC inpatient 187 183.26 All Payors / Plans All Payors / Plans 187 other 187 187 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL GORE BIO-A SYNTHETIC L10 CM X W7 CM TISSUE REINFORCEMENT HIATAL HERNIA REPAIR SUP-270000000 CDM 270 RC inpatient 1071 1049.58 All Payors / Plans All Payors / Plans 1071 other 1071 1071 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL GORE SYNECOR RECTANGLE L30 CM X W20 CM PREPERITONEAL KNIT WEB SUP-270000000 CDM 270 RC inpatient 9420.6 9232.19 All Payors / Plans All Payors / Plans 9420.6 other 9420.6 9420.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL PHASIX POLY-4-HYDROXYBUTYRATE RECTANGLE L4 IN X W3 IN MONOFILAMENT SCAFFOLD RESORBABLE HERNIA REPAIR INTRAABDOMINAL PLACEMENT SUP-270000000 CDM 270 RC inpatient 1707.89 1673.73 All Payors / Plans All Payors / Plans 1707.89 other 1707.89 1707.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE ELLIPSE L10IN X W 8IN MONOFILAMENT LOW PROFILE MEDIUM WEIGHT UNCOATED STERILE LATEX FREE LAPROSCOPIC VENTRAL HERNIA REPAIR SUP-270000000 CDM 270 RC inpatient 2245.36 2200.45 All Payors / Plans All Payors / Plans 2245.36 other 2245.36 2245.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE ELLIPSE L6IN X W 4IN MONOFILAMENT LOW PROFILE MEDIUM WEIGHT UNCOATED STERILE LATEX FREE LAPROSCOPIC VENTRAL HERNIA REPAIR SUP-270000000 CDM 270 RC inpatient 408.58 400.41 All Payors / Plans All Payors / Plans 408.58 other 408.58 408.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE ELLIPSE L8IN X W 6IN MONOFILAMENT LOW PROFILE MEDIUM WEIGHT UNCOATED STERILE LATEX FREE LAPROSCOPIC VENTRAL HERNIA REPAIR SUP-270000000 CDM 270 RC inpatient 2188.42 2144.65 All Payors / Plans All Payors / Plans 2188.42 other 2188.42 2188.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICROCATHETER CEREBROVASCULAR MAMBA FLEX L 135CM STERILE LATEX FREE DISPOSABLE SUP-481000000 CDM 270 RC inpatient 926.5 907.97 All Payors / Plans All Payors / Plans 926.5 other 926.5 926.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICROCATHETER VASCULAR EXCELSIOR SL-10 2.4/1.7FR P/D 0.0165IN ID 150CM 45DEG PRESHAPED 6CM NON-BRAIDED LOW-PROFILE 2-TIP MARKER HYDROLENE 0.014/0.038IN GW SUP-270000000 CDM 270 RC inpatient 1997.5 1957.55 All Payors / Plans All Payors / Plans 1997.5 other 1997.5 1997.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICROCATHETER XT27 X 150 SUP-270000000 CDM 270 RC inpatient 2193 2149.14 All Payors / Plans All Payors / Plans 2193 other 2193 2193 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICRODOSE INJECTION KIT SUP-270000000 CDM 270 RC inpatient 52.5 51.45 All Payors / Plans All Payors / Plans 52.5 other 52.5 52.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICROSAGITTAL BLADE SUP-270000000 CDM 270 RC inpatient 27.38 26.83 All Payors / Plans All Payors / Plans 27.38 other 27.38 27.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAS REX MR8 SUP-270000000 CDM 270 RC inpatient 186.35 182.62 All Payors / Plans All Payors / Plans 186.35 other 186.35 186.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MIS ARTHRODESUS CARTILAGE BURR, SHAPE: CYL SS 4MM, L:16MM" SUP-270000000 CDM 270 RC inpatient 2210 2165.8 All Payors / Plans All Payors / Plans 2210 other 2210 2210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MODULAR POST 25MM SUP-270010030 CDM 270 RC inpatient 10403.4 10195.33 All Payors / Plans All Payors / Plans 10403.4 other 10403.4 10403.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL FEMORAL RETRO 10 X 36 SUP-270000000 CDM 270 RC inpatient 2710.68 2656.47 All Payors / Plans All Payors / Plans 2710.68 other 2710.68 2710.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY INTERTAN 125 D L 40 CM OD 10MM LEFT TROCHANTER SUP-270000000 CDM 270 RC inpatient 3832.5 3755.85 All Payors / Plans All Payors / Plans 3832.5 other 3832.5 3832.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY INTERTAN 130 D L 38 CM OD 10 MM LEFT TROCHANTER SUP-270000000 CDM 270 RC inpatient 3832.5 3755.85 All Payors / Plans All Payors / Plans 3832.5 other 3832.5 3832.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY INTERTAN 130 D L 40 CM OD 10 MM RIGHT TROCHANTER SUP-270000000 CDM 270 RC inpatient 3832.5 3755.85 All Payors / Plans All Payors / Plans 3832.5 other 3832.5 3832.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY TITANIUM 12-14 YR L440 MM OD4 MM DIAPHYSIS METAPHYSIS EPIPHYSIS ELASTIC SYMMETRICAL BRACING ACTION NONSTERILE PURPLE SUP-270010022 CDM 270 RC inpatient 1966.9 1927.56 All Payors / Plans All Payors / Plans 1966.9 other 1966.9 1966.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY TITANIUM 6-8 YR L440 MM OD3 MM DIAPHYSIS METAPHYSIS EPIPHYSIS ELASTIC SYMMETRICAL BRACING ACTION NONSTERILE GOLD SUP-270010022 CDM 270 RC inpatient 2795.31 2739.4 All Payors / Plans All Payors / Plans 2795.31 other 2795.31 2795.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY TITANIUM 9-11 YR L440 MM OD3.5 MM DIAPHYSIS METAPHYSIS EPIPHYSIS ELASTIC SYMMETRICAL BRACING ACTION NONSTERILE BLUE SUP-270010022 CDM 270 RC inpatient 1836.51 1799.78 All Payors / Plans All Payors / Plans 1836.51 other 1836.51 1836.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY TITANIUM PEDIATRIC L440 MM OD2 MM DIAPHYSIS METAPHYSIS EPIPHYSIS ELASTIC SYMMETRICAL BRACING ACTION NONSTERILE GREEN SUP-270010022 CDM 270 RC inpatient 1991.21 1951.39 All Payors / Plans All Payors / Plans 1991.21 other 1991.21 1991.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY TRIGEN META-NAIL TITANIUM L 32 CM OD 10 MM FEMORAL RETROGRADE GOLD SUP-270000000 CDM 270 RC inpatient 2710.68 2656.47 All Payors / Plans All Payors / Plans 2710.68 other 2710.68 2710.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY TRIGEN META-NAIL TITANIUM L 38 CM OD 13 MM FEMORAL RETROGRADE GOLD SUP-270000000 CDM 270 RC inpatient 3227 3162.46 All Payors / Plans All Payors / Plans 3227 other 3227 3227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NARROW SAW BLADE SS SUP-270000000 CDM 270 RC inpatient 369.2 361.82 All Payors / Plans All Payors / Plans 369.2 other 369.2 369.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAVILYST .035 J-TIP GUIDEWIRE 260CM SUP-481000000 CDM 270 RC inpatient 16.54 16.21 All Payors / Plans All Payors / Plans 16.54 other 16.54 16.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAVILYST .035 STRAIGHT TIP GUIDEWIRE 260CM SUP-481000000 CDM 270 RC inpatient 11.81 11.57 All Payors / Plans All Payors / Plans 11.81 other 11.81 11.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE ASPIRATION 22GA 0-8CML F/ENDOSCOPIC ULTRASOUND ACQUIRE LATEX-FREE NON-RADIOLUCENT SUP-270000000 CDM 270 RC inpatient 437.46 428.71 All Payors / Plans All Payors / Plans 437.46 other 437.46 437.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE ASPIRATION ARCPOINT METAL L137 MM OD21 GA ODSEC1.9 MM PULMONARY BRAID TAPER SHEATH SHORT RIGID LENGTH 2 MM CHANNEL SUP-270000000 CDM 270 RC inpatient 388.96 381.18 All Payors / Plans All Payors / Plans 388.96 other 388.96 388.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE ASPIRATION EXPECT SLIMLINE 8- CM 137.5-141.5CM 22GA 1.83MM 20CC COCR ECHOGENIC PATTERN ULTRASOUND STYLET CAP 2.4 SUP-270000000 CDM 270 RC inpatient 519.54 509.15 All Payors / Plans All Payors / Plans 519.54 other 519.54 519.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE ASPIRATION L40 MM L700 MM OD22 GA ODSEC1.8 MM ECHOGENIC DIMPLE FLEXIBLE PRESTERILIZE SAFE RELIABLE STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 93.2 91.34 All Payors / Plans All Payors / Plans 93.2 other 93.2 93.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE ASPIRATION VIZISHOT L70 CM L40 MM OD21 GA ID1.9 MM ECHOGENIC DIMPLED TIP DESIGN MAXIMUM EXTRUDING STROKE STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 190.79 186.97 All Payors / Plans All Payors / Plans 190.79 other 190.79 190.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE BIOPSY CHIBA L 15CM OD 22GA ASPIRATION STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 24.13 23.65 All Payors / Plans All Payors / Plans 24.13 other 24.13 24.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE BIOPSY JAMSHIDI 4IN 11GA DISPOSABLE STERILE LF BONE MARROW TAPER DISTAL ADAPTER SHARP BEVEL TIP SUP-270000000 CDM 270 RC inpatient 15.31 15 All Payors / Plans All Payors / Plans 15.31 other 15.31 15.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE BIOPSY SUPERDIMENSION SHORT L130 MM L2 MM OD21 GA ODSEC1.8 MM PREMARK ASPIRATE CATHETER SUP-270000000 CDM 270 RC inpatient 322.56 316.11 All Payors / Plans All Payors / Plans 322.56 other 322.56 322.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE BIOPSY TRU-CUT THIN WALL L4 1/2 IN OD14 GA DEPTH MARK REMOVABLE STYLET SCALPEL SHARP EDGE STANDARD HANDLE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 145.75 142.84 All Payors / Plans All Payors / Plans 145.75 other 145.75 145.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE BONE CEMENT AVAFLEX CURVE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 1040.89 1020.07 All Payors / Plans All Payors / Plans 1040.89 other 1040.89 1040.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE DISPOSABLE BIOPSY BRAINLAB 1.8MM SUP-270000000 CDM 270 RC inpatient 987 967.26 All Payors / Plans All Payors / Plans 987 other 987 987 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE EPIDURAL PERIFIX TUOHY BISPHENOL A L3 1/2 IN OD18 GA WING HUB PVC FREE DEHP FREE LATEX FREE CLEAR SUP-270000000 CDM 270 RC inpatient 6.12 6 All Payors / Plans All Payors / Plans 6.12 other 6.12 6.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE EPIDURAL PERIFIX TUOHY BISPHENOL A L3 1/2 IN OD20 GA WING HUB PVC FREE DEHP FREE LATEX FREE CLEAR SUP-270000000 CDM 270 RC inpatient 6.12 6 All Payors / Plans All Payors / Plans 6.12 other 6.12 6.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE HYPODERMIC BD REGULAR WALL .5IN 30GA TAN POLYPROPYLENE DISPOSABLE STERILE LF REGULAR BEVEL LUER HUB DEHP FREE SUP-270000000 CDM 270 RC inpatient 20.91 20.49 All Payors / Plans All Payors / Plans 20.91 other 20.91 20.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE HYPODERMIC BD REGULAR WALL 5/8IN 25GA BLUE POLYPROPYLENE DISPOSABLE STERILE LF REGULAR BEVEL LUER HUB DEHP FREE SUP-270000000 CDM 270 RC inpatient 14.34 14.05 All Payors / Plans All Payors / Plans 14.34 other 14.34 14.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE INSUFFLATION 120MM 14GA ENDOPATH ULTRA VERESS STOPCOCK LUER LOCK BLUNT STYLET SUP-270000000 CDM 270 RC inpatient 12.39 12.14 All Payors / Plans All Payors / Plans 12.39 other 12.39 12.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE INSUFFLATION ENDOPATH ULTRA VERESS STAINLESS STEEL PLASTIC L120 MM OD14 GA STOPCOCK LUER LOCK BLUNT STYLET HANDLE STERILE DISPOSABLE PNEUMOPERITONEUM SUP-270009197 CDM 270 RC inpatient 43.52 42.65 All Payors / Plans All Payors / Plans 43.52 other 43.52 43.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SCLEROTHERAPY INTERJECT L4 MM L240 CM OD23 GA ODSEC2.3 MM ID.32 MM INNER CATHETER SHEATH STERILE DISPOSABLE CLEAR SUP-270000000 CDM 270 RC inpatient 38.24 37.48 All Payors / Plans All Payors / Plans 38.24 other 38.24 38.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SCLEROTHERAPY STAR CATHETER INTERJECT L4 MM L240 CM OD25 GA ODSEC2.3 MM BEVEL STRONG PUSHABLE CONTRAST SHEATH SPACER CLIP DISPOSABLE RED SUP-270000000 CDM 270 RC inpatient 78.73 77.16 All Payors / Plans All Payors / Plans 78.73 other 78.73 78.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SPINAL BD QUINCKE REGULAR WALL 3.5IN 18GA PINK POLYPROPYLENE DISPOSABLE STERILE LF REGULAR BEVEL LUER HUB DEHP SUP-270000000 CDM 270 RC inpatient 2.84 2.78 All Payors / Plans All Payors / Plans 2.84 other 2.84 2.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SPINAL BD QUINCKE REGULAR WALL 3.5IN 20GA YELLOW POLYPROPYLENE DISPOSABLE STERILE LF REGULAR BEVEL LUER HUB DEHP SUP-270000000 CDM 270 RC inpatient 6.26 6.13 All Payors / Plans All Payors / Plans 6.26 other 6.26 6.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SPINAL BD QUINCKE REGULAR WALL 3.5IN 22GA BLACK POLYPROPYLENE DISPOSABLE STERILE LF REGULAR BEVEL LUER HUB DEHP SUP-270000000 CDM 270 RC inpatient 2.82 2.76 All Payors / Plans All Payors / Plans 2.82 other 2.82 2.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SPINAL BD QUINCKE REGULAR WALL 3.5IN 25GA BLUE POLYPROPYLENE DISPOSABLE STERILE LF REGULAR BEVEL LUER HUB DEHP SUP-270000000 CDM 270 RC inpatient 5.73 5.62 All Payors / Plans All Payors / Plans 5.73 other 5.73 5.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SPINAL BD QUINCKE STANDARD LENGTH L2 1/2 IN OD20 GA SPINE BEVEL FIT STYLET UNIQUE TRANSLUCENT WINDOW CANNULA STERILE LATEX FREE DISPOSABLE YELLOW ANESTHESIA SUP-270000000 CDM 270 RC inpatient 6.55 6.42 All Payors / Plans All Payors / Plans 6.55 other 6.55 6.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SUTURE MAYO CATGUT 3 1/2 CIRCLE TAPER STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 10.12 9.92 All Payors / Plans All Payors / Plans 10.12 other 10.12 10.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SUTURE MULTIFIRE SCORPION SUP-270000000 CDM 270 RC inpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SUTURE RICHARD-ALLAN 3 1/2 CIRCLE L1.654 IN OD.043 IN FISTULA HEAVY REVERSE CUT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 12.5 12.25 All Payors / Plans All Payors / Plans 12.5 other 12.5 12.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SUTURE RICHARD-ALLAN MAYO STAINLESS STEEL CATGUT 5 1/2 CIRCLE REGULAR TAPER L1.26 IN OD.043 IN TEMPER STRENGTH DEPENDABLE LIGHT STERILE LATEX FREE DISPOSABLE TISSUE CLOSURE SUP-270000000 CDM 270 RC inpatient 10.12 9.92 All Payors / Plans All Payors / Plans 10.12 other 10.12 10.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SUTURE RICHARD-ALLAN STAINLESS STEEL 3 1/2 CIRCLE REGULAR L.984 IN OD.024 IN INTESTINAL TAPER POINT FREE EYE STERILE LATEX FREE TISSUE CLOSURE SUP-270000000 CDM 270 RC inpatient 12.5 12.25 All Payors / Plans All Payors / Plans 12.5 other 12.5 12.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEPTUNE FLUID TRAP SUP-270000000 CDM 270 RC inpatient 7.65 7.5 All Payors / Plans All Payors / Plans 7.65 other 7.65 7.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OBSOLETE PER VENDOR - OBTURATOR 8MM BLADELESS SUP-270000000 CDM 270 RC inpatient 52.5 51.45 All Payors / Plans All Payors / Plans 52.5 other 52.5 52.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OBTURATOR 8MM BLADELESS OPTICAL SUP-270000000 CDM 270 RC inpatient 32.13 31.49 All Payors / Plans All Payors / Plans 32.13 other 32.13 32.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OBTURATOR 8MM BLADELESS OPTICAL LONG SUP-270000000 CDM 270 RC inpatient 53.55 52.48 All Payors / Plans All Payors / Plans 53.55 other 53.55 53.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OBTURATOR LAPAROSCOPIC DA VINCI S/SI ENDOWRIST SHORT OD8 MM STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 55.13 54.03 All Payors / Plans All Payors / Plans 55.13 other 55.13 55.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCCLUDER CARDIOVASCULAR GORE EPTFE OD 25MM SEPTAL SOFT WIRE FRAME FLUOROSCOPIC IMAGE SUP-275000000 CDM 270 RC inpatient 14412 14123.76 All Payors / Plans All Payors / Plans 14412 other 14412 14412 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCCLUDER SHUNT AXIUS L16.25 MM OD1.5 MM CORONARY TEMPORARY SUP-270000000 CDM 270 RC inpatient 215.76 211.44 All Payors / Plans All Payors / Plans 215.76 other 215.76 215.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLIVE WIRE SMOOTH 1.4MM SUP-270000000 CDM 270 RC inpatient 221 216.58 All Payors / Plans All Payors / Plans 221 other 221 221 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.0 X 12MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.0 X 18MM SUP-481000000 CDM 270 RC inpatient 765 749.7 All Payors / Plans All Payors / Plans 765 other 765 765 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.0 X 22MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.0 X 8MM SUP-481000000 CDM 270 RC inpatient 765 749.7 All Payors / Plans All Payors / Plans 765 other 765 765 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.25 X 12MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.25 X 15MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.25 X 8MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.5 X 12MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.5 X 15MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.5 X 18MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.5 X 22MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.5 X 8MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.75 X 15MM SUP-481000000 CDM 270 RC inpatient 459 449.82 All Payors / Plans All Payors / Plans 459 other 459 459 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.75 X 18MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.0 X 12MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.0 X 15MM SUP-481000000 CDM 270 RC inpatient 765 749.7 All Payors / Plans All Payors / Plans 765 other 765 765 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.0 X 18MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.0 X 22MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.0 X 26MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.0 X 30MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.5 X 15MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.5 X 18MM SUP-481000000 CDM 270 RC inpatient 1170 1146.6 All Payors / Plans All Payors / Plans 1170 other 1170 1170 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.5 X 22MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.5 X 26MM SUP-481000000 CDM 270 RC inpatient 1170 1146.6 All Payors / Plans All Payors / Plans 1170 other 1170 1170 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.5 X 8MM SUP-481000000 CDM 270 RC inpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 4.0 X 15MM SUP-481000000 CDM 270 RC inpatient 765 749.7 All Payors / Plans All Payors / Plans 765 other 765 765 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 4.0 X 26MM SUP-481000000 CDM 270 RC inpatient 765 749.7 All Payors / Plans All Payors / Plans 765 other 765 765 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OPSITE DRESSING LG SUP-270009208 CDM 270 RC inpatient 47.89 46.93 All Payors / Plans All Payors / Plans 47.89 other 47.89 47.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OR STERILE TOWELS 4/PK SUP-270000000 CDM 270 RC inpatient 9.98 9.78 All Payors / Plans All Payors / Plans 9.98 other 9.98 9.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OSTEOBALLAST 45X17.5MM SUP-270000000 CDM 270 RC inpatient 3318 3251.64 All Payors / Plans All Payors / Plans 3318 other 3318 3318 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACEMAKER - LEAD - SELECTSECURE 3830-69 SUP-275C18981 CDM 270 RC inpatient 829.5 812.91 All Payors / Plans All Payors / Plans 829.5 other 829.5 829.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACEMAKER ACCOLADE DR EL MRI DUAL CHAMBER SUP-275000000 CDM 270 RC inpatient 7246.6 7101.67 All Payors / Plans All Payors / Plans 7246.6 other 7246.6 7246.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACEMAKER ACCOLADE DR EL MRI SYSTEM _44046_ SUP-275000000 CDM 270 RC inpatient 7950 7791 All Payors / Plans All Payors / Plans 7950 other 7950 7950 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACEMAKER ASSURITY MR SR-RF SUP-275000000 CDM 270 RC inpatient 4940 4841.2 All Payors / Plans All Payors / Plans 4940 other 4940 4940 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACEMAKER AZURE S XT SR W1SR01 MRI DEVICE SUP-275000000 CDM 270 RC inpatient 2225.57 2181.06 All Payors / Plans All Payors / Plans 2225.57 other 2225.57 2225.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACEMAKER CARDIAC MICRA AV2 LEADLESS BUNDLE SUP-275000000 CDM 270 RC inpatient 31772 31136.56 All Payors / Plans All Payors / Plans 31772 other 31772 31772 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK ANKLE SUP-270000000 CDM 270 RC inpatient 73.35 71.88 All Payors / Plans All Payors / Plans 73.35 other 73.35 73.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK ARTERIOGRAM CUSTOM SUP-270000000 CDM 270 RC inpatient 42.92 42.06 All Payors / Plans All Payors / Plans 42.92 other 42.92 42.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK BASIC NEURO SUP-270009164 CDM 270 RC inpatient 108.11 105.95 All Payors / Plans All Payors / Plans 108.11 other 108.11 108.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK BATTERY LITHIUM PRECHARGED STERILE DISPOSABLE POWERED DRIVER SUP-270000000 CDM 270 RC inpatient 565 553.7 All Payors / Plans All Payors / Plans 565 other 565 565 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK BIOPSY BASIN CUSTOM SUP-270000000 CDM 270 RC inpatient 11.78 11.54 All Payors / Plans All Payors / Plans 11.78 other 11.78 11.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK CARDIAC CATHETER SUP-481000000 CDM 270 RC inpatient 32.37 31.72 All Payors / Plans All Payors / Plans 32.37 other 32.37 32.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK CATHETER 36CM 19FR PALINDROME TAL VENATRAC VASCULAR 2 STYLET 2 TISSUE DILATOR SUP-270000000 CDM 270 RC inpatient 609 596.82 All Payors / Plans All Payors / Plans 609 other 609 609 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK CERVICAL ACCESSORY SUP-270000000 CDM 270 RC inpatient 35.16 34.46 All Payors / Plans All Payors / Plans 35.16 other 35.16 35.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK CUSTOM SHAKUR SUP-270000000 CDM 270 RC inpatient 160.35 157.14 All Payors / Plans All Payors / Plans 160.35 other 160.35 160.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK DAVINCI DR IM SUP-270000000 CDM 270 RC inpatient 235.83 231.11 All Payors / Plans All Payors / Plans 235.83 other 235.83 235.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK DAVINCI UROLOGY SUP-270000000 CDM 270 RC inpatient 474.75 465.26 All Payors / Plans All Payors / Plans 474.75 other 474.75 474.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK FEMPOP BYPASS SUP-270009163 CDM 270 RC inpatient 312.79 306.53 All Payors / Plans All Payors / Plans 312.79 other 312.79 312.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK HEART SUP-270009194 CDM 270 RC inpatient 183.61 179.94 All Payors / Plans All Payors / Plans 183.61 other 183.61 183.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK HEART CABG ACCESSORY SUP-270000000 CDM 270 RC inpatient 137.7 134.95 All Payors / Plans All Payors / Plans 137.7 other 137.7 137.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK LAPAROSCOPIC SUP-270000000 CDM 270 RC inpatient 82.68 81.03 All Payors / Plans All Payors / Plans 82.68 other 82.68 82.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK MAJOR ABDOMINAL SUP-270009161 CDM 270 RC inpatient 36.89 36.15 All Payors / Plans All Payors / Plans 36.89 other 36.89 36.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK MINOR SUP-270000000 CDM 270 RC inpatient 25.82 25.3 All Payors / Plans All Payors / Plans 25.82 other 25.82 25.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK PLIF ACCESSORY SUP-270000000 CDM 270 RC inpatient 55.99 54.87 All Payors / Plans All Payors / Plans 55.99 other 55.99 55.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK REVEAL LINQ SUP-481000000 CDM 270 RC inpatient 12.67 12.42 All Payors / Plans All Payors / Plans 12.67 other 12.67 12.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SHOULDER ARTHROSCOPY SUP-270009121 CDM 270 RC inpatient 168.68 165.31 All Payors / Plans All Payors / Plans 168.68 other 168.68 168.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SINUS KENNEDY SUP-270000000 CDM 270 RC inpatient 38.85 38.07 All Payors / Plans All Payors / Plans 38.85 other 38.85 38.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL 175 MM 200 MM 1 WIDE FIELD LENS 1 CORRECTION LENS BIOM THUMBSCREW CAP STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 303.59 297.52 All Payors / Plans All Payors / Plans 303.59 other 303.59 303.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL ARTHROSCOPY SUP-270009167 CDM 270 RC inpatient 141.13 138.31 All Payors / Plans All Payors / Plans 141.13 other 141.13 141.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL BASIN CUSTOM CV DRAPE SUP-270000000 CDM 270 RC inpatient 106.29 104.16 All Payors / Plans All Payors / Plans 106.29 other 106.29 106.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CARTICEL TRANSPLANT ACCESS PENINSULA REGIONAL MEDICAL CENTER SUP-270000000 CDM 270 RC inpatient 184.75 181.06 All Payors / Plans All Payors / Plans 184.75 other 184.75 184.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM AAA SUP-270009162 CDM 270 RC inpatient 407.55 399.4 All Payors / Plans All Payors / Plans 407.55 other 407.55 407.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM AV FISTULA SUP-270000000 CDM 270 RC inpatient 88.08 86.32 All Payors / Plans All Payors / Plans 88.08 other 88.08 88.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM C SECTION SUP-270009192 CDM 270 RC inpatient 157.7 154.55 All Payors / Plans All Payors / Plans 157.7 other 157.7 157.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM C SECTION LATEX FREE SUP-270009192 CDM 270 RC inpatient 120.72 118.31 All Payors / Plans All Payors / Plans 120.72 other 120.72 120.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM CAROTID SUP-270009166 CDM 270 RC inpatient 201.06 197.04 All Payors / Plans All Payors / Plans 201.06 other 201.06 201.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM CHEST SUP-270000000 CDM 270 RC inpatient 197.26 193.31 All Payors / Plans All Payors / Plans 197.26 other 197.26 197.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM CRANI ACCESSORY SUP-270009165 CDM 270 RC inpatient 205.38 201.27 All Payors / Plans All Payors / Plans 205.38 other 205.38 205.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM DENTAL SUP-270000000 CDM 270 RC inpatient 51.13 50.11 All Payors / Plans All Payors / Plans 51.13 other 51.13 51.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM GYN LAPAROSCOPY SUP-270009174 CDM 270 RC inpatient 112.07 109.83 All Payors / Plans All Payors / Plans 112.07 other 112.07 112.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM MAJOR ORTHO HAND SUP-270000000 CDM 270 RC inpatient 78.19 76.63 All Payors / Plans All Payors / Plans 78.19 other 78.19 78.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM PACEMAKER SUP-270000000 CDM 270 RC inpatient 42.98 42.12 All Payors / Plans All Payors / Plans 42.98 other 42.98 42.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM PACEMAKER DYNJ59287 SUP-270000000 CDM 270 RC inpatient 28.29 27.72 All Payors / Plans All Payors / Plans 28.29 other 28.29 28.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM TAVR SUP-270009161 CDM 270 RC inpatient 143.12 140.26 All Payors / Plans All Payors / Plans 143.12 other 143.12 143.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM TOTAL HIP ACCESSORY SUP-270009120 CDM 270 RC inpatient 40.26 39.45 All Payors / Plans All Payors / Plans 40.26 other 40.26 40.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM TOTAL SHOULDER ACCESSORY SUP-270000000 CDM 270 RC inpatient 77.37 75.82 All Payors / Plans All Payors / Plans 77.37 other 77.37 77.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL ECLIPSE LITHOTOMY IV GYN T SHEET NO GOWN STERILE LATEX FREE SUP-270009174 CDM 270 RC inpatient 11.32 11.09 All Payors / Plans All Payors / Plans 11.32 other 11.32 11.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL ECLIPSE T L76 IN X W44 IN L23 IN X W16 IN CYSTOSCOPY VI DRAPE ABSORBENT REINFORCEMENT MESH SCREEN STERILE LATEX FREE SUP-270009170 CDM 270 RC inpatient 12.31 12.06 All Payors / Plans All Payors / Plans 12.31 other 12.31 12.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL EP SUP-270000000 CDM 270 RC inpatient 39.34 38.55 All Payors / Plans All Payors / Plans 39.34 other 39.34 39.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL HYSTEROSCOPY D C SUP-270000000 CDM 270 RC inpatient 20.97 20.55 All Payors / Plans All Payors / Plans 20.97 other 20.97 20.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL TOTAL JOINT SUP-270000000 CDM 270 RC inpatient 247.2 242.26 All Payors / Plans All Payors / Plans 247.2 other 247.2 247.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL TOTAL KNEE ACCESSORY SUP-270009119 CDM 270 RC inpatient 26.07 25.55 All Payors / Plans All Payors / Plans 26.07 other 26.07 26.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SUTURE STERILE PERCUTANEOUS ACHILLES REPAIR SYSTEM SUP-270000000 CDM 270 RC inpatient 3139.5 3076.71 All Payors / Plans All Payors / Plans 3139.5 other 3139.5 3139.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK THROAT INTRA OP OROPAK MEROCEL WITH STRING SUP-270000000 CDM 270 RC inpatient 45.15 44.25 All Payors / Plans All Payors / Plans 45.15 other 45.15 45.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK TRENGUARD PROCEDURE 450 PAC 450LBS SUP-270000000 CDM 270 RC inpatient 67.05 65.71 All Payors / Plans All Payors / Plans 67.05 other 67.05 67.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK TROCH NAIL SUP-270000000 CDM 270 RC inpatient 79.82 78.22 All Payors / Plans All Payors / Plans 79.82 other 79.82 79.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK VITRECTOMY CONSTELLATION ENGAUGE RUBBER OD25 GA OD20 GA ODSEC23 GA 10 CC VISCUOUS FLUID CONTROL SYRINGE NEEDLE CANNULA STERILE LATEX FREE DISPOSABLE VFC SUP-270000000 CDM 270 RC inpatient 71.73 70.3 All Payors / Plans All Payors / Plans 71.73 other 71.73 71.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK VITRECTOMY CONSTELLATION ENGAUGE V-LOCITY C3F8 SF6 GAS FILL SYRINGE RFID AUTOMATIC PURGE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 71.73 70.3 All Payors / Plans All Payors / Plans 71.73 other 71.73 71.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK VITRECTOMY CONSTELLATION OD20 GA PROBE FRAGMENTATION HANDPIECE LIGHTWEIGHT LATEX FREE SUP-270000000 CDM 270 RC inpatient 182.91 179.25 All Payors / Plans All Payors / Plans 182.91 other 182.91 182.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK VITRECTOMY CONSTELLATION TOTAL PLUS 5000 CPM OD23 GA 20 CC 3 WAY STOPCOCK PROBE STRAIGHT ENDOILLUMINATOR AUTO INFUSION VALVE LATEX FREE SUP-270000000 CDM 270 RC inpatient 592.39 580.54 All Payors / Plans All Payors / Plans 592.39 other 592.39 592.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK VITRECTOMY II SUP-270000000 CDM 270 RC inpatient 53.32 52.25 All Payors / Plans All Payors / Plans 53.32 other 53.32 53.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK VITRECTOMY TOTAL PLUS HYPERVIT 20000 CPM OD25 GA BEVEL SUP-270000000 CDM 270 RC inpatient 649.76 636.76 All Payors / Plans All Payors / Plans 649.76 other 649.76 649.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACKING NASAL MEROCEL POPE EPISTAXIS SUP-270000000 CDM 270 RC inpatient 85.26 83.55 All Payors / Plans All Payors / Plans 85.26 other 85.26 85.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACKING WOUND CURITY COTTON GAUZE L5 YD X W2 IN STRIP SELVAGE EDGE PLAIN MESH STERILE LATEX FREE DISPOSABLE SUP-270009022 CDM 270 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACKING WOUND CURITY IODOFORM COTTON MESH GAUZE L5 YD X W1/2 IN STRIP SUP-270009022 CDM 270 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACKING WOUND GAUZE L72 IN X W2 IN VAGINAL 4 PLY RADIOPAQUE STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 10.05 9.85 All Payors / Plans All Payors / Plans 10.05 other 10.05 10.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAD ELECTROSURGICAL GROUNDING NESSY ADULT L168 CM L10 FT CABLE MONITORING SPLIT DISPOSABLE SUP-270000000 CDM 270 RC inpatient 4.28 4.19 All Payors / Plans All Payors / Plans 4.28 other 4.28 4.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAD WOUND DRAIN SENSATRAC VAC TUBE CLAMP CONNECTOR STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 35.57 34.86 All Payors / Plans All Payors / Plans 35.57 other 35.57 35.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PADS CLOSURE D-STAT 4000 SUP-270000000 CDM 270 RC inpatient 241.4 236.57 All Payors / Plans All Payors / Plans 241.4 other 241.4 241.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PANNUS RETENTION SYSTEM 4 PAD 2 STRAP STERILE SUP-270000000 CDM 270 RC inpatient 123.25 120.79 All Payors / Plans All Payors / Plans 123.25 other 123.25 123.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PASSER SUTURE GABBAY-FRATER GUIDE ORGANIZER STERILE LATEX FREE VALVE IMPLANTATION SUP-270000000 CDM 270 RC inpatient 29.18 28.6 All Payors / Plans All Payors / Plans 29.18 other 29.18 29.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATCH CARDIOVASCULAR VASCU-GUARD BOVINE PERICARDIAL TAPER L8 CM X W.8 CM PERIPHERAL APEX PROCESS SUP-270000000 CDM 270 RC inpatient 491.48 481.65 All Payors / Plans All Payors / Plans 491.48 other 491.48 491.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATCH DURAL DURAMATRIX-ONLAY PLUS COLLAGEN L3 IN X W1 IN REGENERATION MEMBRANE STERILE SUP-270000000 CDM 270 RC inpatient 437.15 428.41 All Payors / Plans All Payors / Plans 437.15 other 437.15 437.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATCH DURAL DURAMATRIX-ONLAY PLUS COLLAGEN L5 IN X W4 IN REGENERATION MEMBRANE STERILE SUP-270000000 CDM 270 RC inpatient 1348.85 1321.87 All Payors / Plans All Payors / Plans 1348.85 other 1348.85 1348.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATCH REFERENCE CARTO 3 EXTERNAL SUP-270000000 CDM 270 RC inpatient 494.7 484.81 All Payors / Plans All Payors / Plans 494.7 other 494.7 494.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PATCH, PHOTOFIX CAROTID 0.8X8" SUP-270000000 CDM 270 RC inpatient 306 299.88 All Payors / Plans All Payors / Plans 306 other 306 306 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATELLA DOME 38MM SUP-270010025 CDM 270 RC inpatient 6720 6585.6 All Payors / Plans All Payors / Plans 6720 other 6720 6720 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATELLA DOME 41MM SUP-270010025 CDM 270 RC inpatient 5440 5331.2 All Payors / Plans All Payors / Plans 5440 other 5440 5440 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATELLA REAMER BLADE WITH PILOT HOLE SIZE 38 - LOG619747 SUP-270010025 CDM 270 RC inpatient 210 205.8 All Payors / Plans All Payors / Plans 210 other 210 210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATELLA REAMER BLADE WITH PILOT HOLE SIZE 51 SUP-270010025 CDM 270 RC inpatient 102 99.96 All Payors / Plans All Payors / Plans 102 other 102 102 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATELLA REAMING BLADE 46MM SUP-270010025 CDM 270 RC inpatient 210 205.8 All Payors / Plans All Payors / Plans 210 other 210 210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEAK PLASMABLADE 4.0 DISPOSABLE SUP-270000000 CDM 270 RC inpatient 304.34 298.25 All Payors / Plans All Payors / Plans 304.34 other 304.34 304.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PERFUSION OPEN HEART SUPPLIES SUP-270010026 CDM 270 RC inpatient 1500 1470 All Payors / Plans All Payors / Plans 1500 other 1500 1500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PERI-LOC KWIRE 1.6MM X 150MM LENGTH TROCAR POINT SUP-270000000 CDM 270 RC inpatient 397.8 389.84 All Payors / Plans All Payors / Plans 397.8 other 397.8 397.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIG 6FR C PIG PERFORMA SUP-481000000 CDM 270 RC inpatient 19 18.62 All Payors / Plans All Payors / Plans 19 other 19 19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIGTAIL CATH SUP-270000000 CDM 270 RC inpatient 38.4 37.63 All Payors / Plans All Payors / Plans 38.4 other 38.4 38.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PILLOW ABDUCTION FOAM LARGE SHOULDER ENVELOPE SLING THUMB LOOP PAD D RING CLOSURE NONSTERILE LATEX FREE SUP-270009116 CDM 270 RC inpatient 3.89 3.81 All Payors / Plans All Payors / Plans 3.89 other 3.89 3.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PILLOW POSITIONING INSITE GENTLETOUCH FOAM CONTOUR L7 FT PRONE HEADREST RIGHT INTUBATION SLOT LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 13.88 13.6 All Payors / Plans All Payors / Plans 13.88 other 13.88 13.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIN DISTRACTION TITANIUM L14 MM SHARP STERILE DISPOSABLE YELLOW ANTERIOR CERVICAL FUSION SUP-270000000 CDM 270 RC inpatient 76.5 74.97 All Payors / Plans All Payors / Plans 76.5 other 76.5 76.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIN DRILL VELYS L175 MM OD4 MM ARRAY SUP-270010025 CDM 270 RC inpatient 50.4 49.39 All Payors / Plans All Payors / Plans 50.4 other 50.4 50.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIN FIXATION L.42 IN OD.062 IN PROTECTOR GREEN YELLOW SUP-270000000 CDM 270 RC inpatient 5.79 5.67 All Payors / Plans All Payors / Plans 5.79 other 5.79 5.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIN HALF L15 MM OD3 MM RADIUS DISTAL SUP-270000000 CDM 270 RC inpatient 725.76 711.24 All Payors / Plans All Payors / Plans 725.76 other 725.76 725.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIN HALF L20 MM OD3 MM RADIUS DISTAL SUP-270000000 CDM 270 RC inpatient 725.76 711.24 All Payors / Plans All Payors / Plans 725.76 other 725.76 725.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIN SKULL MAYFIELD PLASTIC ADULT CRANIUM WING GROOVE STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 19.46 19.07 All Payors / Plans All Payors / Plans 19.46 other 19.46 19.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BIOMET MAXON ONE LEVEL 11MM SUP-270010020 CDM 270 RC inpatient 2860 2802.8 All Payors / Plans All Payors / Plans 2860 other 2860 2860 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BIOMET 2 LEVEL MAXON SUP-270010020 CDM 270 RC inpatient 3380 3312.4 All Payors / Plans All Payors / Plans 3380 other 3380 3380 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE ATLANTIS TITANIUM L40 MM SPINE CERVICAL ANTERIOR LOCK TRANSLATIONAL SUP-270010020 CDM 270 RC inpatient 2730 2675.4 All Payors / Plans All Payors / Plans 2730 other 2730 2730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS 10 HOLE STERILE LATEX FREE 2.7 MM SCREW SUP-270000000 CDM 270 RC inpatient 1482.6 1452.95 All Payors / Plans All Payors / Plans 1482.6 other 1482.6 1482.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS 20 HOLE FLEX 2.4 MM SCREW SUP-270000000 CDM 270 RC inpatient 1145.97 1123.05 All Payors / Plans All Payors / Plans 1145.97 other 1145.97 1145.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS 20 HOLE FLEX STERILE LATEX FREE 2.7MM SCREW SUP-270000000 CDM 270 RC inpatient 1482.6 1452.95 All Payors / Plans All Payors / Plans 1482.6 other 1482.6 1482.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS 6 HOLE STRENGTH 2 MM SCREW SUP-270000000 CDM 270 RC inpatient 1075.2 1053.7 All Payors / Plans All Payors / Plans 1075.2 other 1075.2 1075.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS L 297 MM FEMUR LEFT DISTAL 14 HOLE STERILE LATEX FREE 3.5/4.5 MM SCREW PERIPROSTHETIC SUP-270000000 CDM 270 RC inpatient 11702.25 11468.21 All Payors / Plans All Payors / Plans 11702.25 other 11702.25 11702.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS MINI STAINLESS STEEL 6 MM SPACE L 37 MM X W 6 MM X H 1.9MM 6 HOLE VARIABLE ANGLE LOCK LOW PROFILE STRENGTH STERILE 2.4 MM SCREW FRAGMENT SUP-270000000 CDM 270 RC inpatient 1145.97 1123.05 All Payors / Plans All Payors / Plans 1145.97 other 1145.97 1145.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS MINI STAINLESS STEEL 6 MM SPACE L 61 MM X W 6MM X H 1.9MM 10 HOLE CARIABLE ANGLE LOCK LOW PROFILE STRENGTH STERILE 2.4MM SCREW SMALL FRAGMENT SUP-270000000 CDM 270 RC inpatient 1145.97 1123.05 All Payors / Plans All Payors / Plans 1145.97 other 1145.97 1145.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 11MM SPACE I L 78 MM X W 10.9MM X H 2MM W 21.8 MM X H 1.8MM TIBIAL RIGHT PROXIMAL POSTEROMEDIAL 5 HOLE VARIABLE ANGLE LOCK LOW PROFILE PARTIAL ARTICULAR STERILE 3.5 MM SCREW SUP-270000000 CDM 270 RC inpatient 2196.6 2152.67 All Payors / Plans All Payors / Plans 2196.6 other 2196.6 2196.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 11MM SPACE L 103 MM X W 10 MM X H 2 MM W 16.3 MM X H 1.7MM FIBULA RIGHT DISTAL LATERAL 7 HOLE VARIABLE ANGLE LOCK LOW PROFILE STERILE 2.7/3.5 MM SCREW SUP-270000000 CDM 270 RC inpatient 1288.77 1262.99 All Payors / Plans All Payors / Plans 1288.77 other 1288.77 1288.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 11MM SPACE L 93 MM X W 10 MM X H 2 MM W 8 MM X H 1.8 MM FIBULA LEFT DISTAL POSTEROLATERAL 5 HOLE VARIABLE ANGLE LOCK LOW PROFILE STERILE 2.7/3.5 MM SCREW SUP-270000000 CDM 270 RC inpatient 1595.62 1563.71 All Payors / Plans All Payors / Plans 1595.62 other 1595.62 1595.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 11MM SPACE STRAIGHT L 114 MM X W 12MMX H 3 MM HUMERUS PROXIMAL 5 HOLE VARIABLE ANGLE LOCK LOW PROFILE STERILE 3.5 MM SCREW SUP-270000000 CDM 270 RC inpatient 1898.73 1860.76 All Payors / Plans All Payors / Plans 1898.73 other 1898.73 1898.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 12 MM SPACE 1/3 TUBULAR L 82 MM X W 9.5MM X H 1.5MM 7 HOLE LOCK STERILE 3.5 MM SCREW SUP-270000000 CDM 270 RC inpatient 429.83 421.23 All Payors / Plans All Payors / Plans 429.83 other 429.83 429.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 12 MM SPACE 1/3 TUBULAR L 94 MM X W 9.5 MM X H 1.5 MM 8 HOLE LOCK STERILE 3.5 MM SCREW SUP-270000000 CDM 270 RC inpatient 429.83 421.23 All Payors / Plans All Payors / Plans 429.83 other 429.83 429.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 12 MM SPACE 1/3 TUBULAR L70MM X W 9 MM H 1.1 MM 6 HOLE STERILE 3.5 MM SCREW SUP-270000000 CDM 270 RC inpatient 181.44 177.81 All Payors / Plans All Payors / Plans 181.44 other 181.44 181.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 12.5 MM SPACE L 77 MM X W 10.7MM X H 3.4MM 6 HOLE COMPRESSION STERILE 3.5MM SCREW SUP-270000000 CDM 270 RC inpatient 275.4 269.89 All Payors / Plans All Payors / Plans 275.4 other 275.4 275.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 12MM SPACE 1/3 TUBULAR L 118MM X W 9.5MM X H 1.5MM 10 HOLE LOCK STERILE 3.5MM SCREW SUP-270000000 CDM 270 RC inpatient 429.83 421.23 All Payors / Plans All Payors / Plans 429.83 other 429.83 429.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 12MM SPACE 1/3 TUBULAR L 70MM X W 9.5MM X H 1.5MM 6 HOLE LOCK STERILE 3.5MM SCREW SUP-270000000 CDM 270 RC inpatient 429.83 421.23 All Payors / Plans All Payors / Plans 429.83 other 429.83 429.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL L 151MM HUMERUS LEFT DISTAL POSTEROLATERAL 12 HOLE LOW PROFILE VARIABLE ANGLE LOCK EXTRA ARTICULAR 2.7/3.5 MM SCREW SUP-270000000 CDM 270 RC inpatient 3723.2 3648.74 All Payors / Plans All Payors / Plans 3723.2 other 3723.2 3723.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL L 83 MM OLECRANON LEFT 5 HOLE LOW PROFILE VARIABLE ANGLE LOCK STERILE 2.7/3.5 MM SCREW SUP-270000000 CDM 270 RC inpatient 2099.16 2057.18 All Payors / Plans All Payors / Plans 2099.16 other 2099.16 2099.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STANDARD L 48 MM RADIAL LEFT DISTAL VOLAR 3 HOLE STERILE SUP-270000000 CDM 270 RC inpatient 1442.28 1413.43 All Payors / Plans All Payors / Plans 1442.28 other 1442.28 1442.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS T 2 HOLE HEAD 8 HOLE SHAFT 2.4MM SCREW SUP-270000000 CDM 270 RC inpatient 927.69 909.14 All Payors / Plans All Payors / Plans 927.69 other 927.69 927.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS TRIANGLE 6 HOLE 2.4 MM SCREW SUP-270000000 CDM 270 RC inpatient 1418.82 1390.44 All Payors / Plans All Payors / Plans 1418.82 other 1418.82 1418.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS WIDE L 48 MM RADIAL LEFT DISTAL VOLAR 3 HOLE STERILE SUP-270000000 CDM 270 RC inpatient 1167.56 1144.21 All Payors / Plans All Payors / Plans 1167.56 other 1167.56 1167.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS WIDE L 56 MM RADIAL LEFT DISTAL VOLAR 4 HOLE STERILE SUP-270000000 CDM 270 RC inpatient 1442.28 1413.43 All Payors / Plans All Payors / Plans 1442.28 other 1442.28 1442.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS Y 7 HOLE SHAFT TINE STERILE LATEX FREE 2.7MM SCREW SUP-270000000 CDM 270 RC inpatient 1856.4 1819.27 All Payors / Plans All Payors / Plans 1856.4 other 1856.4 1856.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE INTERCONTINENTAL 6 D W20 MM X H11 MM SPINE NONSTERILE SUP-270010020 CDM 270 RC inpatient 2754 2698.92 All Payors / Plans All Payors / Plans 2754 other 2754 2754 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE LCP COMBI STAINLESS STEEL PELVIC 2 HOLE SPRING NONSTERILE 3.5 MM SCREW SUP-270010022 CDM 270 RC inpatient 681.39 667.76 All Payors / Plans All Payors / Plans 681.39 other 681.39 681.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE MATRIXNEURO TITANIUM STRAIGHT L12 MM X H.4 MM CRANIAL 2 HOLE CENTER SPACE RIGID NONSTERILE BLUE SUP-270010013 CDM 270 RC inpatient 170 166.6 All Payors / Plans All Payors / Plans 170 other 170 170 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE STAINLESS STEEL 108 MM RADIUS CURVE L104 MM X W10.2 MM X H2.7 MM PELVIC 8 HOLE LOW PROFILE NONSTERILE 3.5 MM SCREW SUP-270010022 CDM 270 RC inpatient 3689.6 3615.81 All Payors / Plans All Payors / Plans 3689.6 other 3689.6 3689.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE STAINLESS STEEL 108 MM RADIUS L208 MM PELVIC 16 HOLE LOW PROFILE CURVED RECONSTRUCTION NONSTERILE 3.5 MM SCREW SUP-270010022 CDM 270 RC inpatient 1963.67 1924.4 All Payors / Plans All Payors / Plans 1963.67 other 1963.67 1963.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE VLP MINI-MOD TITANIUM 12 X 3 HOLE MESH 2.4MM SCREW MINI FRAGMENT SUP-270000000 CDM 270 RC inpatient 2916.9 2858.56 All Payors / Plans All Payors / Plans 2916.9 other 2916.9 2916.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE ZEVO TITANIUM L21 MM SPINE CERVICAL ANTERIOR LEVEL 1 SUP-270010020 CDM 270 RC inpatient 1870 1832.6 All Payors / Plans All Payors / Plans 1870 other 1870 1870 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BURR HOLE 18.5MM SUP-270000000 CDM 270 RC inpatient 222.36 217.91 All Payors / Plans All Payors / Plans 222.36 other 222.36 222.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE SQUARE 4 HOLE 12MM SUP-270000000 CDM 270 RC inpatient 446.76 437.82 All Payors / Plans All Payors / Plans 446.76 other 446.76 446.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE TIBIAL NEXGEN TIVANIUM UHMWPE 6 L74 MM X W50 MM X H6 MM KNEE CEMENTED MODULAR STEM PRECOAT STERILE SUP-270010025 CDM 270 RC inpatient 3780 3704.4 All Payors / Plans All Payors / Plans 3780 other 3780 3780 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLEDGET CARDIOVASCULAR TEFLON THK1/16 IN LARGE L3/8 IN X W3/16 IN SOFT SUTURE STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 9.82 9.62 All Payors / Plans All Payors / Plans 9.82 other 9.82 9.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLUG CATHETER CURITY CAP STERILE SUP-270000000 CDM 270 RC inpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLUG STEM NEXGEN TIVANIUM TAPER KNEE FLEX STERILE SUP-270010025 CDM 270 RC inpatient 6300 6174 All Payors / Plans All Payors / Plans 6300 other 6300 6300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLUG SURGICAL PERFIX LG TAPER 1.6IN 1.9IN POLYPROPYLENE STERILE GROIN MONOFILAMENT NONABSORBABLE HERNIA REPAIR SUP-270000000 CDM 270 RC inpatient 241.06 236.24 All Payors / Plans All Payors / Plans 241.06 other 241.06 241.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLUG SURGICAL PERFIX MED TAPER 1.3IN 1.55IN POLYPROPYLENE STERILE GROIN MONOFILAMENT NONABSORBABLE HERNIA REPAIR SUP-270000000 CDM 270 RC inpatient 292.11 286.27 All Payors / Plans All Payors / Plans 292.11 other 292.11 292.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLUMEPEN ULTRA SURGICAL SMOKE EVAC PENCIL SUP-270000000 CDM 270 RC inpatient 24.55 24.06 All Payors / Plans All Payors / Plans 24.55 other 24.55 24.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POM WITH MICROSTREAM PHILIPS SUP-270000000 CDM 270 RC inpatient 16.17 15.85 All Payors / Plans All Payors / Plans 16.17 other 16.17 16.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PORT ACCESS AIRSEAL L100 MM OD12 MM OBTURATOR BLADELESS OPTICAL TIP STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 95.33 93.42 All Payors / Plans All Payors / Plans 95.33 other 95.33 95.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PORT ACCESS AIRSEAL L120 MM OD12 MM 2 WALL CANNULA PALM GRIP OBTURATOR BLADELESS OPTICAL TIP VALVELESS TROCAR SUP-270000000 CDM 270 RC inpatient 202.41 198.36 All Payors / Plans All Payors / Plans 202.41 other 202.41 202.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PORT AIRSEAL 5MM ACCESS PORT AND OBTURATOR SUP-270000000 CDM 270 RC inpatient 238.81 234.03 All Payors / Plans All Payors / Plans 238.81 other 238.81 238.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PORT HAND ACCESS ALEXIS GELPORT L120 MM ABDOMEN WOUND RETRACTOR LAPAROSCOPIC MARK PEN INCISION TEMPLATE GELSEAL TECHNOLOGY LATEX FREE SUP-270000000 CDM 270 RC inpatient 1501.5 1471.47 All Payors / Plans All Payors / Plans 1501.5 other 1501.5 1501.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PORT IMPLANTABLE INFUSION SMART PORT CARBOTHANE TITANIUM POLYURETHANE L55 CM OD6.6 FR ID7 FR IDSEC1.4 MM .4 ML .016 ML DETACH CATHETER INTRODUCER LOW PROFILE CT SUP-270000000 CDM 270 RC inpatient 179.93 176.33 All Payors / Plans All Payors / Plans 179.93 other 179.93 179.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PORT IMPLANTABLE INFUSION VACCESS CT 6FR TITANIUM POLYURETHANE POWER INJECTABLE LOW PROFILE SILICONE FILL SUTURE PLUG SUP-270000000 CDM 270 RC inpatient 231.25 226.63 All Payors / Plans All Payors / Plans 231.25 other 231.25 231.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POSITIONER IMPLANT SPINE PIN PLATE HOLD SUP-270010020 CDM 270 RC inpatient 105 102.9 All Payors / Plans All Payors / Plans 105 other 105 105 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POSITIONER OR FOAM H2 IN OD9 IN ID4 IN HEAD HIGH RESILIENT RING CUSHION LATEX FREE RASPBERRY SUP-270000000 CDM 270 RC inpatient 1.29 1.26 All Payors / Plans All Payors / Plans 1.29 other 1.29 1.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POUCH DRAINAGE PREMIER FLEXTEND LOCK N ROLL COMFORTWEAR POROUS FLAT L12 IN OD2 1/2 IN 1 PIECE CUT TO FIT TAPE LATEX FREE ULTRA CLEAR SUP-270009218 CDM 270 RC inpatient 2.2 2.16 All Payors / Plans All Payors / Plans 2.2 other 2.2 2.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POUCH SPECIMEN RETRIEVAL ENDO CATCH II 34.5CM 29.5CM 15MM METAL POLYURETHANE DISPOSABLE LF FLEXIBLE ERGONOMIC HANDLE SUP-270009147 CDM 270 RC inpatient 80.4 78.79 All Payors / Plans All Payors / Plans 80.4 other 80.4 80.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PPM PM2272 ASSURITY MRI DR-RF DEVICE _45055_ SUP-275000000 CDM 270 RC inpatient 3900 3822 All Payors / Plans All Payors / Plans 3900 other 3900 3900 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRELUDE SNAP SUP-481000000 CDM 270 RC inpatient 33.15 32.49 All Payors / Plans All Payors / Plans 33.15 other 33.15 33.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRELUDE SNAP 9 FR SUP-481000000 CDM 270 RC inpatient 68.25 66.89 All Payors / Plans All Payors / Plans 68.25 other 68.25 68.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRELUDESYNC-EZ SUP-481000000 CDM 270 RC inpatient 67.5 66.15 All Payors / Plans All Payors / Plans 67.5 other 67.5 67.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRESSURE PRODUCTS SUP-481000000 CDM 270 RC inpatient 68.25 66.89 All Payors / Plans All Payors / Plans 68.25 other 68.25 68.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE CRYOSURGERY CRYOPROBE L1.15 MR OD2.4 MM FLEXIBLE DISPOSABLE ERBECRYO 2 SUP-270000000 CDM 270 RC inpatient 516.8 506.46 All Payors / Plans All Payors / Plans 516.8 other 516.8 516.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE ELECTROSURGICAL ARTHREX APOLLORF 90 D 1 PIECE HAND CONTROL MULTIPLE PORT PLASMA BASE BIPOLAR RF TECHNOLOGY SUP-270000000 CDM 270 RC inpatient 319.2 312.82 All Payors / Plans All Payors / Plans 319.2 other 319.2 319.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE ELECTROSURGICAL FIAPC L220 CM OD2.3 MM FLEXIBLE STRAIGHT FIRE STERILE DISPOSABLE ARGON PLASMA COAGULATION SUP-270000000 CDM 270 RC inpatient 400.35 392.34 All Payors / Plans All Payors / Plans 400.35 other 400.35 400.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE LAPAROSCOPIC SONASTAR PLASTIC SILICONE RUBBER 23KHZ STANDARD L30 CM ID1.9 MM RIGID SHEATH STRAIGHT ASPIRATION TIP REPOSABLE SUP-270000000 CDM 270 RC inpatient 359.1 351.92 All Payors / Plans All Payors / Plans 359.1 other 359.1 359.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE LASER ENGAUGE VEKTOR OD25 GA ARTICULATE ILLUMINATE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 243.15 238.29 All Payors / Plans All Payors / Plans 243.15 other 243.15 243.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE LASER PUREPOINT 40 D L6 MM OD25 GA RETINA RFID FLEXIBLE NITINOL TIP EASY INSERTION ANGLED STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 324.19 317.71 All Payors / Plans All Payors / Plans 324.19 other 324.19 324.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE NASOPHARYNGEAL 9FR SUP-270000000 CDM 270 RC inpatient 3.31 3.24 All Payors / Plans All Payors / Plans 3.31 other 3.31 3.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE NERVE STIMULATOR NIM-RESPONSE STANDARD OD.33 MM PRASS MONOPOLAR FLUSH TIP SLIMLINE HANDLE STERILE SUP-270000000 CDM 270 RC inpatient 357.84 350.68 All Payors / Plans All Payors / Plans 357.84 other 357.84 357.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE VASCULAR POLYMER STANDARD L45 CM OD1-1.5 MM BULB FLEXIBLE SHAFT EXTRA SUPPLE STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 229.06 224.48 All Payors / Plans All Payors / Plans 229.06 other 229.06 229.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE VITRECTOMY EDGEPLUS 4 MM OD23 GA 1 COUNT VALVED ENTRY SYSTEM STAND ALONE SUP-270000000 CDM 270 RC inpatient 110.36 108.15 All Payors / Plans All Payors / Plans 110.36 other 110.36 110.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE VITRECTOMY EDGEPLUS 4 MM OD25 GA 1 COUNT VALVED ENTRY SYSTEM STAND ALONE LOCKING MECHANISM CANNULA SUP-270000000 CDM 270 RC inpatient 105.13 103.03 All Payors / Plans All Payors / Plans 105.13 other 105.13 105.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE VITRECTOMY GRIESHABER 30 D OD25 GA DSP POINTED TIP DIATHERMY ERGONOMIC HANDLE ACCURUS CONSTELLATION SUP-270000000 CDM 270 RC inpatient 51.06 50.04 All Payors / Plans All Payors / Plans 51.06 other 51.06 51.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE VITRECTOMY TOTAL PLUS CONSTELLATION 5000 CPM OD23 GA EDGEPLUS VALVED CANNULA STRAIGHT ENDOILLUMINATOR SUP-270000000 CDM 270 RC inpatient 1200.47 1176.46 All Payors / Plans All Payors / Plans 1200.47 other 1200.47 1200.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE VITRECTOMY ULTRAVIT 27+ 20000 CPM OD27 MM CONSTELLATION VISION SYSTEM SUP-270000000 CDM 270 RC inpatient 433.5 424.83 All Payors / Plans All Payors / Plans 433.5 other 433.5 433.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROGEL AIR SEALANT SUP-270000000 CDM 270 RC inpatient 4942.14 4843.3 All Payors / Plans All Payors / Plans 4942.14 other 4942.14 4942.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROTECTOR EXTREMITY KODEL UNIVERSAL HEEL ELBOW DELUXE FULL FOOT DESIGN VENTILATION HOLE STRAP HOOK LOOP CLOSURE NONSTERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 2.19 2.15 All Payors / Plans All Payors / Plans 2.19 other 2.19 2.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROTECTOR TISSUE ALEXIS LARGE FLEXIBLE RETRACTION RING ATRAUMATIC 360 DEGREE PROTECTION LATEX FREE 9-14 CM INCISION SUP-270000000 CDM 270 RC inpatient 115.5 113.19 All Payors / Plans All Payors / Plans 115.5 other 115.5 115.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUIKCLOT SUP-481000000 CDM 270 RC inpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RADIAL .035 INQWIRE J-TIP WIRE 210CM SUP-481000000 CDM 270 RC inpatient 17.34 16.99 All Payors / Plans All Payors / Plans 17.34 other 17.34 17.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RADPAD SHIELD SUP-481000000 CDM 270 RC inpatient 114.45 112.16 All Payors / Plans All Payors / Plans 114.45 other 114.45 114.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility REINFORCEMENT STAPLE LINE SEAMGUARD BIOABSORBABLE STERILE LATEX FREE DISPOSABLE BLUE GOLD GREEN WHITE ENDOPATH ECHELON FLEX 60 SUP-270000000 CDM 270 RC inpatient 350 343 All Payors / Plans All Payors / Plans 350 other 350 350 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility REINFORCEMENT STAPLE LINE SEAMGUARD BIOABSORBABLE STERILE LATEX FREE DISPOSABLE DST SERIES CEEA 25 CIRCLE STAPLER SUP-270000000 CDM 270 RC inpatient 619.5 607.11 All Payors / Plans All Payors / Plans 619.5 other 619.5 619.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ECHELON ENDOPATH 2.6MM WHITE VASCULAR THIN TISSUE SUP-270000000 CDM 270 RC inpatient 1167.03 1143.69 All Payors / Plans All Payors / Plans 1167.03 other 1167.03 1167.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ECHELON ENDOPATH H2.6 MM VASCULAR THIN TISSUE WHITE SUP-270000000 CDM 270 RC inpatient 165.61 162.3 All Payors / Plans All Payors / Plans 165.61 other 165.61 165.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ECHELON ENDOPATH H4.1 MM THICK TISSUE GREEN SUP-270000000 CDM 270 RC inpatient 737.35 722.6 All Payors / Plans All Payors / Plans 737.35 other 737.35 737.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ECHELON ENDOPATH L45 MM X H3.6 MM H1.5 MM REGULAR TISSUE BLUE SUP-270000000 CDM 270 RC inpatient 174.74 171.25 All Payors / Plans All Payors / Plans 174.74 other 174.74 174.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ECHELON ENDOPATH L60 MM X H3.6 MM H1.5 MM REGULAR TISSUE BLUE SUP-270000000 CDM 270 RC inpatient 389.01 381.23 All Payors / Plans All Payors / Plans 389.01 other 389.01 389.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ECHELON ENDOPATH L60 MM X H3.8 MM H1.8 MM REGULAR THICK TISSUE GOLD SUP-270000000 CDM 270 RC inpatient 389.01 381.23 All Payors / Plans All Payors / Plans 389.01 other 389.01 389.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ENDO GIA TRI-STAPLE 2MM 2.5MM 3MM 60MM TAN TITANIUM DISPOSABLE STERILE LF MED VASCULAR TISSUE ARTICULATE SUP-270000000 CDM 270 RC inpatient 477.03 467.49 All Payors / Plans All Payors / Plans 477.03 other 477.03 477.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ENDO GIA TRI-STAPLE 3MM 3.5MM 4MM 60MM PURPLE TITANIUM DISPOSABLE STERILE LF MED THICK TISSUE ARTICULATE SUP-270000000 CDM 270 RC inpatient 606.46 594.33 All Payors / Plans All Payors / Plans 606.46 other 606.46 606.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ENDO GIA TRI-STAPLE 4MM 4.5MM 5MM 60MM BLACK PVC DISPOSABLE STERILE LF EXTRA THICK TISSUE ARTICULATE SUP-270000000 CDM 270 RC inpatient 699.06 685.08 All Payors / Plans All Payors / Plans 699.06 other 699.06 699.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ENDO GIA TRI-STAPLE TITANIUM 2 MM 2.5 MM 3 MM L45 MM MEDIUM VASCULAR TISSUE ARTICULATE CURVE TIP ANVIL STERILE LATEX FREE DISPOSABLE TAN SUP-270000000 CDM 270 RC inpatient 1045.28 1024.37 All Payors / Plans All Payors / Plans 1045.28 other 1045.28 1045.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ENDO GIA TRI-STAPLE TITANIUM 2 MM 2.5 MM 3 MM L45 MM MEDIUM VASCULAR TISSUE ARTICULATE KNIFE BLADE FIX ANVIL LARGE BUCKET STERILE LATEX FREE DISPOSABLE TAN SUP-270000000 CDM 270 RC inpatient 339.19 332.41 All Payors / Plans All Payors / Plans 339.19 other 339.19 339.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ENDO GIA TRI-STAPLE TITANIUM 3 MM 3.5 MM 4 MM L45 MM MEDIUM THICK TISSUE ARTICULATE KNIFE BLADE FIX ANVIL LARGE BUCKET STERILE LATEX FREE DISPOSABLE PURPLE SUP-270000000 CDM 270 RC inpatient 435.02 426.32 All Payors / Plans All Payors / Plans 435.02 other 435.02 435.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ENDO GIA TRI-STAPLE TITANIUM 3 MM 3.5 MM 4 MM L45 MM MEDIUM THICK TISSUE ARTICULATE REINFORCE STERILE LATEX FREE DISPOSABLE PURPLE SUP-270000000 CDM 270 RC inpatient 631.13 618.51 All Payors / Plans All Payors / Plans 631.13 other 631.13 631.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ENDO GIA TRI-STAPLE TITANIUM 4 MM 4.5 MM 5 MM L60 MM EXTRA THICK TISSUE ARTICULATE REINFORCE STERILE LATEX FREE DISPOSABLE BLACK SUP-270000000 CDM 270 RC inpatient 873.3 855.83 All Payors / Plans All Payors / Plans 873.3 other 873.3 873.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER PROXIMATE TITANIUM H3.85 MM H1.5 MM REGULAR TISSUE STERILE LATEX FREE DISPOSABLE BLUE ENDOSCOPIC SUP-270009086 CDM 270 RC inpatient 134.98 132.28 All Payors / Plans All Payors / Plans 134.98 other 134.98 134.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER PROXIMATE TX TITANIUM L60 MM X H3.5 MM H1.5 MM REGULAR TISSUE 2 ROW STERILE LATEX FREE DISPOSABLE BLUE ENDOSCOPIC SUP-270009085 CDM 270 RC inpatient 68.68 67.31 All Payors / Plans All Payors / Plans 68.68 other 68.68 68.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER SIGNIA SMALL DIAMETER THIN L45 MM OD8 MM VASCULAR CURVE TIP STERILE LATEX FREE DISPOSABLE CANNULA SUP-270000000 CDM 270 RC inpatient 1102.5 1080.45 All Payors / Plans All Payors / Plans 1102.5 other 1102.5 1102.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER SIGNIA TRI-STAPLE BUTTRESS REINFORCED 60MM MED/THK SUP-270000000 CDM 270 RC inpatient 918.42 900.05 All Payors / Plans All Payors / Plans 918.42 other 918.42 918.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER SUREFORM 45 D2.5 MM STERILE LATEX FREE DISPOSABLE WHITE SUP-270000000 CDM 270 RC inpatient 714 699.72 All Payors / Plans All Payors / Plans 714 other 714 714 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER SUREFORM 45 D4.3 MM STERILE LATEX FREE DISPOSABLE GREEN SUP-270000000 CDM 270 RC inpatient 15876 15558.48 All Payors / Plans All Payors / Plans 15876 other 15876 15876 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD SUTURE ASSISTANT ENDO STITCH POLYSORB BRALON LACTOMER NYLON 3-0 ES-9 L48 IN 1 STITCH STERILE DISPOSABLE VIOLET SUP-270000000 CDM 270 RC inpatient 140.38 137.57 All Payors / Plans All Payors / Plans 140.38 other 140.38 140.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD SUTURE ASSISTANT ENDO STITCH SURGIDAC 0 ES-9 48IN GREEN LACTOMER DISPOSABLE STERILE 1 STITCH SUP-270000000 CDM 270 RC inpatient 144.5 141.61 All Payors / Plans All Payors / Plans 144.5 other 144.5 144.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD SUTURE ENDO STITCH SURGIDAC LACTOMER 2-0 ES-9 L7 IN 1 STITCH DISPOSABLE GREEN SUP-270000000 CDM 270 RC inpatient 1974.4 1934.91 All Payors / Plans All Payors / Plans 1974.4 other 1974.4 1974.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RESERVOIR DRAINAGE JACKSON-PRATT BULB 100CC SILICONE DISPOSABLE STERILE LF SUP-270009038 CDM 270 RC inpatient 8.35 8.18 All Payors / Plans All Payors / Plans 8.35 other 8.35 8.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RESERVOIR SHUNT OMMAYA L2.5 CM 1.14 ML CSF FLAT BOTTOM SIDE INLET STERILE SUP-270000000 CDM 270 RC inpatient 898.74 880.77 All Payors / Plans All Payors / Plans 898.74 other 898.74 898.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRACTOR SURGICAL ALEXIS 360 D MEDIUM FLEXIBLE RING ATRAUMATIC SELF RETAINING WOUND PROTECTOR 5-9 CM INCISION SUP-270000000 CDM 270 RC inpatient 61.2 59.98 All Payors / Plans All Payors / Plans 61.2 other 61.2 61.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRACTOR SURGICAL ALEXIS 360 D XL FLEXIBLE RING ATRAUMATIC SELF RETAINING WOUND PROTECTOR 11-17 CM INCISION SUP-270000000 CDM 270 RC inpatient 144.9 142 All Payors / Plans All Payors / Plans 144.9 other 144.9 144.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRACTOR SURGICAL ALEXIS 360D SM ATRAUMATIC SELF RETAIN FLEXIBLE RING WOUND PROTECTOR 2.5-6CM INCISION SUP-270000000 CDM 270 RC inpatient 61.2 59.98 All Payors / Plans All Payors / Plans 61.2 other 61.2 61.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRACTOR SURGICAL ALEXIS O 360 D LARGE RIGID RING ATRAUMATIC UNIQUE C SECTION 9-14 CM INCISION SUP-270000000 CDM 270 RC inpatient 93.5 91.63 All Payors / Plans All Payors / Plans 93.5 other 93.5 93.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRACTOR/ELEVATOR LAPAROSCOPIC VCARE LG 37MM DISPOSABLE STERILE LF CERVIX UTERUS 2 CUP HOLE MANIPULATOR INFLATABLE SUP-270000000 CDM 270 RC inpatient 149.52 146.53 All Payors / Plans All Payors / Plans 149.52 other 149.52 149.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRACTOR/ELEVATOR LAPAROSCOPIC VCARE MED 34MM DISPOSABLE STERILE LF CERVIX UTERUS 2 CUP LOCK SCREW HYSTERECTOMY SUP-270000000 CDM 270 RC inpatient 72.62 71.17 All Payors / Plans All Payors / Plans 72.62 other 72.62 72.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRIEVER ENDOSCOPIC RESCUENET PROMESH OMNILOOP L5.5 CM X W3CM L230CM OD2.5MM RETRIEVAL NET FOREIGN BODY REMOVAL GREATER VISIBILITY ULTRA STRONG BLUE SUP-270000000 CDM 270 RC inpatient 93.65 91.78 All Payors / Plans All Payors / Plans 93.65 other 93.65 93.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRIEVER ENDOSCOPIC TREVO NXT PROVUE L41 MM OD4 MM TREVO TRAK 21 MICROCATHETER STERILE LATEX FREE DISPOSABLE SUP-27000000 CDM 270 RC inpatient 19313.7 18927.43 All Payors / Plans All Payors / Plans 19313.7 other 19313.7 19313.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRIEVER SUTURE ISOTAC STRAIGHT ROTATOR CUFF ISOMETRY STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 47.7 46.75 All Payors / Plans All Payors / Plans 47.7 other 47.7 47.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIA 2 BONE HARVESTING KIT 520MM STERILE SUP-270000000 CDM 270 RC inpatient 6720.1 6585.7 All Payors / Plans All Payors / Plans 6720.1 other 6720.1 6720.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RING RETRACTOR LONE STAR NORYL PLASTIC L14.1 CM X W14.1 CM 2 PEEL POUCH SELF RETAINING FLEXIBLE LIGHTWEIGHT ELASTIC STAY STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 97.79 95.83 All Payors / Plans All Payors / Plans 97.79 other 97.79 97.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RING RETRACTOR LONE STAR NORYL PLASTIC L32.5 CM X W18.3 CM SELF RETAIN 2 CATHETER CLIP STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 249.26 244.27 All Payors / Plans All Payors / Plans 249.26 other 249.26 249.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROD MARNIER PRECONTOURED 5.5MM X 70 SUP-270000000 CDM 270 RC inpatient 5151 5047.98 All Payors / Plans All Payors / Plans 5151 other 5151 5151 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROD PRECONTOURED 5.5 X 110MM SUP-270010020 CDM 270 RC inpatient 14007 13726.86 All Payors / Plans All Payors / Plans 14007 other 14007 14007 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROD REAMING L950 MM OD2.5 MM BALL TIP STERILE DISPOSABLE SUP-270010022 CDM 270 RC inpatient 443.62 434.75 All Payors / Plans All Payors / Plans 443.62 other 443.62 443.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROLL COTTON LG 8.5X1FT STERILE LF 1LB HIGH ABSORBENT SUP-270000000 CDM 270 RC inpatient 7.71 7.56 All Payors / Plans All Payors / Plans 7.71 other 7.71 7.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROTABLATOR - ROTAWIRE DRIVE FLOPPY SUP-481000000 CDM 270 RC inpatient 424.15 415.67 All Payors / Plans All Payors / Plans 424.15 other 424.15 424.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROTAPRO 1.75MM BURR SUP-270000000 CDM 270 RC inpatient 3272.5 3207.05 All Payors / Plans All Payors / Plans 3272.5 other 3272.5 3272.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RULER SURGICAL PLASTIC PAPER L6 IN FLEXIBLE FIBER FREE STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 1.15 1.13 All Payors / Plans All Payors / Plans 1.15 other 1.15 1.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SAFE SHEATH CSG BRAIDED CORE SUP-481000000 CDM 270 RC inpatient 33.15 32.49 All Payors / Plans All Payors / Plans 33.15 other 33.15 33.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SAFESHEATH 9FR 13CM SUP-275000000 CDM 270 RC inpatient 341.25 334.43 All Payors / Plans All Payors / Plans 341.25 other 341.25 341.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SAFESHEATH CSG BRAIDED CORE SUP-481000000 CDM 270 RC inpatient 33.15 32.49 All Payors / Plans All Payors / Plans 33.15 other 33.15 33.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SAW BLADE SAGITTAL SUP-270000000 CDM 270 RC inpatient 99.67 97.68 All Payors / Plans All Payors / Plans 99.67 other 99.67 99.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCALPEL SURGICAL BARD-PARKER STAINLESS STEEL 10 1 HAND ACTIVATION LOCK RETRACTABLE SHIELD BLADE STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 3.63 3.56 All Payors / Plans All Payors / Plans 3.63 other 3.63 3.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCISSORS LAPAROSCOPIC ENDOPATH 360D CURVE 21CM 5MM DISPOSABLE STERILE LF RATCHET HANDLE MONOPOLAR CAUTERY INSULATE SHAFT SUP-270000000 CDM 270 RC inpatient 140.24 137.44 All Payors / Plans All Payors / Plans 140.24 other 140.24 140.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE 26MM 3.5MM SS NS CORTICAL SELF TAPPING SM FRAGMENT SET SUP-270010022 CDM 270 RC inpatient 56.76 55.62 All Payors / Plans All Payors / Plans 56.76 other 56.76 56.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE 2MM 11MM QUICKFIX TITANIUM FULL THREAD FOOT HAND ANKLE WRIST 3 PRONG SELF SUP-270000000 CDM 270 RC inpatient 504 493.92 All Payors / Plans All Payors / Plans 504 other 504 504 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE COALITION L14 MM OD4.2 MM SPINE SELF DRILL VARIABLE ANGLE NONSTERILE SUP-270010020 CDM 270 RC inpatient 315 308.7 All Payors / Plans All Payors / Plans 315 other 315 315 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 14MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 10 MM OD 4.7MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC inpatient 104.72 102.63 All Payors / Plans All Payors / Plans 104.72 other 104.72 104.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 12MM OD 4.7MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC inpatient 160.16 156.96 All Payors / Plans All Payors / Plans 160.16 other 160.16 160.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 14MM OD 4.7MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC inpatient 104.72 102.63 All Payors / Plans All Payors / Plans 104.72 other 104.72 104.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 36 MM OD 4.7 MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC inpatient 129.36 126.77 All Payors / Plans All Payors / Plans 129.36 other 129.36 129.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 38 MM OD 4.7MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC inpatient 129.36 126.77 All Payors / Plans All Payors / Plans 129.36 other 129.36 129.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 40 MM OD 4.7 MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC inpatient 129.36 126.77 All Payors / Plans All Payors / Plans 129.36 other 129.36 129.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 44 MM OD 4.7MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC inpatient 129.36 126.77 All Payors / Plans All Payors / Plans 129.36 other 129.36 129.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 55 MM OD 4.7 MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC inpatient 104.72 102.63 All Payors / Plans All Payors / Plans 104.72 other 104.72 104.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 65 MM OD 4.7 MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC inpatient 150.36 147.35 All Payors / Plans All Payors / Plans 150.36 other 150.36 150.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 10MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 11 MM OD 2.7 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 228.96 224.38 All Payors / Plans All Payors / Plans 228.96 other 228.96 228.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 11MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 54.6 53.51 All Payors / Plans All Payors / Plans 54.6 other 54.6 54.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 11MM OD 3.5MM CORTEX STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 12MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 13 MM OD 2.7 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 228.96 224.38 All Payors / Plans All Payors / Plans 228.96 other 228.96 228.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 13MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 13MM OD 3.5MM CORTEX STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 14 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 14MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 15 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 572 560.56 All Payors / Plans All Payors / Plans 572 other 572 572 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 15MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 54.6 53.51 All Payors / Plans All Payors / Plans 54.6 other 54.6 54.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 15MM OD 3.5MM CORTEX STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 15MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 16 MM OD 2.7 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 228.96 224.38 All Payors / Plans All Payors / Plans 228.96 other 228.96 228.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 16 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 17 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 54.6 53.51 All Payors / Plans All Payors / Plans 54.6 other 54.6 54.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 18 MM OD 2.7 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 228.96 224.38 All Payors / Plans All Payors / Plans 228.96 other 228.96 228.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 18 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 20MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 462 452.76 All Payors / Plans All Payors / Plans 462 other 462 462 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 24 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 24 MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 26 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 26 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 28 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 28 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 28 MM OD 3.5 MM SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 30 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 30 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 32 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 32 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 34 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 36 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 52.5 51.45 All Payors / Plans All Payors / Plans 52.5 other 52.5 52.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 38 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 38 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 38MM OD 4.5 MM CORTEX SELF TAP STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 99.32 97.33 All Payors / Plans All Payors / Plans 99.32 other 99.32 99.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 40 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 40 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 187 183.26 All Payors / Plans All Payors / Plans 187 other 187 187 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 40MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 42 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 44 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 44MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 46 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 48 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 50 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 50MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 55MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 60MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 462 452.76 All Payors / Plans All Payors / Plans 462 other 462 462 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 70 MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 105 102.9 All Payors / Plans All Payors / Plans 105 other 105 105 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 75MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 52.5 51.45 All Payors / Plans All Payors / Plans 52.5 other 52.5 52.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 80 MM OD 4.5MM SELF TAP LOCK STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 582.75 571.1 All Payors / Plans All Payors / Plans 582.75 other 582.75 582.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 8MM OD 3.5MM CORTEX STERILE SUP-270000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L12 MM OD 3.5 MM CORTEX SELF TAP SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L36 MM OD 4.5 MM SELF TAP LOCK STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 517.65 507.3 All Payors / Plans All Payors / Plans 517.65 other 517.65 517.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L42 MM OD3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 52.5 51.45 All Payors / Plans All Payors / Plans 52.5 other 52.5 52.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L60 MM OD3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L65 MM OD3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L76MM OD 4.5 MM CORTEX SELF TAP STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 80.22 78.62 All Payors / Plans All Payors / Plans 80.22 other 80.22 80.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI STAINLESS STEEL T7 L 11MM OD 2.4MM ODSEC 3.8MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC inpatient 263.12 257.86 All Payors / Plans All Payors / Plans 263.12 other 263.12 263.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI STAINLESS STEEL T7 L 15MM OD 2.4MM ODSEC 3.8MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC inpatient 172.04 168.6 All Payors / Plans All Payors / Plans 172.04 other 172.04 172.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI STAINLESS STEEL T7 L 17 MM OD 2.4 MM ODSEC 3.8MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC inpatient 212.52 208.27 All Payors / Plans All Payors / Plans 212.52 other 212.52 212.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI STAINLESS STEEL T7 L 22MM OD 2.4MM ODSEC 3.8MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC inpatient 212.52 208.27 All Payors / Plans All Payors / Plans 212.52 other 212.52 212.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI STAINLESS STEEL T7 L 26 MM OD 2.4 MM ODSEC 3.8MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC inpatient 212.52 208.27 All Payors / Plans All Payors / Plans 212.52 other 212.52 212.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI STAINLESS STEEL T7 L 30 MM OD 2.4 MM OD SEC 3.8 MMLONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC inpatient 263.12 257.86 All Payors / Plans All Payors / Plans 263.12 other 263.12 263.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI STAINLESS STEEL T7L 19 MM OD 2.4 MM OD SEC 3.8MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC inpatient 172.04 168.6 All Payors / Plans All Payors / Plans 172.04 other 172.04 172.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T6 L 13 MM OD 2 MM ODSEC 3.3 MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC inpatient 206.64 202.51 All Payors / Plans All Payors / Plans 206.64 other 206.64 206.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L 12 MM OD 2.4MM ODSEC3.8MM LONG BONE SMALL BONE CORTEX SELF TAP DRIVER STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L 13 MM OD 2.4MM ODSEC 3.8MM LONG BONE SMALL BONE CORTEX SELF TAP DRIVER STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L 14 MM OD 2.4MM ODSEC3.8MM LONG BONE SMALL BONE CORTEX SELF TAP DRIVER STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L 16 MM OD 2.4MM ODSEC3.8MM LONG BONE SMALL BONE CORTEX SELF TAP DRIVER STERILE SUP-270000000 CDM 270 RC inpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L 32 MM OD 2.4 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L13MM OD 2.4 MM LONG BONE SMALL BONE LOCK DRIVER STERILE SUP-270000000 CDM 270 RC inpatient 212.52 208.27 All Payors / Plans All Payors / Plans 212.52 other 212.52 212.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L18 MM OD 2.4 MM ODSEC 3.8 MM LONG BONE SMALL BONE LOCK DRIVER STERILE SUP-270000000 CDM 270 RC inpatient 263.12 257.86 All Payors / Plans All Payors / Plans 263.12 other 263.12 263.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L20 MM OD 2.4 MM ODSEC 3.8 MM LONG BONE SMALL BONE LOCK DRIVER STERILE SUP-270000000 CDM 270 RC inpatient 172.04 168.6 All Payors / Plans All Payors / Plans 172.04 other 172.04 172.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L30 MM OD 2.4 MNM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T8 L75 MM OD 2.7 MM LONG BONE SMALL BONE CORTEX SELF TAP SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS STAINLESS STEEL L 26 MM OD 2.4 MM WRIST CORTEX CADDY STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS STAINLESS STEEL T7 L 14MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS STAINLESS STEEL T7 L 16MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS STAINLESS STEEL T7 L 18 MM OD 3.5MM CORTEX SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 176.4 172.87 All Payors / Plans All Payors / Plans 176.4 other 176.4 176.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS STAINLESS STEEL T7 L 20MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS STAINLESS STEEL T7 L 22MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T6 L 12 MM OD 2 MM ODSEC 3 MM CORTEX SELF TAP STERILE MINI PLATE SYSTEM SUP-270000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T6 L 18 MM OD 2MM ODSEC 3 MM CORTEX SELF TAP MINI PLATE SYSTEM SUP-270000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T7 L 10 MM OD 2.4 MM SELF-TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 212.52 208.27 All Payors / Plans All Payors / Plans 212.52 other 212.52 212.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T7 L 10MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 54.6 53.51 All Payors / Plans All Payors / Plans 54.6 other 54.6 54.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T7 L 11MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 109.2 107.02 All Payors / Plans All Payors / Plans 109.2 other 109.2 109.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T7 L 12 MM OD 2.4 MM CORTEX LOCK SELF TAP STERILE SUP-270000000 CDM 270 RC inpatient 212.52 208.27 All Payors / Plans All Payors / Plans 212.52 other 212.52 212.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T7 L 14MM OD2.4MM ODSEC 3.8MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC inpatient 263.12 257.86 All Payors / Plans All Payors / Plans 263.12 other 263.12 263.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T7 L 16MM OD2.4MM ODSEC 3.8MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC inpatient 263.12 257.86 All Payors / Plans All Payors / Plans 263.12 other 263.12 263.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T8 L 11MM OD 2.7 MM ODSEC 4.5MM CORTEX SELF TAP MINI PLATE SYSTEM SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T8 L 12MM OD 2.7 MM ODSEC 4.5MM CORTEX SELF TAP MINI PLATE SYSTEM SUP-270000000 CDM 270 RC inpatient 132.3 129.65 All Payors / Plans All Payors / Plans 132.3 other 132.3 132.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T8 L 12MM OD 2.7 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 184.93 181.23 All Payors / Plans All Payors / Plans 184.93 other 184.93 184.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T8 L 14MM OD 2.7 MM ODSEC 4.5MM CORTEX SELF TAP MINI PLATE SYSTEM SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T8 L 16MM OD 2.7MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC inpatient 184.93 181.23 All Payors / Plans All Payors / Plans 184.93 other 184.93 184.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T8 L 20 MM OD 2.7MM LOCK SUP-270000000 CDM 270 RC inpatient 554.78 543.68 All Payors / Plans All Payors / Plans 554.78 other 554.78 554.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T8 L 38 MM OD 2.7 MM SELF TAP LOCK SUP-270000000 CDM 270 RC inpatient 184.93 181.23 All Payors / Plans All Payors / Plans 184.93 other 184.93 184.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L 25 MM OD 5 MM FEMUR LOW PROFILE INTERNAL HEX TRIGEN INTRAMEDULLARY NAIL SYSTEM SUP-270000000 CDM 270 RC inpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L 32.5 MM OD 5 MM FEMUR LOW PROFILE INTERNAL HEX TRIGEN INTRAMEDULLARY NAIL SYSTEM SUP-270000000 CDM 270 RC inpatient 468 458.64 All Payors / Plans All Payors / Plans 468 other 468 468 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L 37.5MM OD 5MM FEMUR LOW PROFILE INTERAL HEX SUP-270000000 CDM 270 RC inpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L 47.5 MM OD 5 MM FEMUR LOW PROFILE INTERNAL HEX TRIGEN INTRAMEDULLARY NAIL SYSTEM SUP-270000000 CDM 270 RC inpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L 52.5 MM OD 5 MM FEMUR LOW PROFILE INTERNAL HEX TRIGEN INTRAMEDULLARY NAIL SYSTEM SUP-270000000 CDM 270 RC inpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L 55 MM OD 5 MM LOW PROFILE INTERNAL HEX SUP-270000000 CDM 270 RC inpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L 70 MM OD 5MM LOW PROFILE INTERNAL HEX SUP-270000000 CDM 270 RC inpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L20 MM OD5.5 MM LOCK PERIPHERAL STERILE SUP-270010030 CDM 270 RC inpatient 88.41 86.64 All Payors / Plans All Payors / Plans 88.41 other 88.41 88.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L40 MM OD3.5 MM ODSEC6 MM PELVIC CORTEX SELF TAP SMALL HEXAGONAL SOCKET SUP-270010022 CDM 270 RC inpatient 112.06 109.82 All Payors / Plans All Payors / Plans 112.06 other 112.06 112.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L45 MM OD3.5 MM PELVIC CORTEX SELF TAP SUP-270010022 CDM 270 RC inpatient 190.58 186.77 All Payors / Plans All Payors / Plans 190.58 other 190.58 190.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L50 MM OD3.5 MM PELVIC CORTEX SELF TAP SUP-270010022 CDM 270 RC inpatient 56.03 54.91 All Payors / Plans All Payors / Plans 56.03 other 56.03 56.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L60 MM OD3.5 MM PELVIC CORTEX SELF TAP SUP-270010022 CDM 270 RC inpatient 59.79 58.59 All Payors / Plans All Payors / Plans 59.79 other 59.79 59.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L65 MM OD3.5 MM PELVIC CORTEX SELF TAP SUP-270010022 CDM 270 RC inpatient 59.79 58.59 All Payors / Plans All Payors / Plans 59.79 other 59.79 59.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE LC-DCP DCP STAINLESS STEEL FULL THREAD HEXAGON L20 MM OD3.5 MM ODSEC6 MM CLAVICLE HUMERUS TIBIA CORTICAL SELF TAP NONSTERILE SMALL FRAGMENT SET SUP-270010022 CDM 270 RC inpatient 45.84 44.92 All Payors / Plans All Payors / Plans 45.84 other 45.84 45.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE LC-DCP DCP STAINLESS STEEL FULL THREAD L32 MM OD3.5 MM ODSEC6 MM CLAVICLE HUMERUS TIBIA CORTICAL SELF TAPPING SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET SUP-270010022 CDM 270 RC inpatient 45.84 44.92 All Payors / Plans All Payors / Plans 45.84 other 45.84 45.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE LOW PROFILE TITANIUM T 15 FULL THREAD L 14 MM OD 3.5 MM MIDFOOT CORTICAL SELF DRILL SOLID HEXALOBE SUP-270000000 CDM 270 RC inpatient 252 246.96 All Payors / Plans All Payors / Plans 252 other 252 252 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE MARINER L45 MM OD6.5 MM SPINE CANNULATED NONSTERILE SUP-270010020 CDM 270 RC inpatient 5950 5831 All Payors / Plans All Payors / Plans 5950 other 5950 5950 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE MARINER L55 MM OD6.5 MM SPINAL SOLID SUP-270000000 CDM 270 RC inpatient 1190 1166.2 All Payors / Plans All Payors / Plans 1190 other 1190 1190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE MATRIXNEURO TITANIUM L4 MM OD1.5 MM CRANIOMAXILLOFACIAL SELF DRILLING NONSTERILE SUP-270010013 CDM 270 RC inpatient 292.52 286.67 All Payors / Plans All Payors / Plans 292.52 other 292.52 292.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE OD 3.5 MM T7 L 18MM OD 2.4MM CORTEX SELF RETAINING SCREWDRIVER SELF TAP FLAT HEAD STERILE EVOS MINI SUP-270000000 CDM 270 RC inpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE OD 3.5 MM T7 L 65 MM OD 2.4MM ODSEC 3.8MM CORTEX SELF RETAINING SCREWDRIVER SELF TAP FLAT HEAD STERILE EVOS MINI SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE OD 3.5MM T7 L 80 MM OD 2.4MM ODSEC 3.8MM CORTEX SELF RETAINING SCREWDRIVER SELF TAP FLAT HEAD STERILE EVOS MINI SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE PERI-LOC STAINLESS STEEL 2.5 MM FLUTE L 36MM L 14MM OD 4MM ODSEC 6MM HIP SELF TAP CANNULATED TROCAR STERILE SUP-270000000 CDM 270 RC inpatient 389.13 381.35 All Payors / Plans All Payors / Plans 389.13 other 389.13 389.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE PERI-LOC STAINLESS STEEL 2.5MM FLUTE L 34 MM L 14MM OD 4 MM ODSEC 6 MM HIP CANNULATED SELF TAP TROCAR STERILE SUP-270000000 CDM 270 RC inpatient 389.13 381.35 All Payors / Plans All Payors / Plans 389.13 other 389.13 389.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE PERI-LOCK STAINLESS STEEL 2.5 MM FLUTE L 38 MM L 14 MM OD 4 MM ODSEC 6 MM HIP CANNULATED SELF TAP TROCAR STERILE SUP-270000000 CDM 270 RC inpatient 389.13 381.35 All Payors / Plans All Payors / Plans 389.13 other 389.13 389.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 20 MM OD 2.4 MM CORITCAL STERILE SUP-270000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 22MM OD 2.7MM CORTICAL STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 24 MM OD 2.4 MM CORTICAL STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 24 MM OD 2.7 MM CORTICAL STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 28 MM OD 2.4 MM CORTICAL STERILE SUP-270000000 CDM 270 RC inpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 30 MM OD 2.7 MM CORTICAL STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 32MM OD 2.7MM CORTICAL STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 34 MM OD 2.4 MM CORTICAL STERILE SUP-270000000 CDM 270 RC inpatient 71.4 69.97 All Payors / Plans All Payors / Plans 71.4 other 71.4 71.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 34MM OD 2.7MM CORTICAL STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 36 MM OD 2.4 MM CORTICAL STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 38MM OD 2.7MM CORTICAL STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 44 MM OD 2.4 MM CORTICAL STERILE SUP-270000000 CDM 270 RC inpatient 54.6 53.51 All Payors / Plans All Payors / Plans 54.6 other 54.6 54.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 46 MM OD 2.4 MM CORTICAL STERILE SUP-270000000 CDM 270 RC inpatient 54.6 53.51 All Payors / Plans All Payors / Plans 54.6 other 54.6 54.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 60 MM OD 2.4 MM CORTICAL STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 70MM OD 2.7MM CORTICAL STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 8 MM OD 2 MM CORTICAL STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 8 MM OD 2 MM LOCK STERILE SUP-270000000 CDM 270 RC inpatient 206.64 202.51 All Payors / Plans All Payors / Plans 206.64 other 206.64 206.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STELL L 26 MM OD 2.7 MM CORTICAL STERILE SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STANDARD L14 MM OD3.6 MM SPINE VARIABLE ANGLE SELF DRILL STERILE SUP-270010020 CDM 270 RC inpatient 1575 1543.5 All Payors / Plans All Payors / Plans 1575 other 1575 1575 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE T7 L 60 MM OD 2.7 MM ODSEC 4.5 MM CORTEX SELF RETAINING SCREWDRIVER SELF TAP FLAT HEAD STERILE EVOS MINI SUP-270000000 CDM 270 RC inpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE T8 OD 2MM L 14MM OD 2.7MM ODSEC 4.3MM SMALL BONE LONG BONE SELF TAP LOCK EVOS SUP-270000000 CDM 270 RC inpatient 184.93 181.23 All Payors / Plans All Payors / Plans 184.93 other 184.93 184.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TITANIUM L36 MM OD3 MM COMPRESSION CANNULATED NONSTERILE SUP-270000000 CDM 270 RC inpatient 1624.35 1591.86 All Payors / Plans All Payors / Plans 1624.35 other 1624.35 1624.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TITANIUM L38 MM OD3 MM COMPRESSION CANNULATED NONSTERILE SUP-270000000 CDM 270 RC inpatient 919.8 901.4 All Payors / Plans All Payors / Plans 919.8 other 919.8 919.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TITANIUM L65 MM OD5.5 MM COMPRESSION CANNULATED NONSTERILE SUP-270000000 CDM 270 RC inpatient 2216.63 2172.3 All Payors / Plans All Payors / Plans 2216.63 other 2216.63 2216.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SCREW BONE TITANIUM SHORT THREAD L44 MM L11 MM OD3.5 MM COMPRESSION SELF TAP, SELF DRILL CANNULATED NONSTERILE" SUP-270000000 CDM 270 RC inpatient 966.88 947.54 All Payors / Plans All Payors / Plans 966.88 other 966.88 966.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TRIDENT II L15 MM OD6.5 MM LOW PROFILE HEXAGONAL STERILE SUP-270010024 CDM 270 RC inpatient 207.9 203.74 All Payors / Plans All Payors / Plans 207.9 other 207.9 207.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TRIDENT II L20 MM OD6.5 MM LOW PROFILE HEXAGONAL STERILE SUP-270010024 CDM 270 RC inpatient 142.8 139.94 All Payors / Plans All Payors / Plans 142.8 other 142.8 142.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TRIDENT II L30 MM OD6.5 MM LOW PROFILE HEXAGONAL STERILE SUP-270010024 CDM 270 RC inpatient 207.9 203.74 All Payors / Plans All Payors / Plans 207.9 other 207.9 207.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TRIGEN L 27.5 MM OD 5 MM TIBIAL INTERNAL CAPTURE SUP-270000000 CDM 270 RC inpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TRIGEN L 30 MM OD 5 MM TIBIAL INTERNAL CAPTURE SUP-270000000 CDM 270 RC inpatient 225 220.5 All Payors / Plans All Payors / Plans 225 other 225 225 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TRIGEN L 35MM OD 5MM TIBIAL INTERNAL CAPTURE SUP-270000000 CDM 270 RC inpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TRIGEN L 40 MM OD 5 MM TIBIAL INTERNAL CAPTURE SUP-270000000 CDM 270 RC inpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VELYS L100 MM OD4 MM STERILE SUP-270010025 CDM 270 RC inpatient 71.4 69.97 All Payors / Plans All Payors / Plans 71.4 other 71.4 71.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VELYS L125 MM OD4 MM STERILE SUP-270010025 CDM 270 RC inpatient 138.72 135.95 All Payors / Plans All Payors / Plans 138.72 other 138.72 138.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP 15D 2.5 MM L28 MM X H 3.3MM OD 5MM ODSEC 5.4MM MIDFOOT HINDFOOT LOCKING LOW PROFILE HEAD HEXAGONAL RECESS DRIVE OSTEOPENIA SUP-270000000 CDM 270 RC inpatient 376.32 368.79 All Payors / Plans All Payors / Plans 376.32 other 376.32 376.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP 15D 2.5 MM L30 MM X H 3.3MM OD 5MM ODSEC 5.4MM MIDFOOT HINDFOOT LOCKING LOW PROFILE HEAD HEXAGONAL RECESS DRIVE OSTEOPENIA SUP-270000000 CDM 270 RC inpatient 376.32 368.79 All Payors / Plans All Payors / Plans 376.32 other 376.32 376.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM L 13 MM OD 2.4 MM FOOT LOCK SELF TAP T7 DRIVER SUP-270000000 CDM 270 RC inpatient 286.02 280.3 All Payors / Plans All Payors / Plans 286.02 other 286.02 286.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM L 14 MM OD 2.4 MM FOOT LOCK SELF TAP T7 DRIVER SUP-270000000 CDM 270 RC inpatient 858.06 840.9 All Payors / Plans All Payors / Plans 858.06 other 858.06 858.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM L 20 MM OD 2.4MM FOOT LOCK SELF TAP SUP-270000000 CDM 270 RC inpatient 286.02 280.3 All Payors / Plans All Payors / Plans 286.02 other 286.02 286.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM T7 L 12 MM OD 2.4 MM FOOT LOCK SELF TAP SUP-270000000 CDM 270 RC inpatient 286.02 280.3 All Payors / Plans All Payors / Plans 286.02 other 286.02 286.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM T7 L 15 MM OD 2.4 MM FOOT LOCK SELF TAP SUP-270000000 CDM 270 RC inpatient 572.04 560.6 All Payors / Plans All Payors / Plans 572.04 other 572.04 572.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM T7 L 6 MM OD 2.4 MM FOOT CORTICAL SELF TAP SUP-270000000 CDM 270 RC inpatient 272.16 266.72 All Payors / Plans All Payors / Plans 272.16 other 272.16 272.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM T7 L 6 MM OD 2.4 MM FOOT LOCK SELF TAP SUP-270000000 CDM 270 RC inpatient 858.06 840.9 All Payors / Plans All Payors / Plans 858.06 other 858.06 858.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM T7 L 8 MM OD 2.4 MM FOOT LOCK SELF TAP SUP-270000000 CDM 270 RC inpatient 286.02 280.3 All Payors / Plans All Payors / Plans 286.02 other 286.02 286.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM T7 L7 MM OD 2.4 MM FOOT LOCK SELF TAP SUP-270000000 CDM 270 RC inpatient 286.02 280.3 All Payors / Plans All Payors / Plans 286.02 other 286.02 286.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE ZEVO TITANIUM L15 MM OD3.5 MM SPINE CERVICAL ANTERIOR VARIABLE SELF DRILL SUP-270010020 CDM 270 RC inpatient 840 823.2 All Payors / Plans All Payors / Plans 840 other 840 840 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW CORTICAL SHANK CANNULATED 5.5MM X 35MM SUP-270000000 CDM 270 RC inpatient 1470 1440.6 All Payors / Plans All Payors / Plans 1470 other 1470 1470 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW DISTRACTION 14MM SS DISPOSABLE STERILE LF SPINE CERVICAL ANTERIOR SHARP TIP SELF TAP THREAD PIN UNIVERSAL BULLET SUP-270000000 CDM 270 RC inpatient 95.61 93.7 All Payors / Plans All Payors / Plans 95.61 other 95.61 95.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW EVOS BLT TIP LCK 4.5MM X 12MM SUP-270000000 CDM 270 RC inpatient 905.1 887 All Payors / Plans All Payors / Plans 905.1 other 905.1 905.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW EVOS LOCKING 4.5MM X 30MM STERILE SUP-270000000 CDM 270 RC inpatient 517.65 507.3 All Payors / Plans All Payors / Plans 517.65 other 517.65 517.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW EVOS LOCKING 4.5MM X 72MM STERILE SUP-270000000 CDM 270 RC inpatient 517.65 507.3 All Payors / Plans All Payors / Plans 517.65 other 517.65 517.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW LOCKING EVOS 4.5MM X 20 MM S-T SUP-270000000 CDM 270 RC inpatient 1035.3 1014.59 All Payors / Plans All Payors / Plans 1035.3 other 1035.3 1035.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW LOCKING EVOS 4.5MM X 66MM S-T SUP-270000000 CDM 270 RC inpatient 616.25 603.93 All Payors / Plans All Payors / Plans 616.25 other 616.25 616.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW LOCKING EVOS L 40MM 4.5 MM S-T SUP-270000000 CDM 270 RC inpatient 517.65 507.3 All Payors / Plans All Payors / Plans 517.65 other 517.65 517.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW PERIPHERAL LOCKING 5.5MM X 24MM SUP-270010030 CDM 270 RC inpatient 89.22 87.44 All Payors / Plans All Payors / Plans 89.22 other 89.22 89.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW PINNACLE CANCELLOUS BONE 6.5MM X 35MM SUP-270010024 CDM 270 RC inpatient 318.78 312.4 All Payors / Plans All Payors / Plans 318.78 other 318.78 318.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW SELF DRILLING 1.5MM 4MM SUP-270000000 CDM 270 RC inpatient 911.4 893.17 All Payors / Plans All Payors / Plans 911.4 other 911.4 911.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SCREW, BONE REMOVER" SUP-270000000 CDM 270 RC inpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEAL 12MM STAPLER CANNULA SUP-270000000 CDM 270 RC inpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEAL 5-8MM UNIVERSAL SUP-270000000 CDM 270 RC inpatient 39.69 38.9 All Payors / Plans All Payors / Plans 39.69 other 39.69 39.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEALANT TISSUE CLOSURE DURASEAL EXACT 5ML DISPOSABLE STERILE LF SPINE SUP-270000000 CDM 270 RC inpatient 1395.9 1367.98 All Payors / Plans All Payors / Plans 1395.9 other 1395.9 1395.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEALER TISSUE ENSEAL G2 STRAIGHT L45 CM OD5 MM ARTICULATE SUP-270000000 CDM 270 RC inpatient 578.25 566.69 All Payors / Plans All Payors / Plans 578.25 other 578.25 578.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEALER TISSUE SYNCHROSEAL DA VINCI L8MM SUP-270000000 CDM 270 RC inpatient 1521.45 1491.02 All Payors / Plans All Payors / Plans 1521.45 other 1521.45 1521.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEALER VESSEL SUP-270000000 CDM 270 RC inpatient 669.46 656.07 All Payors / Plans All Payors / Plans 669.46 other 669.46 669.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEALER/DIVIDER BIPOLAR LIGASURE 180D STRAIGHT 37CM 19.5MM 5MM DISPOSABLE STERILE LF HANDSWITCH 2 ACTION CONTOUR BLUNT SUP-270000000 CDM 270 RC inpatient 814.7 798.41 All Payors / Plans All Payors / Plans 814.7 other 814.7 814.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEALER/DIVIDER BIPOLAR LIGASURE IMPACT 180 D L34 MM LARGE L7.1 IN L36 MM OD13.5 MM HAND ACTIVATION CURVE JAW THERMAL SPREAD LIGHTWEIGHT STERILE DISPOSABLE FORCETRIAD SUP-270000000 CDM 270 RC inpatient 2408.1 2359.94 All Payors / Plans All Payors / Plans 2408.1 other 2408.1 2408.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEALER/DIVIDER LAPAROSCOPIC LIGASURE 350 D L18.5 MM L44 CM L20.3 MM MARYLAND CURVE JAW NANO COAT VALLEYLAB FT10 LS10 FORCETRIAD ENERGY PLATFORM SUP-270000000 CDM 270 RC inpatient 960.19 940.99 All Payors / Plans All Payors / Plans 960.19 other 960.19 960.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SENSOR PULSE OXIMETER FINGER DISPOSABLE ADULT 18IN SUP-270009154 CDM 270 RC inpatient 10.8 10.58 All Payors / Plans All Payors / Plans 10.8 other 10.8 10.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET ACCESS MICROPUNCTURE STAINLESS STEEL PLATINUM .018 IN L40 CM L10 CM L7 CM OD4 FR ODSEC21 GA GUIDEWIRE PART NEEDLE TRANSITIONLESS TIP COAXIAL CATHETER STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 58.67 57.5 All Payors / Plans All Payors / Plans 58.67 other 58.67 58.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET ADMINISTRATION INFUSOMAT 15GTT/ML L122IN 22ML SPACE PUMP FREE FLOW PROTECTION CLAMP SPIN LOCK CONNECTOR UNIVERSAL SPIKE LATEX FREE SUP-270000000 CDM 270 RC inpatient 8.29 8.12 All Payors / Plans All Payors / Plans 8.29 other 8.29 8.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET ADMINISTRATION L48 IN FLUID NONVENTED SPIKE PINCH CLAMP LARGE BORE TUBING SUP-270000000 CDM 270 RC inpatient 3.98 3.9 All Payors / Plans All Payors / Plans 3.98 other 3.98 3.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET ADMINISTRATION LIFESHIELD CAIR CLAVE OPTION-LOK 15 GTT/ML L100 IN ID.1 IN 16 ML CONVERTIBLE PIERCE PIN FILTER VENT COVER SLIDE CLAMP PRIMARY NONSTERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 5.63 5.52 All Payors / Plans All Payors / Plans 5.63 other 5.63 5.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET AIRSEAL BIFURCATED SMOKE EVAC FILTERED TUBE SET SUP-270000000 CDM 270 RC inpatient 195.49 191.58 All Payors / Plans All Payors / Plans 195.49 other 195.49 195.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET ANGIOGRAPHY STANDARD BORE L135 IN MALE LUER LOCK FILTER MICRO DRIP CHAMBER STERILE LATEX FREE DISPOSABLE CLEAR SUP-270000000 CDM 270 RC inpatient 26.04 25.52 All Payors / Plans All Payors / Plans 26.04 other 26.04 26.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET DALL-MILES CABLE & SLEEVE USE 17984 SUP-270010024 CDM 270 RC inpatient 534.65 523.96 All Payors / Plans All Payors / Plans 534.65 other 534.65 534.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET DILATOR STAINLESS STEEL POLYETHYLENE STRAIGHT L37 CM L80 CM OD8-24 FR ODSEC.038 IN URETHRAL RADIOPAQUE GUIDEWIRE SAFETY INDEX MARK SUP-270000000 CDM 270 RC inpatient 671.2 657.78 All Payors / Plans All Payors / Plans 671.2 other 671.2 671.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET DRAINAGE PLEURX PERITONEUM LINE LOCKABLE STERILE LATEX FREE DISPOSABLE CATHETER SYSTEM SUP-270000000 CDM 270 RC inpatient 36.62 35.89 All Payors / Plans All Payors / Plans 36.62 other 36.62 36.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET EXTENSION L35 IN 3.9 ML INTRAVENOUS 3 WAY STOPCOCK MALE LUER LOCK CAP INJECTION SITE STANDARD BORE STERILE LATEX FREE DISPOSABLE WHITE SUP-270000000 CDM 270 RC inpatient 1.67 1.64 All Payors / Plans All Payors / Plans 1.67 other 1.67 1.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET IMPLANT SUTUREBRIDGE ANCHOR DRILL GUIDE PUNCH TAP ACHILLES PACK SUP-270000000 CDM 270 RC inpatient 3654 3580.92 All Payors / Plans All Payors / Plans 3654 other 3654 3654 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET INTRODUCER MICROPUNCTURE PUSH-PLUS NITINOL .018 IN L40 CM L10 CM OD4 FR TRANSITIONLESS STIFFENED CANNULA PLATINUM TIP NITINOL WIREGUIDE COAXIAL CATHETER STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 50.15 49.15 All Payors / Plans All Payors / Plans 50.15 other 50.15 50.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET INTRODUCER MICROPUNCTURE SILHOUETTE STAINLESS STEEL L40 CM L10 CM OD5 FR OD.018 IN WIRE GUIDE PLATINUM TIP TRANSITIONLESS COAXIAL CATHETER DILATOR STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 28.5 27.93 All Payors / Plans All Payors / Plans 28.5 other 28.5 28.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET INTRODUCER PEEL-AWAY MICROPUNCTURE ECHOTIP TORQ-FLEX STAINLESS STEEL .018 IN T L65 CM L9 CM OD5.5 FR LUER LOCK SHEATH ENTRY NEEDLE GUIDEWIRE PICC DENNY MODIFICATION STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 169.07 165.69 All Payors / Plans All Payors / Plans 169.07 other 169.07 169.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET INTRODUCER PERFORMER L13 CM OD16 FR ACCEPTS .038 IN GUIDEWIRE SUP-272000000 CDM 270 RC inpatient 249.48 244.49 All Payors / Plans All Payors / Plans 249.48 other 249.48 249.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET IRRIGATION DEHP C100 ML STANDARD Y 2 BRANCH L100 IN ID.28 IN UROLOGICAL CONNECTOR 2 NONVENT PIERCING PIN 3 PINCH CLAMP STERILE LATEX FREE ARTHROSCOPY SUP-270000000 CDM 270 RC inpatient 21.06 20.64 All Payors / Plans All Payors / Plans 21.06 other 21.06 21.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET IRRIGATION HUMMER II 2 TUBE HOLDER MICRODEBRIDER LF DISPOSABLE SUP-270000000 CDM 270 RC inpatient 96.84 94.9 All Payors / Plans All Payors / Plans 96.84 other 96.84 96.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET IRRIGATION L77 IN ID.241 IN BLADDER GRAVITY FLOW LARGE BORE NONVENT PIERCING PIN SIGHT CHAMBER STERILE LATEX FREE CYSTOSCOPY SUP-270000000 CDM 270 RC inpatient 11.57 11.34 All Payors / Plans All Payors / Plans 11.57 other 11.57 11.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET IRRIGATION LEVEL 1 NORMOFLO 300 MMHG GAS VENT SURGE CHAMBER 2 SPIKE POSTOPERATIVE CBI SETUP STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 78.89 77.31 All Payors / Plans All Payors / Plans 78.89 other 78.89 78.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET IRRIGATION MALIS BIPOLAR CORD INTEGRATE TUBE ROTARY DISPOSABLE SUP-270000000 CDM 270 RC inpatient 56.38 55.25 All Payors / Plans All Payors / Plans 56.38 other 56.38 56.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET STENT ZIMMON POLYETHYLENE 2 PIGTAIL CURVE L5 CM OD10 FR BILIARY PUSH CATHETER SMOOTH CANNULATION TAPER TIP STERILE PURPLE ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 312.9 306.64 All Payors / Plans All Payors / Plans 312.9 other 312.9 312.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET TUBING AIRSEAL ACTIVATE CHARCOAL 3 LUMEN FILTER STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 98.31 96.34 All Payors / Plans All Payors / Plans 98.31 other 98.31 98.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET TUBING COOL POINT L2.6 MR 2 WAY COMMUNICATION IRRIGATION PUMP CATHETER SUP-270000000 CDM 270 RC inpatient 51 49.98 All Payors / Plans All Payors / Plans 51 other 51 51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET TUBING DUALWAVE CASSETTE OUTFLOW STERILE DISPOSABLE ARTHROSCOPY PUMP SUP-270000000 CDM 270 RC inpatient 68.88 67.5 All Payors / Plans All Payors / Plans 68.88 other 68.88 68.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET TUBING ULTRASONIC ASPIRATOR SONASTAR SUP-270000000 CDM 270 RC inpatient 176.26 172.73 All Payors / Plans All Payors / Plans 176.26 other 176.26 176.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET VENTRICULAR DRAINAGE TRAUMACATH L35 CM OD10 FR ODSEC3.3 MM ID1.9 MM CONNECTOR TROCAR SUTURE COLLAR STYLET STERILE LATEX FREE SUP-270009149 CDM 270 RC inpatient 96 94.08 All Payors / Plans All Payors / Plans 96 other 96 96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEARS ELECTROSURGICAL HARMONIC ACE CURVE 36CM 5MM TITANIUM DISPOSABLE STERILE LF SHAFT PISTOL HANDLE HANDCONTROL SUP-270000000 CDM 270 RC inpatient 875.16 857.66 All Payors / Plans All Payors / Plans 875.16 other 875.16 875.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEARS ELECTROSURGICAL HARMONIC FOCUS+ CURVE TAPER 9CM DISPOSABLE STERILE 2 HAND CONTROL ADAPTIVE TISSUE TECHNOLOGY SOFT SUP-270000000 CDM 270 RC inpatient 950.18 931.18 All Payors / Plans All Payors / Plans 950.18 other 950.18 950.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEARS LAPAROSCOPIC HARMONIC ACE +7 L45 CM OD5 MM CURVE TIP ADVANCE HEMOSTASIS ULTRASONIC SUP-270000000 CDM 270 RC inpatient 1198.29 1174.32 All Payors / Plans All Payors / Plans 1198.29 other 1198.29 1198.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH ACCESS FLEXOR 55CM 12FR AQ DISPOSABLE STERILE LATEX URETERAL DILATION CONTINUOUS WORK CHANNEL FLEXIBLE SCOPE SUP-270000000 CDM 270 RC inpatient 384.43 376.74 All Payors / Plans All Payors / Plans 384.43 other 384.43 384.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH ACCESS NAVIGATOR HD STAINLESS STEEL HYDROPHILIC L28 CM OD11-13 FR URETERAL 2 DUROMETER DILATOR RADIOPAQUE INNOVATIVE HUB LATEX FREE URETEROSCOPIC SUP-270000000 CDM 270 RC inpatient 267.56 262.21 All Payors / Plans All Payors / Plans 267.56 other 267.56 267.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH ACCESS NAVIGATOR HD STAINLESS STEEL HYDROPHILIC L36 CM OD11-13 FR URETERAL 2 DUROMETER DILATOR RADIOPAQUE INNOVATIVE HUB LATEX FREE URETEROSCOPIC SUP-270000000 CDM 270 RC inpatient 267.56 262.21 All Payors / Plans All Payors / Plans 267.56 other 267.56 267.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH ACCESS NAVIGATOR HD STAINLESS STEEL HYDROPHILIC L46 CM OD11-13 FR URETERAL 2 DUROMETER DILATOR RADIOPAQUE INNOVATIVE HUB LATEX FREE URETEROSCOPIC SUP-270000000 CDM 270 RC inpatient 267.56 262.21 All Payors / Plans All Payors / Plans 267.56 other 267.56 267.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH AXS INFINITY LS LONG 80 CM SUP-270000000 CDM 270 RC inpatient 1113 1090.74 All Payors / Plans All Payors / Plans 1113 other 1113 1113 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH AXS INFINITY LS LONG 90 CM SUP-270000000 CDM 270 RC inpatient 1245.3 1220.39 All Payors / Plans All Payors / Plans 1245.3 other 1245.3 1245.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH CATHETER TOURGUIDE HYDROPHILIC 180 D L70 CM L55 CM ID6.5 FR STEERABLE SUP-270000000 CDM 270 RC inpatient 1037 1016.26 All Payors / Plans All Payors / Plans 1037 other 1037 1037 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH GUIDING FLEXOR CHECK-FLO 55CM 6FR 2.2MM RAABE MODIFICATION ACCEPTS .038IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 99.86 97.86 All Payors / Plans All Payors / Plans 99.86 other 99.86 99.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH GUIDING FLEXOR SHUTTLE-SL 90CM 6FR .087IN HYDROPHILIC DISPOSABLE STERILE TUOHY BORST SIDEARM RADIOPAQUE STIFFEN SUP-270000000 CDM 270 RC inpatient 228.86 224.28 All Payors / Plans All Payors / Plans 228.86 other 228.86 228.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH GUIDING PREFACE MULTIPURPOSE CURVE L62 CM OD8 FR ID.11 IN 2 WIRE BRAID MULTISEGMENT OBLIQUE CUT VALVE SUP-272000000 CDM 270 RC inpatient 367.5 360.15 All Payors / Plans All Payors / Plans 367.5 other 367.5 367.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER FLEXCATH PEBAX BARIUM SULFATE 135 D L65 CM L81 CM OD15 FR ID12 FR STERRABLE ARCTIC FRONT ADVANCE CRYOBALLOON ACHIEVE MAPPING CATHETER DILATOR RADIOPAQUE MARKER STERILE REUSABLE SUP-270000000 CDM 270 RC inpatient 1700 1666 All Payors / Plans All Payors / Plans 1700 other 1700 1700 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER GORE DRYSEAL L33 CM OD12 FR ODSEC4.7 MM ID4 MM DILATOR VALVE INFLATION SYRINGE SUP-270000000 CDM 270 RC inpatient 1684.8 1651.1 All Payors / Plans All Payors / Plans 1684.8 other 1684.8 1684.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER GORE DRYSEAL L33 CM OD14 FR ODSEC5.3 MM ID4.7 MM DILATOR VALVE INFLATION SYRINGE SUP-481000000 CDM 270 RC inpatient 1360.8 1333.58 All Payors / Plans All Payors / Plans 1360.8 other 1360.8 1360.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER GORE DRYSEAL L33 CM OD18 FR ODSEC6.7 MM ID6 MM DILATOR VALVE INFLATION SYRINGE SUP-270010015 CDM 270 RC inpatient 2145 2102.1 All Payors / Plans All Payors / Plans 2145 other 2145 2145 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER PINNACLE .038IN 10CM 2.5CM 5FR HYDROPHILIC PTFE KINK RESISTANT DILATOR GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 8.93 8.75 All Payors / Plans All Payors / Plans 8.93 other 8.93 8.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER PINNACLE DESTINATION PTFE HYDROPHILIC L10 CM L2.5 CM OD7 FR PERIPHERAL KINK RESISTANT DESIGN CROSS CUT VALVE SMOOTH TRANSITION DILATOR SUP-270000000 CDM 270 RC inpatient 18.38 18.01 All Payors / Plans All Payors / Plans 18.38 other 18.38 18.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER PINNACLE HYDROPHILIC PTFE .038 IN L10 CM L2.5 CM OD11 FR PERIPHERAL GUIDEWIRE DILATOR KINK RESISTANT SUP-481000000 CDM 270 RC inpatient 18.69 18.32 All Payors / Plans All Payors / Plans 18.69 other 18.69 18.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER PINNACLE HYDROPHILIC PTFE .038 IN L10 CM L2.5 CM OD9 FR GUIDEWIRE DILATOR KINK RESISTANT SUP-270000000 CDM 270 RC inpatient 14.88 14.58 All Payors / Plans All Payors / Plans 14.88 other 14.88 14.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER PINNACLE STAINLESS STEEL .035 IN L10 CM L2.5 CM ID5 FR PERIPHERAL SNAP ON DILATOR LOCK KINK RESISTANT SMOOTH TRANSITION SPRING COIL GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 89.25 87.47 All Payors / Plans All Payors / Plans 89.25 other 89.25 89.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER PINNACLE STAINLESS STEEL .035 IN L10 CM L2.5 CM ID6 FR PERIPHERAL SNAP ON DILATOR LOCK KINK RESISTANT SMOOTH TRANSITION SPRING COIL GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 148.75 145.78 All Payors / Plans All Payors / Plans 148.75 other 148.75 148.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER PINNACLE STAINLESS STEEL .035IN L10 CM L2.5 CM ID11 FR PERIPHERAL SNAP ON DILATOR LOCK KINK RESISTANT SMOOTH TRANSITION SPRING COIL GUIDEWIRE SUP-272000000 CDM 270 RC inpatient 18.48 18.11 All Payors / Plans All Payors / Plans 18.48 other 18.48 18.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER VIZIGO CURVE ID8.5 FR LGC SUP-270000000 CDM 270 RC inpatient 2181.9 2138.26 All Payors / Plans All Payors / Plans 2181.9 other 2181.9 2181.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER VIZIGO CURVE ID8.5 FR MDC SUP-270000000 CDM 270 RC inpatient 1766.3 1730.97 All Payors / Plans All Payors / Plans 1766.3 other 1766.3 1766.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH LAPAROSCOPIC L45 MM STAPLER SUP-270000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH MICRA INTRODUCER SUP-275000000 CDM 270 RC inpatient 1560 1528.8 All Payors / Plans All Payors / Plans 1560 other 1560 1560 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH SAFE 7 FRENCH SUP-275000000 CDM 270 RC inpatient 86.7 84.97 All Payors / Plans All Payors / Plans 86.7 other 86.7 86.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH VERSA CROSS STEERABLE 8.5F MEDIUM BIDIRECTIONAL SUP-481000000 CDM 270 RC inpatient 2205 2160.9 All Payors / Plans All Payors / Plans 2205 other 2205 2205 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH16 FR X 45CM CHECK-FLO SUP-481000000 CDM 270 RC inpatient 262.23 256.99 All Payors / Plans All Payors / Plans 262.23 other 262.23 262.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHELL ACETABULAR PINNACLE POROCOAT OD56 MM HIP SECTOR SUP-270010024 CDM 270 RC inpatient 1890 1852.2 All Payors / Plans All Payors / Plans 1890 other 1890 1890 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHELL ACETABULAR TRIDENT II TRITANIUM E OD52 MM HIP MULTIHOLE STERILE SUP-270010024 CDM 270 RC inpatient 3139.2 3076.42 All Payors / Plans All Payors / Plans 3139.2 other 3139.2 3139.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHERPA NX BALANCED 6F EBU 3.75 SUP-481000000 CDM 270 RC inpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOCKWAVE 3.0X12MM SUP-270000000 CDM 270 RC inpatient 9870 9672.6 All Payors / Plans All Payors / Plans 9870 other 9870 9870 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOCKWAVE C2 SUP-270000000 CDM 270 RC inpatient 9870 9672.6 All Payors / Plans All Payors / Plans 9870 other 9870 9870 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOCKWAVE C2 3.0 X 12MM SUP-270000000 CDM 270 RC inpatient 9870 9672.6 All Payors / Plans All Payors / Plans 9870 other 9870 9870 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOE POSTOPERATIVE AEGIS 10.5-12 LG RUBBER NS LF MALE FOOT BILATERAL SEMIRIGID SOLE LOOP LOCK CLOSURE REINFORCED PAD SUP-270009115 CDM 270 RC inpatient 5.83 5.71 All Payors / Plans All Payors / Plans 5.83 other 5.83 5.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOE POSTOPERATIVE AEGIS 6.5-8 MED RUBBER NS LF FEMALE FOOT BILATERAL SEMIRIGID SOLE LOOP LOCK CLOSURE REINFORCED PAD SUP-270009115 CDM 270 RC inpatient 5.83 5.71 All Payors / Plans All Payors / Plans 5.83 other 5.83 5.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOE POSTOPERATIVE AEGIS 8.5-10 LG RUBBER NS LF FEMALE FOOT BILATERAL SEMIRIGID SOLE LOOP LOCK CLOSURE REINFORCED PAD SUP-270009115 CDM 270 RC inpatient 5.83 5.71 All Payors / Plans All Payors / Plans 5.83 other 5.83 5.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOE POSTOPERATIVE AEGIS 8.5-10 MED RUBBER NS LF MALE FOOT BILATERAL SEMIRIGID SOLE LOOP LOCK CLOSURE REINFORCED PAD SUP-270009115 CDM 270 RC inpatient 5.83 5.71 All Payors / Plans All Payors / Plans 5.83 other 5.83 5.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOE POSTOPERATIVE CANVAS RUBBER FEMALE 4-6 SMALL UNIVERSAL FOOT BILATERAL RIGID SOLE HOOK LOOP CLOSURE CLOSED HEEL NONSTERILE LATEX FREE BEIGE SUP-270009115 CDM 270 RC inpatient 5.83 5.71 All Payors / Plans All Payors / Plans 5.83 other 5.83 5.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOE POSTOPERATIVE CANVAS RUBBER MALE 6-8 SMALL BOTTOM RIGID SOLE HOOK LOOP CLOSURE OPEN TOE NONSTERILE LATEX FREE BEIGE SUP-270009115 CDM 270 RC inpatient 5.83 5.71 All Payors / Plans All Payors / Plans 5.83 other 5.83 5.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHORT MICRO PROCEDURE TRAY SUP-270000000 CDM 270 RC inpatient 1264.2 1238.92 All Payors / Plans All Payors / Plans 1264.2 other 1264.2 1264.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHUNT CARDIOVASCULAR CLEARVIEW SILICONE L14 MM OD1 MM INTRACORONARY BULB TAPERED TIP RADIOPAQUE STERILE ARTERIOTOMY SUP-270000000 CDM 270 RC inpatient 174.3 170.81 All Payors / Plans All Payors / Plans 174.3 other 174.3 174.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHUNT CAROTID BARD JAVID TAPER L27.5 CM OD10-17 FR TYPE 1852 KINK RESISTANT POLISH TIP BYPASS SUP-270000000 CDM 270 RC inpatient 26.67 26.14 All Payors / Plans All Payors / Plans 26.67 other 26.67 26.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIGMOIDOSCOPE RIGID KLEENSPEC HALOGEN 35V L25 CM OD19 MM HIGHLY VISIBLE GRADUATION EXAM OBTURATOR ILLUMINATION SYSTEM DISPOSABLE SUP-270000000 CDM 270 RC inpatient 5.12 5.02 All Payors / Plans All Payors / Plans 5.12 other 5.12 5.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE ADAPTER V40 TITANIUM ALUMINA CERAMIC SUP-270010024 CDM 270 RC inpatient 373.8 366.32 All Payors / Plans All Payors / Plans 373.8 other 373.8 373.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE COMPRESSION KENDALL SCD EXPRESS LG KNEE LENGTH NYLON DISPOSABLE NS LF ADJUSTABLE CIRCUMFERENTIAL BLADDER SUP-270009045 CDM 270 RC inpatient 33.86 33.18 All Payors / Plans All Payors / Plans 33.86 other 33.86 33.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE COMPRESSION KENDALL SCD EXPRESS MEDIUM KNEE LENGTH OD21- IN ADJUSTABLE CIRCUMFERENTIAL BLADDER STREAMLINE CONNECTOR NONSTERILE LATEX FREE DISPOSABLE SUP-270009045 CDM 270 RC inpatient 33.86 33.18 All Payors / Plans All Payors / Plans 33.86 other 33.86 33.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE COMPRESSION MED KNEE LENGTH KENDALL SCD EXPRESS ADJUSTABLE CIRCUMFERENTIAL SUP-270009045 CDM 270 RC inpatient 33.86 33.18 All Payors / Plans All Payors / Plans 33.86 other 33.86 33.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE LAPAROSCOPIC ENDOPATH XCEL UNIVERSAL 100MM 12MM DISPOSABLE STERILE STABILITY BLADELESS OBTURATOR OPTIONAL PISTOL SUP-270000000 CDM 270 RC inpatient 17.39 17.04 All Payors / Plans All Payors / Plans 17.39 other 17.39 17.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE LAPAROSCOPIC ENDOPATH XCEL UNIVERSAL 100MM 5MM DISPOSABLE STERILE STABILITY BLADELESS OBTURATOR OPTIONAL PISTOL SUP-270000000 CDM 270 RC inpatient 17.39 17.04 All Payors / Plans All Payors / Plans 17.39 other 17.39 17.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE SCLERAL SILICONE ROUND STYLE 72 BUCKLING SUP-270000000 CDM 270 RC inpatient 24.36 23.87 All Payors / Plans All Payors / Plans 24.36 other 24.36 24.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE SURGICAL ECLIPSE L23 IN CSR WRAP GOWN STERILE LATEX FREE BLUE SUP-270000000 CDM 270 RC inpatient 1.29 1.26 All Payors / Plans All Payors / Plans 1.29 other 1.29 1.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE W/BALLOON 12MM X 100MM SUP-270000000 CDM 270 RC inpatient 102 99.96 All Payors / Plans All Payors / Plans 102 other 102 102 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLING GYNECOLOGICAL GYNECARE TVT EXACT OD3 MM TROCAR SHAFT ERGONOMIC HANDLE STRESS URINARY INCONTINENCE RETROPUBIC SUP-270000000 CDM 270 RC inpatient 2736.55 2681.82 All Payors / Plans All Payors / Plans 2736.55 other 2736.55 2736.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLING ORTHOPEDIC TIETEX LARGE ARM ENVELOPE SHOULDER STRAP SLIDE BUCKLE SUP-270009116 CDM 270 RC inpatient 3.89 3.81 All Payors / Plans All Payors / Plans 3.89 other 3.89 3.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SMARTCAP AQUASHIELD SUP-270000000 CDM 270 RC inpatient 26.78 26.24 All Payors / Plans All Payors / Plans 26.78 other 26.78 26.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SNARE ENDOSCOPIC CAPTIFLEX MICRO OVAL L240 CM OD2.4 MM ODSEC13 MM FLEXIBLE STERILE DISPOSABLE POLYPECTOMY SUP-270000000 CDM 270 RC inpatient 21.2 20.78 All Payors / Plans All Payors / Plans 21.2 other 21.2 21.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SNARE ENDOSCOPIC CAPTIFLEX XS OVAL L240 CM W11 MM OD2.4 MM LOOP FLEXIBLE BRAID WIRE HOT COLD INDICATION STERILE DISPOSABLE POLYPECTOMY SUP-270000000 CDM 270 RC inpatient 14.28 13.99 All Payors / Plans All Payors / Plans 14.28 other 14.28 14.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SNARE ENDOSCOPIC JUMBO LARGE OVAL MEDIUM STIFF DISPOSABLE OLYMPUS SUP-270000000 CDM 270 RC inpatient 18.7 18.33 All Payors / Plans All Payors / Plans 18.7 other 18.7 18.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SNARE SURGICAL ROUND OD20 MM COLD SUP-270000000 CDM 270 RC inpatient 23.19 22.73 All Payors / Plans All Payors / Plans 23.19 other 23.19 23.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION ANTIFOG DEVON DEFOGGER FOG-OUT ISOPROPANOL FOAM PAD NONTOXIC NONFLAMMABLE STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 1.53 1.5 All Payors / Plans All Payors / Plans 1.53 other 1.53 1.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION ANTISEPTIC 70% ISOPROPYL ALCOHOL 16 OZ BOTTLE LATEX FREE SUP-270000000 CDM 270 RC inpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION BSS 15ML SUP-270000000 CDM 270 RC inpatient 7.89 7.73 All Payors / Plans All Payors / Plans 7.89 other 7.89 7.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IRRIGATION 1000ML WATER STERILE LF PLASTIC POUR BOTTLE SUP-270000000 CDM 270 RC inpatient 1.75 1.72 All Payors / Plans All Payors / Plans 1.75 other 1.75 1.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IRRIGATION SODIUM CHLORIDE 0.9% POUR BOTTLE 1000ML SUP-270000000 CDM 270 RC inpatient 4.62 4.53 All Payors / Plans All Payors / Plans 4.62 other 4.62 4.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IRRIGATION SODIUM CHLORIDE 0.9% POUR BOTTLE 500ML SUP-270000000 CDM 270 RC inpatient 1.74 1.71 All Payors / Plans All Payors / Plans 1.74 other 1.74 1.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IRRIGATION UROMATIC 2000ML WATER STERILE LF PLASTIC CONTAINER SUP-270009079 CDM 270 RC inpatient 4.79 4.69 All Payors / Plans All Payors / Plans 4.79 other 4.79 4.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IV INJECTION SODIUM CHLORIDE 0.9% 1000ML SUP-270000000 CDM 270 RC inpatient 1.61 1.58 All Payors / Plans All Payors / Plans 1.61 other 1.61 1.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IV INJECTION SODIUM CHLORIDE 0.9% 100ML SUP-270000000 CDM 270 RC inpatient 2.82 2.76 All Payors / Plans All Payors / Plans 2.82 other 2.82 2.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IV IRRIGATION GLYCINE 1.5% UROMATIC PLASTIC BAG 3000ML SUP-270009078 CDM 270 RC inpatient 7.01 6.87 All Payors / Plans All Payors / Plans 7.01 other 7.01 7.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IV IRRIGATION SODIUM CHLORIDE 0.9% 3000ML SUP-270009079 CDM 270 RC inpatient 5.56 5.45 All Payors / Plans All Payors / Plans 5.56 other 5.56 5.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IV IRRIGATION SODIUM CHLORIDE 0.9% PLASTIC BAG 1000ML SUP-270009181 CDM 270 RC inpatient 30 29.4 All Payors / Plans All Payors / Plans 30 other 30 30 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IV IRRIGATION WATER STERILE 3000ML SUP-270009077 CDM 270 RC inpatient 5.06 4.96 All Payors / Plans All Payors / Plans 5.06 other 5.06 5.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IV VIAFLEX 500ML 0.9% SODIUM CHLORIDE LF PLASTIC CONTAINER SUP-270000000 CDM 270 RC inpatient 2.78 2.72 All Payors / Plans All Payors / Plans 2.78 other 2.78 2.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION OPHTHALMIC SILIKON 1000 8.5ML POLYDIMETHYLSILOXANE STERILE LF OIL SUP-270000000 CDM 270 RC inpatient 770.73 755.32 All Payors / Plans All Payors / Plans 770.73 other 770.73 770.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION PREP 10% PVP IODINE 3/4 OZ POUCH PACKET CONTAINER STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 2.77 2.71 All Payors / Plans All Payors / Plans 2.77 other 2.77 2.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION PREP 3M DURAPREP 26ML 74% ISOPROPYL ALCOHOL 0.7% IODINE POVACRYLEX STERILE SKIN COATED SELF CONTAIN APPLICATOR SUP-270000000 CDM 270 RC inpatient 3.76 3.68 All Payors / Plans All Payors / Plans 3.76 other 3.76 3.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION PREP 3M DURAPREP 74% ISOPROPYL ALCOHOL 0.7% IODINE POVACRYLEX 6 ML SKIN 1 COAT SELF CONTAIN APPLICATOR STERILE PREOPERATIVE SUP-270009184 CDM 270 RC inpatient 2.96 2.9 All Payors / Plans All Payors / Plans 2.96 other 2.96 2.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION PREP BETADINE 10% PVP IODINE 4 OZ FLIPTOP CAP SUP-270000000 CDM 270 RC inpatient 2.26 2.21 All Payors / Plans All Payors / Plans 2.26 other 2.26 2.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION SURGICAL SCRUB HIBICLENS 4% CHLORHEXIDINE GLUCONATE 4 OZ SKIN BOTTLE LIQUID ANTIMICROBIAL CLEAR PINK SCENTED SUP-270000000 CDM 270 RC inpatient 4.18 4.1 All Payors / Plans All Payors / Plans 4.18 other 4.18 4.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION WOUND CLEANSING BACTISURE SUP-270000000 CDM 270 RC inpatient 535.5 524.79 All Payors / Plans All Payors / Plans 535.5 other 535.5 535.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SPACER SPINAL INTERBODY 16X14X7MM, 7 DEGREE, 3D" SUP-270010020 CDM 270 RC inpatient 6760 6624.8 All Payors / Plans All Payors / Plans 6760 other 6760 6760 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPACER SPINAL PROLIFT 15 D L28 MM X W10 MM X H8 MM EXPAND STERILE LATEX FREE SUP-270010020 CDM 270 RC inpatient 5100 4998 All Payors / Plans All Payors / Plans 5100 other 5100 5100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPHINCTEROTOME ENDOSCOPIC ULTRATOME XL L5 MM L200 CM L5 MM OD5.5 FR BILIARY PANCREAS 3 LUMEN CUT WIRE SHORT NOSE STERILE DISPOSABLE ACCEPTS .035 IN DREAMWIRE SUP-270000000 CDM 270 RC inpatient 146.34 143.41 All Payors / Plans All Payors / Plans 146.34 other 146.34 146.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPIKE ANGIOGRAPHY L6.5 IN 3 WAY STOPCOCK MANAGEMENT SUP-270000000 CDM 270 RC inpatient 2.15 2.11 All Payors / Plans All Payors / Plans 2.15 other 2.15 2.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPLINT NASAL DOYLE II SILICONE SEPTUM COMPRESS ANTERIOR TIP INTEGRAL AIRWAY STERILE LATEX FREE DISPOSABLE WHITE SUP-270000000 CDM 270 RC inpatient 170.1 166.7 All Payors / Plans All Payors / Plans 170.1 other 170.1 170.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPLINT ORTHOPEDIC ORTHO-GLASS FIBERGLASS L15 FT X W4 IN WRIST IMMOBILIZER WRINKLE FREE STRETCH PAD COVER INTERLOCK PERFORMANCE TECHNOLOGY LATEX FREE SUP-270000000 CDM 270 RC inpatient 121.72 119.29 All Payors / Plans All Payors / Plans 121.72 other 121.72 121.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPONGE EYE SURGICAL SPEAR STERILE CELLULOSE SUP-270000000 CDM 270 RC inpatient 5.15 5.05 All Payors / Plans All Payors / Plans 5.15 other 5.15 5.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPONGE RAY-COT RAYON 1/2INX 6 IN SUP-270000000 CDM 270 RC inpatient 34.65 33.96 All Payors / Plans All Payors / Plans 34.65 other 34.65 34.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPONGE SURGICAL UNIQCOT RAYON .55 MM THIN L1 IN X W1 IN LOW ADHESION PROFILE STRONG RADIOPAQUE STERILE SUP-270000000 CDM 270 RC inpatient 2.98 2.92 All Payors / Plans All Payors / Plans 2.98 other 2.98 2.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPONGE SURGICAL UNIQCOT RAYON L1/2 IN X W1/2 IN RADIOPAQUE PATTY STERILE SUP-270000000 CDM 270 RC inpatient 7.45 7.3 All Payors / Plans All Payors / Plans 7.45 other 7.45 7.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPYSCOPE DS II SUP-270000000 CDM 270 RC inpatient 4628.25 4535.69 All Payors / Plans All Payors / Plans 4628.25 other 4628.25 4628.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STABILIZER SURGICAL OCTOPUS TISSUE EVOLUTION SUP-270000000 CDM 270 RC inpatient 2509.5 2459.31 All Payors / Plans All Payors / Plans 2509.5 other 2509.5 2509.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ECHELON CIRCULAR 29 MM 26 L5.2 MM X H1.5-2.2 MM 3D GRIP SURFACE POWER ADJUSTABLE STAPLE SUP-270000000 CDM 270 RC inpatient 878.2 860.64 All Payors / Plans All Payors / Plans 878.2 other 878.2 878.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ECHELON FLEX ENDOPATH L45 MM L340 MM 6 ROW 12 FIRING ARTICULATION ROTATE KNOB STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 296.43 290.5 All Payors / Plans All Payors / Plans 296.43 other 296.43 296.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ECHELON FLEX POWERED PLUS LONG 440MM 60MM LINEAR CUTTER ENDOSCOPIC SUP-270000000 CDM 270 RC inpatient 825.1 808.6 All Payors / Plans All Payors / Plans 825.1 other 825.1 825.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ECHELON FLEX POWERED PLUS STANDARD 340MM 60MM LF LINEAR CUT ENDOSCOPIC SUP-270000000 CDM 270 RC inpatient 781.96 766.32 All Payors / Plans All Payors / Plans 781.96 other 781.96 781.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ENDO GIA ULTRA TRI-STAPLE SHORT UNIVERSAL 6CM 12MM TITANIUM DISPOSABLE STERILE LF THIN VASCULAR TISSUE SUP-270000000 CDM 270 RC inpatient 235.75 231.04 All Payors / Plans All Payors / Plans 235.75 other 235.75 235.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ENDO GIA ULTRA TRI-STAPLE UNIVERSAL STANDARD 16CMX4MM PVC DISPOSABLE STERILE LF EXTRA THICK TISSUE SUP-270000000 CDM 270 RC inpatient 212.01 207.77 All Payors / Plans All Payors / Plans 212.01 other 212.01 212.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ENDO GIA ULTRA TRI-STAPLE XL UNIVERSAL 26CMX4MM BLACK TITANIUM EXTRA THICK TISSUE ARTICULATE HAND GRASP SUP-270000000 CDM 270 RC inpatient 339.19 332.41 All Payors / Plans All Payors / Plans 339.19 other 339.19 339.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ENDOPATH 45MM 300MM BLUE DISPOSABLE STERILE LF 8 FIRING LINEAR CUTTER RELOAD NO ARTICULATION SUP-270009088 CDM 270 RC inpatient 132.68 130.03 All Payors / Plans All Payors / Plans 132.68 other 132.68 132.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ENDOPATH CURVE CIRCLE 5.5MM 28CMX1-2.5MM 29MM DISPOSABLE STERILE LF INTRALUMINAL LINEAR CUTTER SUP-270000000 CDM 270 RC inpatient 446.49 437.56 All Payors / Plans All Payors / Plans 446.49 other 446.49 446.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ENDOPATH CURVE CIRCLE H5.5 MM L28 CM X H1-2.5 MM OD25 MM INTRALUMINAL LINEAR CUTTER ADJUSTABLE FLEXIBLE STERILE LATEX FREE DISPOSABLE 16.4 MM LUMEN ENDOSCOPIC SUP-270000000 CDM 270 RC inpatient 551.55 540.52 All Payors / Plans All Payors / Plans 551.55 other 551.55 551.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL PROTACK TITANIUM L35.5 MM X W5 MM VASCULAR 30 HELICAL FASTENER STERILE LATEX FREE DISPOSABLE HERNIA MESH SUP-270000000 CDM 270 RC inpatient 2563 2511.74 All Payors / Plans All Payors / Plans 2563 other 2563 2563 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL PROXIMATE PPH 33MM DISPOSABLE STERILE LF SET PROLAPSE HEMORRHOID SUP-270000000 CDM 270 RC inpatient 834.81 818.11 All Payors / Plans All Payors / Plans 834.81 other 834.81 834.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL PROXIMATE TITANIUM STANDARD H1.5 MM L75 MM X H4.5 MM H2 MM REGULAR TISSUE 4 ROW LINEAR CUTTER SAFETY LOCKOUT HEAVY WIRE STERILE LATEX FREE DISPOSABLE BLUE ENDOSCOPIC SUP-270009226 CDM 270 RC inpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL PROXIMATE TITANIUM STANDARD L55 MM X H3.81 MM H1.5 MM REGULAR TISSUE 4 ROW LINEAR CUTTER CARTRIDGE SAFETY LOCK OUT STERILE LATEX FREE DISPOSABLE BLUE ENDOSCOPIC SUP-270009088 CDM 270 RC inpatient 132.68 130.03 All Payors / Plans All Payors / Plans 132.68 other 132.68 132.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL PROXIMATE TITANIUM STANDARD L60 MM X H3.5 MM H1.5 MM REGULAR TISSUE 2 ROW LINEAR RELOADABLE PARALLEL JAW CLOSURE STERILE LATEX FREE DISPOSABLE BLUE SUP-270009088 CDM 270 RC inpatient 132.68 130.03 All Payors / Plans All Payors / Plans 132.68 other 132.68 132.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL SUREFORM 45 OD14 MM STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 821.1 804.68 All Payors / Plans All Payors / Plans 821.1 other 821.1 821.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER SKIN PROXIMATE PX STAINLESS STEEL WIDE RECTANGULAR L3.9 MM X W6.9 MM OD.58 MM 35 COUNT MULTIDIRECTIONAL RELEASE FIX HEAD ERGONOMIC PISTOL GRIP HANDLE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 7.7 7.55 All Payors / Plans All Payors / Plans 7.7 other 7.7 7.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER SKIN PROXIMATE RH STAINLESS STEEL 360 D WIDE RECTANGULAR L3.9 MM X W6.9 MM OD.58 MM 35 COUNT ROTATE HEAD ERGONOMIC PISTOL GRIP HANDLE RATCHET MECHANISM STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 37.12 36.38 All Payors / Plans All Payors / Plans 37.12 other 37.12 37.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STEM ACTIS COLLARED ST SIZE 3 SUP-270010024 CDM 270 RC inpatient 6460 6330.8 All Payors / Plans All Payors / Plans 6460 other 6460 6460 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STEM FEMORAL ACTIS DUOFIX 6 STANDARD OFFSET HIP COLLAR STERILE SUP-270010024 CDM 270 RC inpatient 6460 6330.8 All Payors / Plans All Payors / Plans 6460 other 6460 6460 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STEM FEMORAL RESTORATION HA STRAIGHT CONICAL L155 MM OD18 MM HIP MODULAR SYSTEM SUP-270010024 CDM 270 RC inpatient 2891.2 2833.38 All Payors / Plans All Payors / Plans 2891.2 other 2891.2 2891.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STEM HUMERAL ARTHREX UNIVERS REVERS 6 SHOULDER STERILE SUP-270010030 CDM 270 RC inpatient 12650 12397 All Payors / Plans All Payors / Plans 12650 other 12650 12650 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STEM HUMERAL ARTHREX UNIVERS REVERS 7 SHOULDER STERILE SUP-270010030 CDM 270 RC inpatient 1836 1799.28 All Payors / Plans All Payors / Plans 1836 other 1836 1836 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STEM HUMERAL PERFORM 2+ SHOULDER STERILE LATEX FREE SUP-270010030 CDM 270 RC inpatient 4246.26 4161.33 All Payors / Plans All Payors / Plans 4246.26 other 4246.26 4246.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT ARGYLE CAROTID SUP-270000000 CDM 270 RC inpatient 75.94 74.42 All Payors / Plans All Payors / Plans 75.94 other 75.94 75.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY EXPRESS LD L40 MM L37 MM L75 CM OD10 MM ILIAC OTW PREMOUNT CATHETER ACCEPTS 7 FR SHEATH SUP-270000000 CDM 270 RC inpatient 1995 1955.1 All Payors / Plans All Payors / Plans 1995 other 1995 1995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY EXPRESS LD TANDEM ARCHITECTURE METAL L30 MM L27 MM L75 CM OD7 MM OTW PREMOUNT BALLOON EXPAND STERILE DISPOSABLE ACCEPTS 6 FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC inpatient 969 949.62 All Payors / Plans All Payors / Plans 969 other 969 969 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY EXPRESS LD TANDEM ARCHITECTURE METAL L40 MM L37 MM L75 CM OD6 MM OTW PREMOUNT BALLOON EXPAND STERILE DISPOSABLE ACCEPTS 6 FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC inpatient 1942.5 1903.65 All Payors / Plans All Payors / Plans 1942.5 other 1942.5 1942.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY EXPRESS LD TANDEM ARCHITECTURE METAL L40 MM L37 MM L75 CM OD8 MM OTW PREMOUNT BALLOON EXPAND STERILE DISPOSABLE ACCEPTS 6 FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC inpatient 1995 1955.1 All Payors / Plans All Payors / Plans 1995 other 1995 1995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY FLEXIMA PLASTIC DUODENAL BEND L10 CM OD7 FR TEMPORARY DELIVERY SYSTEM DISPOSABLE ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 250.78 245.76 All Payors / Plans All Payors / Plans 250.78 other 250.78 250.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY FLEXIMA PLASTIC DUODENAL BEND L7 CM OD10 FR TEMPORARY DELIVERY SYSTEM DISPOSABLE ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 140.83 138.01 All Payors / Plans All Payors / Plans 140.83 other 140.83 140.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY FLEXIMA PLASTIC DUODENAL BEND L7 CM OD7 FR TEMPORARY DELIVERY SYSTEM DISPOSABLE ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 253.07 248.01 All Payors / Plans All Payors / Plans 253.07 other 253.07 253.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY WALLFLEX PERMALUME .035 IN L60 MM L3.2 MM OD10 MM ODSEC8.5 FR FLUOROSCOPY MARKER RAPID EXCHANGE PARTIAL COVER CATHETER SUP-270000000 CDM 270 RC inpatient 4657.56 4564.41 All Payors / Plans All Payors / Plans 4657.56 other 4657.56 4657.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY WALLFLEX PERMALUME L60 MM OD10 MM ODSEC8.5 FR RAPID EXCHANGE SELF EXPAND ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 6076.73 5955.2 All Payors / Plans All Payors / Plans 6076.73 other 6076.73 6076.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT ENDOPROSTHESIS XACT TAPERED 7-9 FRENCH X 40MM SUP-270000000 CDM 270 RC inpatient 4189.5 4105.71 All Payors / Plans All Payors / Plans 4189.5 other 4189.5 4189.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT ENDOPROSTHESIS GORE VIABAHN HEPARIN L15 CM L120 CM OD6 MM ODSEC6 FR SUPERFICIAL FEMORAL ARTERY ILIAC STERILE LATEX FREE ACCEPTS .014/.018 IN GUIDEWIRE 4.8-5.5 MM VESSEL SUP-270000000 CDM 270 RC inpatient 6422.6 6294.15 All Payors / Plans All Payors / Plans 6422.6 other 6422.6 6422.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT ENDOPROSTHESIS XACT TAPERED 6-8 FRENCH X 40MM SUP-270000000 CDM 270 RC inpatient 4189.5 4105.71 All Payors / Plans All Payors / Plans 4189.5 other 4189.5 4189.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT PANCREATIC ZIMMON POLYETHYLENE TAPER PIGTAIL CURVE SPIRAL L5 CM OD5 FR STERILE DISPOSABLE BLUE SUP-270000000 CDM 270 RC inpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT TRACHEOBRONCHIAL ULTRAFLEX NITINOL SILICONE L95 CM OD4 MM L30 MM L15 MM OD12 MM ODSEC20 FR FLEXIBLE OPEN LOOP RADIOPAQUE LOW PROFILE KNIT STERILE DISPOSABLE ACCEPTS .035 IN PULMONARY JAGWIRE SUP-270000000 CDM 270 RC inpatient 6392.93 6265.07 All Payors / Plans All Payors / Plans 6392.93 other 6392.93 6392.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT URETERAL CONTOUR PERCUFLEX HYDROPLUS PIGTAIL CURVE L 22 CM OD 6 FR TAPER TIP BLADDER MARK LOW PROFILE LARGE INNER LUMEN SUP-270000000 CDM 270 RC inpatient 234.55 229.86 All Payors / Plans All Payors / Plans 234.55 other 234.55 234.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT URETERAL CONTOUR PERCUFLEX HYDROPLUS PIGTAIL CURVE L24 CM OD6 FR TAPER TIP BLADDER MARK LOW PROFILE LARGE INNER LUMEN LATEX FREE SUP-270000000 CDM 270 RC inpatient 234.55 229.86 All Payors / Plans All Payors / Plans 234.55 other 234.55 234.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT URETERAL CONTOUR PERCUFLEX HYDROPLUS PIGTAIL CURVE L26 CM OD6 FR TAPER TIP BLADDER MARK LOW PROFILE LARGE INNER LUMEN LATEX FREE SUP-270000000 CDM 270 RC inpatient 189.87 186.07 All Payors / Plans All Payors / Plans 189.87 other 189.87 189.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT URETERAL CONTOUR PERCUFLEX PLUS HYDROPLUS PIGTAIL CURVE L24 CM OD8 FR LARGE INNER LUMEN LOW PROFILE BLADDER MARK TAPER TIP LATEX FREE SUP-270000000 CDM 270 RC inpatient 234.55 229.86 All Payors / Plans All Payors / Plans 234.55 other 234.55 234.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT URETERAL CONTOUR PERCUFLEX PLUS HYDROPLUS PIGTAIL CURVE L26 CM OD8 FR LARGE INNER LUMEN LOW PROFILE BLADDER MARK TAPER TIP LATEX FREE SUP-270000000 CDM 270 RC inpatient 234.55 229.86 All Payors / Plans All Payors / Plans 234.55 other 234.55 234.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT URETERAL PERCUFLEX 8X24CM SUP-270000000 CDM 270 RC inpatient 234.55 229.86 All Payors / Plans All Payors / Plans 234.55 other 234.55 234.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT URETERAL PERCUFLEX PLUS HYDROPLUS PIGTAIL CURVE L22 CM OD4.8 FR TAPER TIP BLADDER MARK LOW PROFILE LARGE INNER LUMEN LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 234.55 229.86 All Payors / Plans All Payors / Plans 234.55 other 234.55 234.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT URETERAL PERCUFLEX PLUS HYDROPLUS PIGTAIL CURVE L24 CM OD4.8 FR TAPER TIP BLADDER MARK LOW PROFILE LARGE INNER LUMEN LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 234.55 229.86 All Payors / Plans All Payors / Plans 234.55 other 234.55 234.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT VASCULAR ENROUTE UBER FLEX STRAIGHT L30 MM L57 CM OD 8MM DELIVERY SYSTEM ANGLE TIP DYNAMIC FLOW CONTROLLER ACCEPTS .014/.038 IN GUIDEWIRE 6-7MM VESSEL TRANSCAROTID ARTERY REVASCULARIZATION SUP-270000000 CDM 270 RC inpatient 5985 5865.3 All Payors / Plans All Payors / Plans 5985 other 5985 5985 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT VASCULAR ENROUTE UBER FLEX STRAIGHT L30 MM L57 CM OD 9MM DELIVERY SYSTEM ANGLE TIP DYNAMIC FLOW CONTROLLER ACCEPTS .014/.038 IN GUIDEWIRE 7-8MM VESSEL TRANSCAROTID ARTERY REVASCULARIZATION SUP-270000000 CDM 270 RC inpatient 2907 2848.86 All Payors / Plans All Payors / Plans 2907 other 2907 2907 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT VASCULAR ENROUTE UBER FLEX STRAIGHT L40 MM L57 CM OD 9MM DELIVERY SYSTEM ANGLE TIP DYNAMIC FLOW CONTROLLER ACCEPTS .014/.038 IN GUIDEWIRE 7-8MM VESSEL TRANSCAROTID ARTERY REVASCULARIZATION SUP-270000000 CDM 270 RC inpatient 5985 5865.3 All Payors / Plans All Payors / Plans 5985 other 5985 5985 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT VASCULAR EPIC 110CM 40MM 75CM 10MM NITINOL ILIAC ARTERY OTW RADIOPAQUE SELF EXPAND ACCEPTS .035IN GUIDEWIRE 6FR SUP-270000000 CDM 270 RC inpatient 1680 1646.4 All Payors / Plans All Payors / Plans 1680 other 1680 1680 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT VASCULAR EPIC NITINOL .035 IN L40 MM L75 CM OD8 MM ILIAC ARTERY SELF EXPAND OTW GUIDEWIRE RADIOPAQUE MARKER ACCEPTS 6 FR SHEATH SUP-270000000 CDM 270 RC inpatient 1360 1332.8 All Payors / Plans All Payors / Plans 1360 other 1360 1360 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT VASCULAR EPIC NITINOL L20 MM L75 CM OD8 MM ILIUM SELF EXPAND ACCEPTS 6 FR SHEATH SUP-270000000 CDM 270 RC inpatient 1360 1332.8 All Payors / Plans All Payors / Plans 1360 other 1360 1360 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT VASCULAR EPIC NITINOL L75 CM L80 MM L114 CM OD10 MM ILIAC ARTERY SELF EXPAND ACCEPTS 6 FR SHEATH SUP-270000000 CDM 270 RC inpatient 1360 1332.8 All Payors / Plans All Payors / Plans 1360 other 1360 1360 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT VASCULAR XACT NITINOL TAPER L40 MM OD8-6 MM SUP-270000000 CDM 270 RC inpatient 4315.5 4229.19 All Payors / Plans All Payors / Plans 4315.5 other 4315.5 4315.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STEPPED REAMER SUP-270000000 CDM 270 RC inpatient 1105 1082.9 All Payors / Plans All Payors / Plans 1105 other 1105 1105 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STOCKINETTE ORTHOPEDIC CONVERTORS POLYESTER LARGE L48 IN X W9 IN IMPERVIOUS BARRIER DRAPE WOVEN STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 3.7 3.63 All Payors / Plans All Payors / Plans 3.7 other 3.7 3.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STOCKINETTE ORTHOPEDIC COTTON L54 IN X W16 IN IMPERVIOUS STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 13.52 13.25 All Payors / Plans All Payors / Plans 13.52 other 13.52 13.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STOCKING COMPRESSION CAP NYLON 19 MMHG REGULAR XL KNEE LENGTH OD18-21 IN ODSEC11-12 IN COOL LIGHTWEIGHT INSPECTION TOE FLOAT DESIGN LATEX FREE GREEN SUP-270009044 CDM 270 RC inpatient 4.32 4.23 All Payors / Plans All Payors / Plans 4.32 other 4.32 4.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STOCKING COMPRESSION SMALL THIGH LENGTH ANTIEMBOLISM SUP-270009042 CDM 270 RC inpatient 7.62 7.47 All Payors / Plans All Payors / Plans 7.62 other 7.62 7.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STOPCOCK ANGIOGRAPHY 1050 PSI 3 WAY ROTATE ADAPTER RIGHT PORT SUP-270000000 CDM 270 RC inpatient 4.86 4.76 All Payors / Plans All Payors / Plans 4.86 other 4.86 4.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STOPCOCK ANGIOGRAPHY NAMIC 1050 PSI 3 WAY ROTATE ADAPTER RIGHT PORT SUP-270000000 CDM 270 RC inpatient 6.8 6.66 All Payors / Plans All Payors / Plans 6.8 other 6.8 6.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STOPCOCK INTRAVENOUS PLASTIC ID .07IN PERIPHERAL 1 WAY FEMALE TO MALE LUER LOCK STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 11.97 11.73 All Payors / Plans All Payors / Plans 11.97 other 11.97 11.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STOPCOCK INTRAVENOUS ULTRA 4 WAY MALE LUER LOCK STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 23.8 23.32 All Payors / Plans All Payors / Plans 23.8 other 23.8 23.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STRAP CATHETER VELCRO FOAM UNIVERSAL L22 IN X W2 IN ELASTIC SKIN IRRITATE TAPE HOOK LOOP FASTENER SOFT NONSTERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 4.38 4.29 All Payors / Plans All Payors / Plans 4.38 other 4.38 4.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STRAP POSITIONING TECLIN L19 IN X W3.5 IN STIRRUP SLIP RING NONSTERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 6.55 6.42 All Payors / Plans All Payors / Plans 6.55 other 6.55 6.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STRIP SCLERAL SILICONE L125 MM X W3.5 MM X H.75 MM STYLE 41 SUP-270000000 CDM 270 RC inpatient 38.22 37.46 All Payors / Plans All Payors / Plans 38.22 other 38.22 38.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STYLET STRAIGHTENING SUP-270000000 CDM 270 RC inpatient 127.5 124.95 All Payors / Plans All Payors / Plans 127.5 other 127.5 127.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STYLETS ABBOTT/ST JUDE CRM _34810_ SUP-270000000 CDM 270 RC inpatient 22 21.56 All Payors / Plans All Payors / Plans 22 other 22 22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUNDT EXTERNAL SHUNT 4MMX5MM SUP-270000000 CDM 270 RC inpatient 1089.25 1067.47 All Payors / Plans All Payors / Plans 1089.25 other 1089.25 1089.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUPERBAG 15 2XL NYLON SPECIMEN RETRIEVAL BAG SUP-270000000 CDM 270 RC inpatient 137.53 134.78 All Payors / Plans All Payors / Plans 137.53 other 137.53 137.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUPERBAG 1O MED NYLON SPECIMEN RETRIEVAL BAG SUP-270000000 CDM 270 RC inpatient 51.83 50.79 All Payors / Plans All Payors / Plans 51.83 other 51.83 51.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUPPORT MAMMARY SURGI-BRA 42-44IN 2XL 96% COTTON 4% SPANDEX VELCRO LF BREAST PAD SUP-270009195 CDM 270 RC inpatient 45.24 44.34 All Payors / Plans All Payors / Plans 45.24 other 45.24 45.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUPPORTER ATHLETIC BAUER & BLACK LG 39-44IN 3IN LATEX ADULT ELASTIC WAISTBAND SUP-270009039 CDM 270 RC inpatient 4.98 4.88 All Payors / Plans All Payors / Plans 4.98 other 4.98 4.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUREFORM 60 RELOAD BLUE SUP-270000000 CDM 270 RC inpatient 507.15 497.01 All Payors / Plans All Payors / Plans 507.15 other 507.15 507.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUREFORM 60 RELOAD WHITE SUP-270000000 CDM 270 RC inpatient 2028.6 1988.03 All Payors / Plans All Payors / Plans 2028.6 other 2028.6 2028.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUREFORM 60 STAPLER SUP-270000000 CDM 270 RC inpatient 1168.65 1145.28 All Payors / Plans All Payors / Plans 1168.65 other 1168.65 1168.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SURGICAL ABLATION SYSTEM OPEN, LONG JAW WITH GLIDEPATH MAGNETIC GUIDE" SUP-270000000 CDM 270 RC inpatient 5400 5292 All Payors / Plans All Payors / Plans 5400 other 5400 5400 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SURGICAL IRRIGATION TUBE SUP-270000000 CDM 270 RC inpatient 356.2 349.08 All Payors / Plans All Payors / Plans 356.2 other 356.2 356.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE 0 MH 27IN CHROMIC MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 9.32 9.13 All Payors / Plans All Payors / Plans 9.32 other 9.32 9.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 0 CT-1 L27 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC inpatient 5.75 5.64 All Payors / Plans All Payors / Plans 5.75 other 5.75 5.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 1 CT L36 IN MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 7.83 7.67 All Payors / Plans All Payors / Plans 7.83 other 7.83 7.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 1 CT-1 L27 IN MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 4.83 4.73 All Payors / Plans All Payors / Plans 4.83 other 4.83 4.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 2-0 CT-1 L27 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC inpatient 5.58 5.47 All Payors / Plans All Payors / Plans 5.58 other 5.58 5.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 2-0 SH L27 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC inpatient 5.31 5.2 All Payors / Plans All Payors / Plans 5.31 other 5.31 5.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 3-0 CT-1 L36 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC inpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 3-0 FS-2 L27 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC inpatient 5.23 5.13 All Payors / Plans All Payors / Plans 5.23 other 5.23 5.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 3-0 SH L27 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC inpatient 4.65 4.56 All Payors / Plans All Payors / Plans 4.65 other 4.65 4.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 4-0 J-1 L18 IN MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 5.54 5.43 All Payors / Plans All Payors / Plans 5.54 other 5.54 5.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 4-0 RB-1 L27 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC inpatient 6.03 5.91 All Payors / Plans All Payors / Plans 6.03 other 6.03 6.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 4-0 SH L27 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC inpatient 6.43 6.3 All Payors / Plans All Payors / Plans 6.43 other 6.43 6.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL 0 CT-1 L36 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC inpatient 3.61 3.54 All Payors / Plans All Payors / Plans 3.61 other 3.61 3.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL 2-0 CT-1 L36 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC inpatient 3.69 3.62 All Payors / Plans All Payors / Plans 3.69 other 3.69 3.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL 3-0 CT-1 L36 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC inpatient 3.65 3.58 All Payors / Plans All Payors / Plans 3.65 other 3.65 3.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL 3-0 KS L27 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC inpatient 6.59 6.46 All Payors / Plans All Payors / Plans 6.59 other 6.59 6.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL 3-0 SH L27 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC inpatient 138.98 136.2 All Payors / Plans All Payors / Plans 138.98 other 138.98 138.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL 3-0 SH L27 IN MONOFILAMENT VIOLET SUP-270000000 CDM 270 RC inpatient 3.13 3.07 All Payors / Plans All Payors / Plans 3.13 other 3.13 3.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL MULTIPASS 4-0 PS-2 L27 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC inpatient 5.44 5.33 All Payors / Plans All Payors / Plans 5.44 other 5.44 5.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL MULTIPASS 6-0 P-3 L18 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC inpatient 11.34 11.11 All Payors / Plans All Payors / Plans 11.34 other 11.34 11.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL PLUS MULTIPASS 3-0 PS-2 27IN UNDYED MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 5.38 5.27 All Payors / Plans All Payors / Plans 5.38 other 5.38 5.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MULTIPASS 5-0 PS-4 18IN YELLOWISH TAN PLAIN MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 10.86 10.64 All Payors / Plans All Payors / Plans 10.86 other 10.86 10.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MULTIPASS CHROMIC 5-0 P-3 L18 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC inpatient 11.68 11.45 All Payors / Plans All Payors / Plans 11.68 other 11.68 11.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 0 CT-1 L27 IN MONOFILAMENT VIOLET SUP-270000000 CDM 270 RC inpatient 4.89 4.79 All Payors / Plans All Payors / Plans 4.89 other 4.89 4.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 0 CTX L60 IN MONOFILAMENT LOOP VIOLET SUP-270000000 CDM 270 RC inpatient 10.88 10.66 All Payors / Plans All Payors / Plans 10.88 other 10.88 10.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 0 TP-1 L60 IN MONOFILAMENT LOOP VIOLET SUP-270000000 CDM 270 RC inpatient 20.91 20.49 All Payors / Plans All Payors / Plans 20.91 other 20.91 20.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 1 CT-1 L27 IN MONOFILAMENT VIOLET SUP-270000000 CDM 270 RC inpatient 2.3 2.25 All Payors / Plans All Payors / Plans 2.3 other 2.3 2.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 1 CTX L36 IN MONOFILAMENT VIOLET SUP-270000000 CDM 270 RC inpatient 4.56 4.47 All Payors / Plans All Payors / Plans 4.56 other 4.56 4.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 1 TP-1 L96 IN MONOFILAMENT LOOP VIOLET SUP-270000000 CDM 270 RC inpatient 18.35 17.98 All Payors / Plans All Payors / Plans 18.35 other 18.35 18.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 2-0 SH L27 IN MONOFILAMENT VIOLET SUP-270000000 CDM 270 RC inpatient 4.69 4.6 All Payors / Plans All Payors / Plans 4.69 other 4.69 4.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 3-0 FS-2 L27 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC inpatient 14.02 13.74 All Payors / Plans All Payors / Plans 14.02 other 14.02 14.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 3-0 SH L27 IN MONOFILAMENT VIOLET SUP-270000000 CDM 270 RC inpatient 5.06 4.96 All Payors / Plans All Payors / Plans 5.06 other 5.06 5.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 4-0 FS-2 L27 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC inpatient 9.99 9.79 All Payors / Plans All Payors / Plans 9.99 other 9.99 9.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II MULTIPASS 4-0 P-3 L18 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC inpatient 9.95 9.75 All Payors / Plans All Payors / Plans 9.95 other 9.95 9.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II MULTIPASS 4-0 PS-2 18IN UNDYED MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 11.27 11.04 All Payors / Plans All Payors / Plans 11.27 other 11.27 11.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS PLUS 2-0 CT L 27 IN ANTIBACTERIAL VIOLET SUP-270000000 CDM 270 RC inpatient 11.48 11.25 All Payors / Plans All Payors / Plans 11.48 other 11.48 11.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS PLUS MULTIPASS 5-0 P-3 18IN UNDYED MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 13.99 13.71 All Payors / Plans All Payors / Plans 13.99 other 13.99 13.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PLAIN 0 L54 IN MONOFILAMENT TIES YELLOWISH TAN SUP-270000000 CDM 270 RC inpatient 5.3 5.19 All Payors / Plans All Payors / Plans 5.3 other 5.3 5.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PLAIN 3-0 CT-1 L18 IN MONOFILAMENT 3 STRAND SUP-270000000 CDM 270 RC inpatient 15.58 15.27 All Payors / Plans All Payors / Plans 15.58 other 15.58 15.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE QUILL PDO 2 1/2 CIRCLE L36 CM L48 MM 2 ARM MONOFILAMENT BARB TAPER POINT VIOLET SUP-270000000 CDM 270 RC inpatient 20.45 20.04 All Payors / Plans All Payors / Plans 20.45 other 20.45 20.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE ULTIMA CHROMIC 7-0 CS175-8 L18 IN 2 ARM MONOFILAMENT BROWN SUP-270000000 CDM 270 RC inpatient 18.7 18.33 All Payors / Plans All Payors / Plans 18.7 other 18.7 18.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 CT-1 L18 IN CONTROL RELEASE BRAID 8 STRAND COATED UNDYED SUP-270000000 CDM 270 RC inpatient 10.63 10.42 All Payors / Plans All Payors / Plans 10.63 other 10.63 10.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 CT-1 L18 IN CONTROL RELEASE BRAID 8 STRAND COATED VIOLET SUP-270000000 CDM 270 RC inpatient 10.61 10.4 All Payors / Plans All Payors / Plans 10.61 other 10.61 10.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 CT-1 L27 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC inpatient 1.4 1.37 All Payors / Plans All Payors / Plans 1.4 other 1.4 1.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 CT-1 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC inpatient 2.91 2.85 All Payors / Plans All Payors / Plans 2.91 other 2.91 2.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 CT-1 L36 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC inpatient 2.48 2.43 All Payors / Plans All Payors / Plans 2.48 other 2.48 2.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 CTX L36 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC inpatient 2.57 2.52 All Payors / Plans All Payors / Plans 2.57 other 2.57 2.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 STANDARD SHORT L18 IN BRAID TIES 3 STRAND COATED VIOLET SUP-270000000 CDM 270 RC inpatient 4.42 4.33 All Payors / Plans All Payors / Plans 4.42 other 4.42 4.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 UR-5 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC inpatient 3.42 3.35 All Payors / Plans All Payors / Plans 3.42 other 3.42 3.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 UR-6 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC inpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 1 CP L27 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC inpatient 1.45 1.42 All Payors / Plans All Payors / Plans 1.45 other 1.45 1.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 1 CT L36 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC inpatient 3.58 3.51 All Payors / Plans All Payors / Plans 3.58 other 3.58 3.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2 CP L27 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC inpatient 3.22 3.16 All Payors / Plans All Payors / Plans 3.22 other 3.22 3.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 18IN UNDYED BRAID TIE 3 STRAND COATED SUP-270000000 CDM 270 RC inpatient 4.28 4.19 All Payors / Plans All Payors / Plans 4.28 other 4.28 4.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 CP-1 L27 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC inpatient 1.51 1.48 All Payors / Plans All Payors / Plans 1.51 other 1.51 1.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 CP-2 L18 IN CONTROL RELEASE BRAID 8 STRAND COATED UNDYED SUP-270000000 CDM 270 RC inpatient 12.9 12.64 All Payors / Plans All Payors / Plans 12.9 other 12.9 12.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 CT L36 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC inpatient 3.33 3.26 All Payors / Plans All Payors / Plans 3.33 other 3.33 3.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 CT-1 L18 IN CONTROL RELEASE BRAID 8 STRAND COATED VIOLET SUP-270000000 CDM 270 RC inpatient 21.77 21.33 All Payors / Plans All Payors / Plans 21.77 other 21.77 21.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 CT-1 L27 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC inpatient 2.78 2.72 All Payors / Plans All Payors / Plans 2.78 other 2.78 2.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 CT-1 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC inpatient 1.71 1.68 All Payors / Plans All Payors / Plans 1.71 other 1.71 1.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 CT-2 L18 IN CONTROL RELEASE BRAID 8 STRAND COATED VIOLET SUP-270000000 CDM 270 RC inpatient 123.52 121.05 All Payors / Plans All Payors / Plans 123.52 other 123.52 123.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 CT-2 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC inpatient 2.78 2.72 All Payors / Plans All Payors / Plans 2.78 other 2.78 2.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 SH L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC inpatient 2.32 2.27 All Payors / Plans All Payors / Plans 2.32 other 2.32 2.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 UR-6 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC inpatient 3.4 3.33 All Payors / Plans All Payors / Plans 3.4 other 3.4 3.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 3-0 CT-1 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC inpatient 2.34 2.29 All Payors / Plans All Payors / Plans 2.34 other 2.34 2.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 3-0 SH L18 IN CONTROL RELEASE BRAID 8 STRAND COATED UNDYED SUP-270000000 CDM 270 RC inpatient 17.59 17.24 All Payors / Plans All Payors / Plans 17.59 other 17.59 17.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 3-0 SH L18 IN CONTROL RELEASE BRAID 8 STRAND COATED VIOLET SUP-270000000 CDM 270 RC inpatient 17.38 17.03 All Payors / Plans All Payors / Plans 17.38 other 17.38 17.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 3-0 SH L27 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC inpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 3-0 SH L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC inpatient 1.4 1.37 All Payors / Plans All Payors / Plans 1.4 other 1.4 1.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 3-0 SH-1 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC inpatient 2.57 2.52 All Payors / Plans All Payors / Plans 2.57 other 2.57 2.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 4-0 FS-2 L27 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC inpatient 5.58 5.47 All Payors / Plans All Payors / Plans 5.58 other 5.58 5.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 4-0 SH L27 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC inpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 4-0 SH-1 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC inpatient 2.83 2.77 All Payors / Plans All Payors / Plans 2.83 other 2.83 2.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 4-0 TF L18 IN CONTROL RELEASE BRAID 8 STRAND COATED VIOLET SUP-270000000 CDM 270 RC inpatient 28.2 27.64 All Payors / Plans All Payors / Plans 28.2 other 28.2 28.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 5-0 P-1 L18 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC inpatient 10.4 10.19 All Payors / Plans All Payors / Plans 10.4 other 10.4 10.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 5-0 RB-1 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC inpatient 2.78 2.72 All Payors / Plans All Payors / Plans 2.78 other 2.78 2.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 6-0 P-1 18IN VIOLET BRAID COATED D SPECIAL SUP-270000000 CDM 270 RC inpatient 199.68 195.69 All Payors / Plans All Payors / Plans 199.68 other 199.68 199.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL LIGAPAK 2-0 L54 IN BRAID REEL COATED VIOLET SUP-270000000 CDM 270 RC inpatient 1.89 1.85 All Payors / Plans All Payors / Plans 1.89 other 1.89 1.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL LIGAPAK 3-0 L54 IN BRAID REEL COATED VIOLET SUP-270000000 CDM 270 RC inpatient 1.98 1.94 All Payors / Plans All Payors / Plans 1.98 other 1.98 1.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL MICROPOINT 6-0 S-14 12IN VIOLET 2 ARM BRAID COATED SUP-270000000 CDM 270 RC inpatient 12.44 12.19 All Payors / Plans All Payors / Plans 12.44 other 12.44 12.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL MICROPOINT 7-0 TG140-8 18IN VIOLET 2 ARM BRAID COATED SUP-270000000 CDM 270 RC inpatient 12.59 12.34 All Payors / Plans All Payors / Plans 12.59 other 12.59 12.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL MULTIPASS 3-0 PS-1 27IN UNDYED BRAID COATED SUP-270000000 CDM 270 RC inpatient 4.75 4.66 All Payors / Plans All Payors / Plans 4.75 other 4.75 4.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL MULTIPASS 4-0 P-3 18IN UNDYED BRAID COATED SUP-270000000 CDM 270 RC inpatient 8.02 7.86 All Payors / Plans All Payors / Plans 8.02 other 8.02 8.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL MULTIPASS 4-0 PS-2 27IN UNDYED BRAID COATED SUP-270000000 CDM 270 RC inpatient 7.32 7.17 All Payors / Plans All Payors / Plans 7.32 other 7.32 7.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL MULTIPASS 5-0 P-3 18IN UNDYED BRAID COATED SUP-270000000 CDM 270 RC inpatient 8.68 8.51 All Payors / Plans All Payors / Plans 8.68 other 8.68 8.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL MULTIPASS 5-0 PS-3 L18 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC inpatient 8.27 8.1 All Payors / Plans All Payors / Plans 8.27 other 8.27 8.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL MULTIPASS 8-0 BV130-5 5IN VIOLET BRAID COATED SUP-270000000 CDM 270 RC inpatient 29.32 28.73 All Payors / Plans All Payors / Plans 29.32 other 29.32 29.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL PLUS 0 CT-1 L18 IN CONTROL RELEASE BRAID 8 STRAND ANTIBACTERIAL UNDYED SUP-270000000 CDM 270 RC inpatient 20.4 19.99 All Payors / Plans All Payors / Plans 20.4 other 20.4 20.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL PLUS 2-0 CP-2 L18 IN CONTROL RELEASE BRAID 8 STRAND ANTIBACTERIAL UNDYED SUP-270000000 CDM 270 RC inpatient 75.72 74.21 All Payors / Plans All Payors / Plans 75.72 other 75.72 75.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL PLUS 4-0 SH L27 IN BRAID ANTIBACTERIAL COATED VIOLET SUP-270000000 CDM 270 RC inpatient 3.7 3.63 All Payors / Plans All Payors / Plans 3.7 other 3.7 3.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL PLUS LIGAPAK 3-0 L54 IN BRAID REEL ANTIBACTERIAL COATED VIOLET SUP-270000000 CDM 270 RC inpatient 4.68 4.59 All Payors / Plans All Payors / Plans 4.68 other 4.68 4.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL PLUS MULTIPASS 3-0 PS-1 L27 IN BRAID ANTIBACTERIAL COATED UNDYED SUP-270000000 CDM 270 RC inpatient 9.68 9.49 All Payors / Plans All Payors / Plans 9.68 other 9.68 9.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE CLOSURE V-LOC 2-0 V-20 L12IIN NONABSORBABLE BLUE SUP-270000000 CDM 270 RC inpatient 43.22 42.36 All Payors / Plans All Payors / Plans 43.22 other 43.22 43.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ETHILON MONOFILAMENT BLACK NEEDLE:PS-1 SIZE:3-0 LENGTH:18IN SUP-270000000 CDM 270 RC inpatient 6.7 6.57 All Payors / Plans All Payors / Plans 6.7 other 6.7 6.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE FIBERLOOP 4-0 SUP-270000000 CDM 270 RC inpatient 1260 1234.8 All Payors / Plans All Payors / Plans 1260 other 1260 1260 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE FIBERTAPE CERCLAGE SUP-270000000 CDM 270 RC inpatient 1995 1955.1 All Payors / Plans All Payors / Plans 1995 other 1995 1995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE DOUBLEWIRE 8 BE-3 14IN 2 WIRE HIGH STRENGTH STERNOTOMY SUP-270000000 CDM 270 RC inpatient 227.5 222.95 All Payors / Plans All Payors / Plans 227.5 other 227.5 227.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 0 CT-1 L30 IN BRAID GREEN SUP-270000000 CDM 270 RC inpatient 3.1 3.04 All Payors / Plans All Payors / Plans 3.1 other 3.1 3.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 0 CT-2 18IN GREEN POLYESTER CONTROL RELEASE BRAID 8 STRAND SUP-270000000 CDM 270 RC inpatient 28.22 27.66 All Payors / Plans All Payors / Plans 28.22 other 28.22 28.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 0 CTX 18IN GREEN POLYESTER CONTROL RELEASE BRAID 8 STRAND SUP-270000000 CDM 270 RC inpatient 245.3 240.39 All Payors / Plans All Payors / Plans 245.3 other 245.3 245.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 0 SH L36 IN 2 ARM BRAID GREEN SUP-270000000 CDM 270 RC inpatient 7.97 7.81 All Payors / Plans All Payors / Plans 7.97 other 7.97 7.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 1 CT-1 L30 IN BRAID GREEN SUP-270000000 CDM 270 RC inpatient 1.67 1.64 All Payors / Plans All Payors / Plans 1.67 other 1.67 1.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 2 V-37 L30 IN BRAID 4 STRAND GREEN SUP-270000000 CDM 270 RC inpatient 28.16 27.6 All Payors / Plans All Payors / Plans 28.16 other 28.16 28.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 2-0 CT-1 L30 IN BRAID GREEN SUP-270000000 CDM 270 RC inpatient 6.88 6.74 All Payors / Plans All Payors / Plans 6.88 other 6.88 6.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 2-0 CT-2 18IN GREEN POLYESTER CONTROL RELEASE BRAID 8 STRAND SUP-270000000 CDM 270 RC inpatient 306.96 300.82 All Payors / Plans All Payors / Plans 306.96 other 306.96 306.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 2-0 SH L36 IN 2 ARM BRAID GREEN SUP-270000000 CDM 270 RC inpatient 7.84 7.68 All Payors / Plans All Payors / Plans 7.84 other 7.84 7.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 3-0 SH L30 IN BRAID GREEN SUP-270000000 CDM 270 RC inpatient 7.44 7.29 All Payors / Plans All Payors / Plans 7.44 other 7.44 7.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 5 V-37 L30 IN BRAID 4 STRAND GREEN SUP-270000000 CDM 270 RC inpatient 24.28 23.79 All Payors / Plans All Payors / Plans 24.28 other 24.28 24.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND EXCEL 2 30IN GREEN LIGHT GREEN WHITE TIES BRAID D SUP-270000000 CDM 270 RC inpatient 54.44 53.35 All Payors / Plans All Payors / Plans 54.44 other 54.44 54.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND EXCEL TAPERCUT THK1.5 MM 2-0 V-4 L30 IN L7 MM X W3 MM 2 ARM BRAID 10 STRAND FIRM PLEDGET GREEN WHITE SUP-270000000 CDM 270 RC inpatient 2611.47 2559.24 All Payors / Plans All Payors / Plans 2611.47 other 2611.47 2611.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND EXCEL THK1.5 MM 0 SH L30 IN L7 MM X W3 MM 2 ARM BRAID 10 STRAND FIRM PLEDGET GREEN WHITE SUP-270000000 CDM 270 RC inpatient 262.44 257.19 All Payors / Plans All Payors / Plans 262.44 other 262.44 262.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON 2 LR 20IN BLACK MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 8.37 8.2 All Payors / Plans All Payors / Plans 8.37 other 8.37 8.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON 2-0 FS L18 IN MONOFILAMENT BLACK SUP-270000000 CDM 270 RC inpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON 2-0 FSLX L30 IN MONOFILAMENT BLACK SUP-270000000 CDM 270 RC inpatient 3.66 3.59 All Payors / Plans All Payors / Plans 3.66 other 3.66 3.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON 4-0 PS-2 L18 IN BLACK SUP-270000000 CDM 270 RC inpatient 7.19 7.05 All Payors / Plans All Payors / Plans 7.19 other 7.19 7.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON MICROPOINT 10-0 TG160-6 6IN BLACK 2 ARM MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 17.1 16.76 All Payors / Plans All Payors / Plans 17.1 other 17.1 17.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON MULTIPASS 3-0 PS-1 18IN BLACK MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 3.98 3.9 All Payors / Plans All Payors / Plans 3.98 other 3.98 3.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON MULTIPASS 4-0 P-3 L18 IN MONOFILAMENT BLACK SUP-270000000 CDM 270 RC inpatient 7.97 7.81 All Payors / Plans All Payors / Plans 7.97 other 7.97 7.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON MULTIPASS 4-0 PS-2 18IN UNDYED MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 7.59 7.44 All Payors / Plans All Payors / Plans 7.59 other 7.59 7.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON MULTIPASS 5-0 P-3 18IN BLACK MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 7.11 6.97 All Payors / Plans All Payors / Plans 7.11 other 7.11 7.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON MULTIPASS 5-0 PS-2 18IN BLACK MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 7.06 6.92 All Payors / Plans All Payors / Plans 7.06 other 7.06 7.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON MULTIPASS 5-0 PS-4 18IN BLACK MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 22.99 22.53 All Payors / Plans All Payors / Plans 22.99 other 22.99 22.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON MULTIPASS 8-0 BV130-5 L5 IN MONOFILAMENT BLACK SUP-270000000 CDM 270 RC inpatient 29.55 28.96 All Payors / Plans All Payors / Plans 29.55 other 29.55 29.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON SABRELOC 5-0 S-24 18IN BLACK 2 ARM MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 24.77 24.27 All Payors / Plans All Payors / Plans 24.77 other 24.77 24.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON ULTIMA NYLON 66 8-0 CS175-8 L12 IN 2 ARM MONOFILAMENT BLACK SUP-270000000 CDM 270 RC inpatient 15.51 15.2 All Payors / Plans All Payors / Plans 15.51 other 15.51 15.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE FIBERLINK FIBERWIRE 2 L26 IN L1.5 IN BRAID TIES MULTISTRAND CLOSE LOOP BLUE SUP-270000000 CDM 270 RC inpatient 115.5 113.19 All Payors / Plans All Payors / Plans 115.5 other 115.5 115.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE FIBERTAPE FIBERWIRE 2 TAPER L54 IN L36 IN X W2 MM BRAID BLUE SUP-270000000 CDM 270 RC inpatient 220.5 216.09 All Payors / Plans All Payors / Plans 220.5 other 220.5 220.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE FIBERWIRE 2 T-5 L38 IN BRAID TIES MULTISTRAND LOWER KNOT PROFILE BLUE SUP-270000000 CDM 270 RC inpatient 22.44 21.99 All Payors / Plans All Payors / Plans 22.44 other 22.44 22.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE FIBERWIRE 2 T-8 L38 IN 2 ARM BRAID MULTISTRAND LOWER KNOT PROFILE BARB BLUE SUP-270000000 CDM 270 RC inpatient 44.88 43.98 All Payors / Plans All Payors / Plans 44.88 other 44.88 44.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE FIBERWIRE 5 CCS-1 L38 IN BRAID TIES MULTISTRAND LOWER KNOT PROFILE BLUE SUP-270000000 CDM 270 RC inpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE GORE-TEX CV-3 TH-26 L36IN MONOFILAMENT WHITE SUP-270000000 CDM 270 RC inpatient 191.63 187.8 All Payors / Plans All Payors / Plans 191.63 other 191.63 191.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE GORE-TEX CV-6 PT-13 L30 IN 2 ARM MONOFILAMENT WHITE SUP-270000000 CDM 270 RC inpatient 153.88 150.8 All Payors / Plans All Payors / Plans 153.88 other 153.88 153.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE GORE-TEX CV-6 PT-9 L30 IN 2 ARM MONOFILAMENT WHITE SUP-270000000 CDM 270 RC inpatient 159.37 156.18 All Payors / Plans All Payors / Plans 159.37 other 159.37 159.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE GORE-TEX CV-7 PT-13 L24 IN 2 ARM MONOFILAMENT WHITE SUP-270000000 CDM 270 RC inpatient 101.04 99.02 All Payors / Plans All Payors / Plans 101.04 other 101.04 101.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE GORE-TEX CV-8 TTC-9 L18 IN 2 ARM MONOFILAMENT WHITE SUP-270000000 CDM 270 RC inpatient 84.17 82.49 All Payors / Plans All Payors / Plans 84.17 other 84.17 84.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE MERSILENE 5 MM CTX L12 IN 2 ARM WOVEN WHITE SUP-270000000 CDM 270 RC inpatient 50.97 49.95 All Payors / Plans All Payors / Plans 50.97 other 50.97 50.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE NUROLON 2-0 SH 18IN BLACK NYLON 6 6 CONTROL RELEASE BRAID 8 STRAND SUP-270000000 CDM 270 RC inpatient 9.31 9.12 All Payors / Plans All Payors / Plans 9.31 other 9.31 9.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE NUROLON 4-0 TF 18IN BLACK NYLON 6 6 CONTROL RELEASE BRAID 8 STRAND SUP-270000000 CDM 270 RC inpatient 13.38 13.11 All Payors / Plans All Payors / Plans 13.38 other 13.38 13.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 0 18IN BLACK SILK BRAID TIE 6 STRAND PRECUT SUP-270000000 CDM 270 RC inpatient 52.75 51.7 All Payors / Plans All Payors / Plans 52.75 other 52.75 52.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 0 30IN BLACK SILK BRAID TIE 6 STRAND PRECUT SUP-270000000 CDM 270 RC inpatient 1.25 1.23 All Payors / Plans All Payors / Plans 1.25 other 1.25 1.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 1 30IN BLACK SILK BRAID TIE 6 STRAND PRECUT SUP-270000000 CDM 270 RC inpatient 2.18 2.14 All Payors / Plans All Payors / Plans 2.18 other 2.18 2.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 2-0 18IN BLACK SILK BRAID TIES 12 STRAND PRECUT SUP-270000000 CDM 270 RC inpatient 1.39 1.36 All Payors / Plans All Payors / Plans 1.39 other 1.39 1.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 2-0 30IN BLACK SILK BRAID TIE 12 STRAND PRECUT SUP-270000000 CDM 270 RC inpatient 3.81 3.73 All Payors / Plans All Payors / Plans 3.81 other 3.81 3.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 3-0 18IN BLACK SILK BRAID TIES 12 STRAND PRECUT SUP-270000000 CDM 270 RC inpatient 1.65 1.62 All Payors / Plans All Payors / Plans 1.65 other 1.65 1.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 3-0 30IN BLACK SILK BRAID TIE 12 STRAND PRECUT SUP-270000000 CDM 270 RC inpatient 4.63 4.54 All Payors / Plans All Payors / Plans 4.63 other 4.63 4.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 4-0 144IN BLACK SILK BRAID REEL SUP-270000000 CDM 270 RC inpatient 38.77 37.99 All Payors / Plans All Payors / Plans 38.77 other 38.77 38.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 4-0 18IN BLACK SILK BRAID TIES 12 STRAND PRECUT SUP-270000000 CDM 270 RC inpatient 3.23 3.17 All Payors / Plans All Payors / Plans 3.23 other 3.23 3.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND MULTIPASS 6-0 P-3 18IN BLACK SILK BRAID SUP-270000000 CDM 270 RC inpatient 7.63 7.48 All Payors / Plans All Payors / Plans 7.63 other 7.63 7.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND MULTIPASS SILK 3-0 PS-1 L18 IN BRAID BLACK SUP-270000000 CDM 270 RC inpatient 8.43 8.26 All Payors / Plans All Payors / Plans 8.43 other 8.43 8.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SILK 0 CT-1 L18 IN CONTROL RELEASE BRAID 8 STRAND BLACK SUP-270000000 CDM 270 RC inpatient 14.04 13.76 All Payors / Plans All Payors / Plans 14.04 other 14.04 14.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SILK 0 MH L30 IN BRAID BLACK SUP-270000000 CDM 270 RC inpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SILK 1 MH L30 IN BRAID BLACK SUP-270000000 CDM 270 RC inpatient 3.46 3.39 All Payors / Plans All Payors / Plans 3.46 other 3.46 3.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SILK 2-0 MH L30 IN BRAID BLACK SUP-270000000 CDM 270 RC inpatient 2.21 2.17 All Payors / Plans All Payors / Plans 2.21 other 2.21 2.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SILK 2-0 SH L18 IN CONTROL RELEASE BRAID 8 STRAND BLACK SUP-270000000 CDM 270 RC inpatient 15.86 15.54 All Payors / Plans All Payors / Plans 15.86 other 15.86 15.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SILK 2-0 SH L30 IN BRAID BLACK SUP-270000000 CDM 270 RC inpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SILK 3-0 SH L18 IN CONTROL RELEASE BRAID 8 STRAND BLACK SUP-270000000 CDM 270 RC inpatient 8.16 8 All Payors / Plans All Payors / Plans 8.16 other 8.16 8.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SILK 3-0 SH L30 IN BRAID BLACK SUP-270000000 CDM 270 RC inpatient 2.27 2.22 All Payors / Plans All Payors / Plans 2.27 other 2.27 2.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SUTUPAK SILK 1 L18 IN BRAID TIES 6 STRAND PRECUT BLACK SUP-270000000 CDM 270 RC inpatient 1.56 1.53 All Payors / Plans All Payors / Plans 1.56 other 1.56 1.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 1 CTX L30 IN MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 3.72 3.65 All Payors / Plans All Payors / Plans 3.72 other 3.72 3.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 2-0 CT-1 L30 IN MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 18.27 17.9 All Payors / Plans All Payors / Plans 18.27 other 18.27 18.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 2-0 FS L18 IN MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 4.92 4.82 All Payors / Plans All Payors / Plans 4.92 other 4.92 4.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 2-0 MH L48 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 10.97 10.75 All Payors / Plans All Payors / Plans 10.97 other 10.97 10.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 2-0 SH L36 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 9.04 8.86 All Payors / Plans All Payors / Plans 9.04 other 9.04 9.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 3-0 FS-1 L18 IN MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 2.85 2.79 All Payors / Plans All Payors / Plans 2.85 other 2.85 2.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 3-0 MH L36 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 8.99 8.81 All Payors / Plans All Payors / Plans 8.99 other 8.99 8.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 3-0 SH L36 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 10.76 10.54 All Payors / Plans All Payors / Plans 10.76 other 10.76 10.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 4-0 BB L24 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 14.52 14.23 All Payors / Plans All Payors / Plans 14.52 other 14.52 14.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 4-0 RB-1 L36 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 18.42 18.05 All Payors / Plans All Payors / Plans 18.42 other 18.42 18.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 4-0 SH L36 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 9.29 9.1 All Payors / Plans All Payors / Plans 9.29 other 9.29 9.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 5-0 C-1 L36 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 22.2 21.76 All Payors / Plans All Payors / Plans 22.2 other 22.2 22.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 6-0 BV-1 L24 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 32.24 31.6 All Payors / Plans All Payors / Plans 32.24 other 32.24 32.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 6-0 BV-1 L30 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 27.84 27.28 All Payors / Plans All Payors / Plans 27.84 other 27.84 27.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 6-0 C-1 L30 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 17.14 16.8 All Payors / Plans All Payors / Plans 17.14 other 17.14 17.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 6-0 P-1 L18 IN MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 23.54 23.07 All Payors / Plans All Payors / Plans 23.54 other 23.54 23.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 7-0 BV-1 L30 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 35.59 34.88 All Payors / Plans All Payors / Plans 35.59 other 35.59 35.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE MULTIPASS 4-0 P-3 18IN BLUE MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 10.99 10.77 All Payors / Plans All Payors / Plans 10.99 other 10.99 10.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE MULTIPASS 4-0 PS-2 18IN BLUE MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 8.73 8.56 All Payors / Plans All Payors / Plans 8.73 other 8.73 8.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE MULTIPASS 5-0 P-3 18IN BLUE MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 9.53 9.34 All Payors / Plans All Payors / Plans 9.53 other 9.53 9.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE MULTIPASS 8-0 BV130-5 24IN BLUE 2 ARM MONOFILAMENT SUP-270000000 CDM 270 RC inpatient 81.08 79.46 All Payors / Plans All Payors / Plans 81.08 other 81.08 81.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE POLYPROPYLENE 0 CT L30 IN MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 2.24 2.2 All Payors / Plans All Payors / Plans 2.24 other 2.24 2.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE POLYPROPYLENE 5-0 C-1 L36 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC inpatient 30.9 30.28 All Payors / Plans All Payors / Plans 30.9 other 30.9 30.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE SUTURETAPE L40 IN OD1.3 MM X 2 STRAND BLACK BLUE WHITE SUP-270000000 CDM 270 RC inpatient 66.3 64.97 All Payors / Plans All Payors / Plans 66.3 other 66.3 66.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE TAPERCUT STAINLESS STEEL 6 V-40 L18 IN MONOFILAMENT 4 STRAND SUP-270000000 CDM 270 RC inpatient 25.05 24.55 All Payors / Plans All Payors / Plans 25.05 other 25.05 25.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE TI-CRON CARDIOPOINT 2-0 CV-316 L 30 IN 2 ARM BRAID 10 STRAND COATED BLUE WHITE SUP-270000000 CDM 270 RC inpatient 940.8 921.98 All Payors / Plans All Payors / Plans 940.8 other 940.8 940.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE TI-CRON CARDIOPOINT 2-0CV-331 L30IN 2 ARM BRAID 8 STRAND COATED BLUE WHITE SUP-270000000 CDM 270 RC inpatient 871.25 853.83 All Payors / Plans All Payors / Plans 871.25 other 871.25 871.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE TIGERLINK FIBERWIRE 2 L26 IN CLOSED LOOP BLACK WHITE SUP-270000000 CDM 270 RC inpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE PROLENE 7/0 24IN BV175-6 SUP-270000000 CDM 270 RC inpatient 47.46 46.51 All Payors / Plans All Payors / Plans 47.46 other 47.46 47.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE VICRYL 2-0 SUP-270000000 CDM 270 RC inpatient 5.39 5.28 All Payors / Plans All Payors / Plans 5.39 other 5.39 5.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SUTURE VLOC NON ABS DVC 1BL 18""L GS-21" SUP-270000000 CDM 270 RC inpatient 36.88 36.14 All Payors / Plans All Payors / Plans 36.88 other 36.88 36.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTUTE NONABSORABLE ETHILON 6-0 SUP-270000000 CDM 270 RC inpatient 8.74 8.57 All Payors / Plans All Payors / Plans 8.74 other 8.74 8.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SWITCH FLOW HIGH PRESSURE SUP-270000000 CDM 270 RC inpatient 5.8 5.68 All Payors / Plans All Payors / Plans 5.8 other 5.8 5.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE ANGIOGRAPHY MEDALLION 1 ML CLEAR POLYCARBONATE BARREL FIXED MALE LUER PLUNGER YELLOW SUP-270000000 CDM 270 RC inpatient 7.14 7 All Payors / Plans All Payors / Plans 7.14 other 7.14 7.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE ANGIOGRAPHY MEDRAD FASTURN 150ML DISPOSABLE STERILE LF FILL TUBE MARK V PROVIS SUP-270000000 CDM 270 RC inpatient 8.74 8.57 All Payors / Plans All Payors / Plans 8.74 other 8.74 8.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE BULB DOVER 60 CC PROTECTOR CAP STERILE SUP-270000000 CDM 270 RC inpatient 1.38 1.35 All Payors / Plans All Payors / Plans 1.38 other 1.38 1.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE EAR PVC 2 OZ SOFT PLIABLE IRRIGATION SUCTION STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 1.3 1.27 All Payors / Plans All Payors / Plans 1.3 other 1.3 1.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE INJECTION 10ML FLUID DISPENSING SYSTEM SUP-270000000 CDM 270 RC inpatient 25.13 24.63 All Payors / Plans All Payors / Plans 25.13 other 25.13 25.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE IRRIGATION TOOMEY CONTRO-PISTON TYVEK 70CC GRADUATE ELONGATE TIP EXTRA LONG ORIFICE LUER ADAPTER STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 2.18 2.14 All Payors / Plans All Payors / Plans 2.18 other 2.18 2.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE MEDICAL 60 ML LUER LOCK STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 1.25 1.23 All Payors / Plans All Payors / Plans 1.25 other 1.25 1.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE MEDICAL BD BD LUER-LOK 10ML CLEAR POLYPROPYLENE DISPOSABLE STERILE LF GRADUATE CONTROL NONPYROGENIC DEHP FREE SUP-270000000 CDM 270 RC inpatient 1.24 1.22 All Payors / Plans All Payors / Plans 1.24 other 1.24 1.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE MEDICAL PERIFIX BISPHENOL A PLASTIC 8 ML LOSS OF RESISTANCE LUER LOCK DEHP FREE PVC FREE LATEX FREE SUP-270000000 CDM 270 RC inpatient 1.7 1.67 All Payors / Plans All Payors / Plans 1.7 other 1.7 1.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE TUBERCULIN BD BD PRECISIONGLIDE REGULAR BEVEL REGULAR WALL L1/2 IN OD27 GA 1 ML DETACHABLE NEEDLE SLIP TIP HUB STERILE LATEX FREE DISPOSABLE GRAY SUP-270000000 CDM 270 RC inpatient 32.11 31.47 All Payors / Plans All Payors / Plans 32.11 other 32.11 32.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM BONE CEMENT REVOLUTION FEMORAL MIX BREAKAWAY NOZZLE LATEX SUP-270000000 CDM 270 RC inpatient 88.88 87.1 All Payors / Plans All Payors / Plans 88.88 other 88.88 88.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM CARDIAC MONITOR LINQ II RECORDER SUP-270000000 CDM 270 RC inpatient 4590 4498.2 All Payors / Plans All Payors / Plans 4590 other 4590 4590 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM CLOSURE VASCADE MVP ID6-12 FR VENOUS SUP-270000000 CDM 270 RC inpatient 2652 2598.96 All Payors / Plans All Payors / Plans 2652 other 2652 2652 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM CORONARY STENT SYNERGY XD MR 2.25 X 8MM SUP-270000000 CDM 270 RC inpatient 935 916.3 All Payors / Plans All Payors / Plans 935 other 935 935 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM CORONARY STENT SYNERGY XD MR 2.50 X 24MM SUP-270000000 CDM 270 RC inpatient 1155 1131.9 All Payors / Plans All Payors / Plans 1155 other 1155 1155 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM CORONARY STENT SYNERGY XD MR 3.00 X 20MM SUP-270000000 CDM 270 RC inpatient 1155 1131.9 All Payors / Plans All Payors / Plans 1155 other 1155 1155 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM CORONARY STENT SYNERGY XD MR 4.00 X 20MM SUP-270000000 CDM 270 RC inpatient 1155 1131.9 All Payors / Plans All Payors / Plans 1155 other 1155 1155 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM DELIVERY MITRACLIP XTW CLIP 4TH GENERATION SUP-270000000 CDM 270 RC inpatient 40500 39690 All Payors / Plans All Payors / Plans 40500 other 40500 40500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM DELIVERY SAPIEN 3 OD23 MM COMMANDER DELIVERY SYSTEM STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 46000 45080 All Payors / Plans All Payors / Plans 46000 other 46000 46000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM DELIVERY SAPIEN 3 OD26 MM COMMANDER DELIVERY SYSTEM STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 46000 45080 All Payors / Plans All Payors / Plans 46000 other 46000 46000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM DETACHMENT INZONE SUP-270000000 CDM 270 RC inpatient 606.9 594.76 All Payors / Plans All Payors / Plans 606.9 other 606.9 606.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM DIAGNOSTIC CATHETER IVAS ELITE L10 MM OD10 GA STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 5756.29 5641.16 All Payors / Plans All Payors / Plans 5756.29 other 5756.29 5756.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM EMBOLIC PROTECTION EMBOSHIELD NAV6 STAINLESS STEEL PTFE .014 IN LARGE L190 CM OD4-7 MM SUP-270000000 CDM 270 RC inpatient 5623.8 5511.32 All Payors / Plans All Payors / Plans 5623.8 other 5623.8 5623.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM FIXATION SPEEDBRIDGE SWIVELOCK FIBERTAPE PEEK OD4.75 MM 2 PRELOAD LOOP DISPOSABLE PUNCH BLACK BLUE WHITE SUP-270000000 CDM 270 RC inpatient 3360 3292.8 All Payors / Plans All Payors / Plans 3360 other 3360 3360 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM FIXATION TIGHTROPE XP STAINLESS STEEL SYNDESMOSIS REPAIR SUP-270000000 CDM 270 RC inpatient 3139.5 3076.71 All Payors / Plans All Payors / Plans 3139.5 other 3139.5 3139.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM INTRODUCER ACCUSTICK II L15 CM OD21 GA NEEDLE STYLET RADIOPAQUE SUP-270000000 CDM 270 RC inpatient 20.58 20.17 All Payors / Plans All Payors / Plans 20.58 other 20.58 20.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM NEGATIVE PRESSURE PICO 7 L20 CM X W10 CM STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 173.63 170.16 All Payors / Plans All Payors / Plans 173.63 other 173.63 173.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM THROMBECTOMY ANGIOJET ULTRA SOLENT PROXI PERIPHERAL CATHETER WASTE BAG PUMP SET SCALABLE SUP-270000000 CDM 270 RC inpatient 4207.5 4123.35 All Payors / Plans All Payors / Plans 4207.5 other 4207.5 4207.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM VITRECTOMY EDGEPLUS 6 MM OD25 GA 1 COUNT VALVED ENTRY LOCKING MECHANISM CANNULA LOW FRICTION SUP-270000000 CDM 270 RC inpatient 105.13 103.03 All Payors / Plans All Payors / Plans 105.13 other 105.13 105.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAPE SURGICAL 3M DURAPORE 10YDX1IN WHITE CLOTH LF HYPOALLERGENIC WATER RESISTANT BIDIRECTIONAL TEAR SUP-270000000 CDM 270 RC inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAPE SURGICAL 3M DURAPORE 10YDX3IN WHITE CLOTH LF HYPOALLERGENIC WATER RESISTANT BIDIRECTIONAL TEAR SUP-270000000 CDM 270 RC inpatient 1.55 1.52 All Payors / Plans All Payors / Plans 1.55 other 1.55 1.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAPE SURGICAL 3M MICROFOAM 5.5YDX3IN WHITE FOAM LF HYPOALLERGENIC WATER RESISTANT MULTIDIRECTIONAL STRETCH ELASTIC SUP-270000000 CDM 270 RC inpatient 6.6 6.47 All Payors / Plans All Payors / Plans 6.6 other 6.6 6.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAPE SURGICAL 3M TRANSPORE 10YDX1IN CLEAR PLASTIC DISPOSABLE LF HYPOALLERGENIC WATER RESISTANT BIDIRECTIONAL TEAR SUP-270000000 CDM 270 RC inpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAPE SURGICAL 3M TRANSPORE 10YDX2IN CLEAR PLASTIC DISPOSABLE LF HYPOALLERGENIC WATER RESISTANT BIDIRECTION TEAR SUP-270000000 CDM 270 RC inpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAPE UMBILICAL 36X1/8IN COTTON STERILE LF TIE WOVEN NONABSORBABLE MULTIPACK SUP-270000000 CDM 270 RC inpatient 3.88 3.8 All Payors / Plans All Payors / Plans 3.88 other 3.88 3.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAPE UMBILICAL COTTON FLAT L30 IN X W1/8 IN STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 8.26 8.09 All Payors / Plans All Payors / Plans 8.26 other 8.26 8.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAVR CONFIDA BRECKER GUIDEWIRE 260CM SUP-481000000 CDM 270 RC inpatient 331.5 324.87 All Payors / Plans All Payors / Plans 331.5 other 331.5 331.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAVR COOK 10F DILATOR 20CM SUP-270000000 CDM 270 RC inpatient 16.99 16.65 All Payors / Plans All Payors / Plans 16.99 other 16.99 16.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THERAPY COLD SUP-270000000 CDM 270 RC inpatient 145.95 143.03 All Payors / Plans All Payors / Plans 145.95 other 145.95 145.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIP APPLICATOR PROGEL L29 CM SPRAYER EXTENDED SUP-270000000 CDM 270 RC inpatient 350.28 343.27 All Payors / Plans All Payors / Plans 350.28 other 350.28 350.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIP PHACOEMULSIFICATION GRIESHABER REVOLUTION DSP POLYMERIC 360 D OD 25 GA TISSUE BACK FLUSH LIGHTWEIGHT ERGONOMIC HANDLE STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 213.84 209.56 All Payors / Plans All Payors / Plans 213.84 other 213.84 213.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIP PULSED LAVAGE L12.7 CM MULTIORIFICE FAN SPRAY SPLASH SHIELD HIGH CAPACITY STERILE INTRAMEDULLARY NAIL SUP-270000000 CDM 270 RC inpatient 7.94 7.78 All Payors / Plans All Payors / Plans 7.94 other 7.94 7.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIP PULSED LAVAGE L22.86 CM OD.89 CM FEMUR RADIAL SPRAY HIGH CAPACITY STERILE INTRAMEDULLARY NAIL PULSAVAC PLUS PULSAVAC PLUS AC SUP-270000000 CDM 270 RC inpatient 15.12 14.82 All Payors / Plans All Payors / Plans 15.12 other 15.12 15.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIP SUCTION ARGYLE YANKAUER VINYL PEDIATRIC L25 CM OD12 FR FINE FLEXIBLE NONBREAKABLE SMOOTH INNER LUMEN STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIP SUCTION MEDI-VAC YANKAUER BULBOUS WITHOUT CONTROL VENT HANDLE STERILE LATEX FREE CLEAR SUP-270000000 CDM 270 RC inpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIP SUCTION POOLE 32FR 8.75IN STRAIGHT GENTLE SUMP SUP-270000000 CDM 270 RC inpatient 40.13 39.33 All Payors / Plans All Payors / Plans 40.13 other 40.13 40.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIP SUCTION YANKAUER PLASTIC STANDARD TUBE RIGID TRANSPARENT SLIP RESISTANT HANDLE STERILE LATEX FREE CLEAR SUP-270000000 CDM 270 RC inpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MIDAS REX LEGEND CYLINDER L10 CM OD4 MM STERILE BURR SUP-270000000 CDM 270 RC inpatient 367.23 359.89 All Payors / Plans All Payors / Plans 367.23 other 367.23 367.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MIDAS REX LEGEND MATCH HEAD FLUTE L9 CM OD3 MM BURR SUP-270010028 CDM 270 RC inpatient 313.55 307.28 All Payors / Plans All Payors / Plans 313.55 other 313.55 313.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MIDAS REX MR8 7 CM TAPER OD2.3 MM STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 156.18 153.06 All Payors / Plans All Payors / Plans 156.18 other 156.18 156.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MIDAS REX MR8 BALL L9 CM OD5 MM SYMMETRICAL STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 986.58 966.85 All Payors / Plans All Payors / Plans 986.58 other 986.58 986.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MIDAS REX MR8 MATCH HEAD L9 CM OD3 MM STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 188.13 184.37 All Payors / Plans All Payors / Plans 188.13 other 188.13 188.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MR8 CYLINDER L10 CM OD4 MM SUP-270000000 CDM 270 RC inpatient 367.23 359.89 All Payors / Plans All Payors / Plans 367.23 other 367.23 367.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MR8 MATCH HEAD L10 CM OD3 MM STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 343.48 336.61 All Payors / Plans All Payors / Plans 343.48 other 343.48 343.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MR8 MATCH HEAD L14 CM OD3 MM STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 315.03 308.73 All Payors / Plans All Payors / Plans 315.03 other 315.03 315.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MR8 TAPER L7 CM OD1.1 MM SUP-270000000 CDM 270 RC inpatient 290.49 284.68 All Payors / Plans All Payors / Plans 290.49 other 290.49 290.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRACKER NAVIGATION FUSION AXIEM ENT INSTRUMENT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 432.6 423.95 All Payors / Plans All Payors / Plans 432.6 other 432.6 432.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRACKER NAVIGATION FUSION AXIEM NONINVASIVE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 525 514.5 All Payors / Plans All Payors / Plans 525 other 525 525 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRANSFORM 7X10 SUP-270000000 CDM 270 RC inpatient 3255.5 3190.39 All Payors / Plans All Payors / Plans 3255.5 other 3255.5 3255.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETER ARGYLE SWAN NECK CURL L122.3 CM OD15 FR PRESTERNAL CUFF STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 676.6 663.07 All Payors / Plans All Payors / Plans 676.6 other 676.6 676.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETER POWERLINE 577ML/HR 5FR POLYURETHANE STERILE LF 2 LUMEN POWER INJECTABLE MICROINTRODUCER SUP-270000000 CDM 270 RC inpatient 1208.97 1184.79 All Payors / Plans All Payors / Plans 1208.97 other 1208.97 1208.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETER POWERPICC NITINOL .018 IN L70 CM OD5 FR 2 LUMEN GUIDEWIRE SUP-270000000 CDM 270 RC inpatient 96.89 94.95 All Payors / Plans All Payors / Plans 96.89 other 96.89 96.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETER SURESTEP LUBRI-SIL IC COMPLETE CARE OD 16 FRENCH 350ML FOLEY URINE METER TEMPERATURE SENSING STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 83.58 81.91 All Payors / Plans All Payors / Plans 83.58 other 83.58 83.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETERIZATION BARD OD16 FR 350ML URINE METER SUP-270009006 CDM 270 RC inpatient 41.75 40.92 All Payors / Plans All Payors / Plans 41.75 other 41.75 41.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETERIZATION BARDEX COMPLETE CARE OD16 FR FOLEY URINE METER ADVANCE STERILE 400 SUP-270009006 CDM 270 RC inpatient 12.49 12.24 All Payors / Plans All Payors / Plans 12.49 other 12.49 12.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETERIZATION BARDEX STATLOCK 16FR BACTI-GUARD HYDROGEL NATURAL RUBBER DISPOSABLE STERILE LATEX FOLEY URINE METER SUP-270009006 CDM 270 RC inpatient 12.49 12.24 All Payors / Plans All Payors / Plans 12.49 other 12.49 12.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETERIZATION COMPLETE CARE BARDEX IC STATLOCK BARD 60IN 16FR 5ML BACTI-GUARD NATURAL RUBBER HYDROGEL DISPOSABLE SUP-270009004 CDM 270 RC inpatient 8.5 8.33 All Payors / Plans All Payors / Plans 8.5 other 8.5 8.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETERIZATION COMPLETE CARE BARDEX IC STATLOCK BARD BACTI-GUARD NATURAL RUBBER HYDROGEL L60 IN OD18 FR 5 ML ADVANCE FOLEY ANTIREFLUX CHAMBER DRAINAGE BAG STERILE LATEX DISPOSABLE SUP-270009004 CDM 270 RC inpatient 8.5 8.33 All Payors / Plans All Payors / Plans 8.5 other 8.5 8.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETERIZATION LUBRI SIL ADVANCE 16 FR 2 CONNECTOR FOLEY URINE METER TEMP SENSING LATEX FREE SUP-270000000 CDM 270 RC inpatient 38.69 37.92 All Payors / Plans All Payors / Plans 38.69 other 38.69 38.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETERIZATION LUBRI-SIL COMPLETE CARE STATLOCK 60IN 16FR BACTI-GUARD HYDROGEL DISPOSABLE STERILE LF FOLEY URINE SUP-270000000 CDM 270 RC inpatient 33.65 32.98 All Payors / Plans All Payors / Plans 33.65 other 33.65 33.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY GASTRIC LAVAGE MONOJECT ARGYLE EDLICH PVC LARGE L36 IN OD34 FR 140 CC 4 EYE CLOSED END GRADUATED SYRINGE TRANSPARENT STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 12.78 12.52 All Payors / Plans All Payors / Plans 12.78 other 12.78 12.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY SKIN PREP PVP-1 SCRUB CARE SUP-270009183 CDM 270 RC inpatient 5.76 5.64 All Payors / Plans All Payors / Plans 5.76 other 5.76 5.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY SKIN SCRUB 4OZ CHG VINYL COTTON STERILE LF WET SUP-270000000 CDM 270 RC inpatient 24.3 23.81 All Payors / Plans All Payors / Plans 24.3 other 24.3 24.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY SKIN SCRUB VINYL WET SMALL WING SPONGE STICK COTTON TIP APPLICATOR LATEX FREE SUP-270009183 CDM 270 RC inpatient 6.01 5.89 All Payors / Plans All Payors / Plans 6.01 other 6.01 6.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY STERLIZATION SPHERES SUP-270000000 CDM 270 RC inpatient 308.23 302.07 All Payors / Plans All Payors / Plans 308.23 other 308.23 308.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY SURGICAL 54X54IN STERILE LF 2 BASIN GRADUATED SUP-270000000 CDM 270 RC inpatient 6.18 6.06 All Payors / Plans All Payors / Plans 6.18 other 6.18 6.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY SURGICAL WAYNE CHLORAPREP L29 CM L5 CM OD14 FR ODSEC18 GA PERCUTANEOUS 19 SIDEPORT CATHETER ECHOGENIC ENTRY NEEDLE GUIDEWIRE DILATOR STERILE DISPOSABLE PNEUMOTHORAX SUP-270000000 CDM 270 RC inpatient 723.38 708.91 All Payors / Plans All Payors / Plans 723.38 other 723.38 723.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR BLADELESS W/BALLOON 12MMX100MM SUP-270000000 CDM 270 RC inpatient 204 199.92 All Payors / Plans All Payors / Plans 204 other 204 204 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR HASSON 12MM SUP-270000000 CDM 270 RC inpatient 252 246.96 All Payors / Plans All Payors / Plans 252 other 252 252 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL 100MM 11MM DISPOSABLE STERILE LF STABILITY SLEEVE BLADELESS OBTURATOR OPTIONAL PISTOL SUP-270000000 CDM 270 RC inpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL 100MM 12MM DISPOSABLE STERILE STABILITY SLEEVE DILATE SUP-270000000 CDM 270 RC inpatient 51.47 50.44 All Payors / Plans All Payors / Plans 51.47 other 51.47 51.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL 150MM 5MM DISPOSABLE STERILE STABILITY SLEEVE SUP-270000000 CDM 270 RC inpatient 51.47 50.44 All Payors / Plans All Payors / Plans 51.47 other 51.47 51.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL L100 MM OD12 MM BLADELESS OPTICAL TIP OBTURATOR RADIOLUCENT SLEEVE STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL L100 MM OD15 MM BLADELESS OPTICAL TIP OBTURATOR RADIOLUCENT SLEEVE STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 72.46 71.01 All Payors / Plans All Payors / Plans 72.46 other 72.46 72.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL L100 MM OD8 MM STABILITY SLEEVE BLADELESS OPTICAL TIP OBTURATOR STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 42.28 41.43 All Payors / Plans All Payors / Plans 42.28 other 42.28 42.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL L150 MM OD12 MM STABILITY SLEEVE BLADELESS LOW SYSTEM DRAG FORCE OPTIONAL PISTOL HANDLE STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 64.89 63.59 All Payors / Plans All Payors / Plans 64.89 other 64.89 64.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL OPTIVIEW 100MM 12MM DISPOSABLE STERILE SMOOTH SLEEVE OBTURATOR BLUNT TIP PISTOL HANDLE SUP-270000000 CDM 270 RC inpatient 51.47 50.44 All Payors / Plans All Payors / Plans 51.47 other 51.47 51.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL OPTIVIEW 100MM 5MM DISPOSABLE STERILE STABILITY SLEEVE BLADELESS OBTURATOR RADIOLUCENT SUP-270000000 CDM 270 RC inpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL OPTIVIEW L100 MM OD5 MM STABILITY SLEEVE DILAT TIP STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 51.47 50.44 All Payors / Plans All Payors / Plans 51.47 other 51.47 51.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR SLEEVE W/BALLOON 5MM X 100MM SUP-270000000 CDM 270 RC inpatient 93.5 91.63 All Payors / Plans All Payors / Plans 93.5 other 93.5 93.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR SURGICAL ARGYLE L18 3/4 CM FALLER TUNNEL STERILE LATEX FREE PERITONEAL DIALYSIS SUP-270000000 CDM 270 RC inpatient 225.98 221.46 All Payors / Plans All Payors / Plans 225.98 other 225.98 225.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR W BALLOON 5MM X 100MM SUP-270000000 CDM 270 RC inpatient 187 183.26 All Payors / Plans All Payors / Plans 187 other 187 187 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRUE DILATATION BALLOON 24MM X 4.5CM SUP-481000000 CDM 270 RC inpatient 3000 2940 All Payors / Plans All Payors / Plans 3000 other 3000 3000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBE CONNECTING DRAINAGE BAG SUP-270000000 CDM 270 RC inpatient 11.91 11.67 All Payors / Plans All Payors / Plans 11.91 other 11.91 11.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBE GASTROSTOMY SILICONE L9.5 IN OD20 FR 15 CC 3 PORT GASTRIC BALLOON ROUND TIP LATEX FREE WHITE SUP-270009103 CDM 270 RC inpatient 75.73 74.22 All Payors / Plans All Payors / Plans 75.73 other 75.73 75.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBE JEJUNOSTOMY MIC SECUR-LOK 45CM 18FR 7-10ML SILICONE DISPOSABLE STERILE LF RADIOPAQUE STRIPE RETENTION BALLOON SUP-270000000 CDM 270 RC inpatient 474.26 464.77 All Payors / Plans All Payors / Plans 474.26 other 474.26 474.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBE NASOGASTRIC SALEM SUMP SENTINEL LINE SENTINEL EYE 48IN 18FR PVC STERILE STOMACH 2 LUMEN DEHP FREE 5IN 1 ADAPTER SUP-270000000 CDM 270 RC inpatient 2.18 2.14 All Payors / Plans All Payors / Plans 2.18 other 2.18 2.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBE NASOGASTRIC TUM-E-VAC ADULT L48 IN OD32 FR 1 LUMEN RADIOPAQUE NONSTERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 8.95 8.77 All Payors / Plans All Payors / Plans 8.95 other 8.95 8.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBE SUCTION ARGYLE YANKAUER VINYL L25 CM OD22 FR SET LARGE TIP NO VACUUM CONTROL INNER LUMEN LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBE TRACHEOSTOMY PORTEX BLUSELECT L 26.74 MM ID 8.0 MM WEDGE CUFF NONFEN STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 66.26 64.93 All Payors / Plans All Payors / Plans 66.26 other 66.26 66.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBE VENTILATION ARMSTRONG FLUOROPLASTIC BEVEL GROMMET ID1.14 MM EAR SUP-270000000 CDM 270 RC inpatient 1643.67 1610.8 All Payors / Plans All Payors / Plans 1643.67 other 1643.67 1643.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING ABLATION CARTO SMARTABLATE PUMP STERILE SUP-270000000 CDM 270 RC inpatient 92.82 90.96 All Payors / Plans All Payors / Plans 92.82 other 92.82 92.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING ANGIOGRAPHY PVC 900 PSI L48 IN OD.158 IN ID.071 IN RIGID CONTRAST INJECTION FIXED MALE CONNECTOR CLEAR SUP-270000000 CDM 270 RC inpatient 2.41 2.36 All Payors / Plans All Payors / Plans 2.41 other 2.41 2.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING ASPIRATION AXS UNIVERSAL L300 CM OD8 MM STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 663.6 650.33 All Payors / Plans All Payors / Plans 663.6 other 663.6 663.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING DRAINAGE ARGYLE PENROSE RUBBER FLAT L12 IN X W5/8 IN OD3/8 IN RADIOPAQUE STERILE LATEX DISPOSABLE SUP-270000000 CDM 270 RC inpatient 1.16 1.14 All Payors / Plans All Payors / Plans 1.16 other 1.16 1.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING DRAINAGE ARGYLE PENROSE RUBBER L30 CM OD16 MM THORACIC RADIOPAQUE STERILE LATEX DISPOSABLE SUP-270000000 CDM 270 RC inpatient 1.16 1.14 All Payors / Plans All Payors / Plans 1.16 other 1.16 1.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING INSUFFLATION DYOPNEUMATIC .1UM 10FT STERILE LF ABDOMINAL BACTERIAL VIRAL FILTER 1 LUER LOCK CPC CONNECTOR SUP-270000000 CDM 270 RC inpatient 31.52 30.89 All Payors / Plans All Payors / Plans 31.52 other 31.52 31.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING INSUFFLATION L10 FT 40 L LUER LOCK HIGH FLOW HEATED PATIENT KIT STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 18.48 18.11 All Payors / Plans All Payors / Plans 18.48 other 18.48 18.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING IRRIGATION TIP DISPOSABLE SUP-270000000 CDM 270 RC inpatient 32.53 31.88 All Payors / Plans All Payors / Plans 32.53 other 32.53 32.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING PRESSURE MONITOR POLYETHYLENE L48 IN MALE TO FEMALE CONNECTOR LUER LOCK TRANSDUCER LINE FIX STERILE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 20.79 20.37 All Payors / Plans All Payors / Plans 20.79 other 20.79 20.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING PRESSURE MONITOR TRUWAVE L12 IN MALE TO FEMALE CONNECTOR TRANSDUCER DISPOSABLE SUP-270000000 CDM 270 RC inpatient 4.51 4.42 All Payors / Plans All Payors / Plans 4.51 other 4.51 4.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING SMOKE EVACUATOR PUREVIEW PLUME-AWAY FILTRATION LAPAROSCOPIC SUP-270000000 CDM 270 RC inpatient 36.55 35.82 All Payors / Plans All Payors / Plans 36.55 other 36.55 36.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING SUCTION BERKELEY SAFETOUCH L18 IN BOTTLE TO BOTTLE HOSE CONNECT LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 2.54 2.49 All Payors / Plans All Payors / Plans 2.54 other 2.54 2.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING SUCTION L6 FT OD1/2 IN UTERINE SWIVEL HANDLE STERILE LATEX DISPOSABLE AMUVAC SUP-270000000 CDM 270 RC inpatient 15.14 14.84 All Payors / Plans All Payors / Plans 15.14 other 15.14 15.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING SUCTION MEDI-VAC L12 FT ID1/4 IN NONCONDUCTIVE MALE TO MALE CONNECTOR STERILE LATEX FREE CLEAR SUP-270000000 CDM 270 RC inpatient 1.18 1.16 All Payors / Plans All Payors / Plans 1.18 other 1.18 1.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING SUCTION MEDI-VAC MAXI-GRIP L6 FT ID1/4 IN NONCONDUCTIVE MALE TO MALE STERILE CLEAR SUP-270000000 CDM 270 RC inpatient 1.22 1.2 All Payors / Plans All Payors / Plans 1.22 other 1.22 1.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING SUCTION POOLE GENTLE SUMP STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC inpatient 3.02 2.96 All Payors / Plans All Payors / Plans 3.02 other 3.02 3.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility UNIT ELECTROSURGICAL GENESYS HTA PROCEDURE SET SUP-270000000 CDM 270 RC inpatient 3759 3683.82 All Payors / Plans All Payors / Plans 3759 other 3759 3759 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC CARBO-SEAL GELWEAVE VALSALVA OD21 MM ID24 MM MECHANICAL ROTATABLE CONDUIT LOW PROFILE HOLDER SUP-270000000 CDM 270 RC inpatient 16252.5 15927.45 All Payors / Plans All Payors / Plans 16252.5 other 16252.5 16252.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC EDWARDS SAPIEN 3 COMMANDER OD 29MM DELIVERY SYSTEM SUP-270000000 CDM 270 RC inpatient 43000 42140 All Payors / Plans All Payors / Plans 43000 other 43000 43000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC EVOLUT FX 26 MM SUP-270000000 CDM 270 RC inpatient 43500 42630 All Payors / Plans All Payors / Plans 43500 other 43500 43500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC EVOLUT FX 29 MM SUP-270000000 CDM 270 RC inpatient 43500 42630 All Payors / Plans All Payors / Plans 43500 other 43500 43500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC EVOLUT FX 34 MM SUP-270000000 CDM 270 RC inpatient 46500 45570 All Payors / Plans All Payors / Plans 46500 other 46500 46500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC INSPIRIS RESILIA 21MM SUP-270000000 CDM 270 RC inpatient 16485 16155.3 All Payors / Plans All Payors / Plans 16485 other 16485 16485 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC INSPIRIS RESILIA 23MM SUP-270000000 CDM 270 RC inpatient 13345 13078.1 All Payors / Plans All Payors / Plans 13345 other 13345 13345 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC SAPIEN 3 BOVINE OD29 MM TRANSCATHETER STERILE SUP-270000000 CDM 270 RC inpatient 46000 45080 All Payors / Plans All Payors / Plans 46000 other 46000 46000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC SAPIEN 3 EDWARDS OD23 MM HEART TRANSCATHETER STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 46000 45080 All Payors / Plans All Payors / Plans 46000 other 46000 46000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC SAPIEN 3 EDWARDS OD26 MM HEART TRANSCATHETER STERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 43500 42630 All Payors / Plans All Payors / Plans 43500 other 43500 43500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE HEMOSTASIS ACCESS PLUS VALUELINK LARGE BORE SUP-270000000 CDM 270 RC inpatient 49.06 48.08 All Payors / Plans All Payors / Plans 49.06 other 49.06 49.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE HEMOSTASIS PHD METAL POLYCARBONATE SILICONE ID 7.3 FR INSERTION TOOL TORQUE DEVICE COMPRESSION SEAL PUSH RELEASE MECHANISM CLEAR SUP-481000000 CDM 270 RC inpatient 37.4 36.65 All Payors / Plans All Payors / Plans 37.4 other 37.4 37.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE MITRAL EPIC FLEXFIT PORCINE PERICARDIAL LOW PROFILE H19 MM OD29 MM ID27 MM BIOPROSTHESIS STENT HOLDER SUP-270000000 CDM 270 RC inpatient 9618 9425.64 All Payors / Plans All Payors / Plans 9618 other 9618 9618 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE MITRAL MASTER-SERIES PYROLYTIC CARBON 85 D 5.18 SQ CM STANDARD OD31 MM ID26.1 MM HEART CUFF LEAFLET OPEN CONTROL TORQUE ROTATION MECHANISM SUP-270000000 CDM 270 RC inpatient 12708.8 12454.62 All Payors / Plans All Payors / Plans 12708.8 other 12708.8 12708.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE SUCTION VISERA FLEXIBLE ATTACHMENT STERILE DISPOSABLE BRONCHOSCOPE SUP-270000000 CDM 270 RC inpatient 29.69 29.1 All Payors / Plans All Payors / Plans 29.69 other 29.69 29.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVULOTOME ANGIOSCOPIC HYDRO LEMAITRE L98 CM OD1.5 MM IRRIGATION PORT CUT BLADE BULLET HEAD HANDLE STERILE DISPOSABLE GREEN WHITE SUP-270000000 CDM 270 RC inpatient 6297.9 6171.94 All Payors / Plans All Payors / Plans 6297.9 other 6297.9 6297.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERACROSS ZERO EXCHANGE WATCHMAN SHEATH DELIVERY SUP-272000000 CDM 270 RC inpatient 1116.9 1094.56 All Payors / Plans All Payors / Plans 1116.9 other 1116.9 1116.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERSA CROSS TRANSSEPTAL ACCESS 8.5F FIXED SYSTEM W/45 SHEATH AND PIGTAIL_62301_ SUP-481000000 CDM 270 RC inpatient 1734 1699.32 All Payors / Plans All Payors / Plans 1734 other 1734 1734 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VIABAHN BALLOON SUP-270000000 CDM 270 RC inpatient 6755.8 6620.68 All Payors / Plans All Payors / Plans 6755.8 other 6755.8 6755.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VIABAHN BX BALLOON SUP-270000000 CDM 270 RC inpatient 8345.4 8178.49 All Payors / Plans All Payors / Plans 8345.4 other 8345.4 8345.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VIABAHN BX BALLOON ENDO SUP-270000000 CDM 270 RC inpatient 6665.7 6532.39 All Payors / Plans All Payors / Plans 6665.7 other 6665.7 6665.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VISTASEAL FIBRIN SEALANT (HUMAN) 10 ML-12 PACK KIT SUP-270000000 CDM 270 RC inpatient 542.95 532.09 All Payors / Plans All Payors / Plans 542.95 other 542.95 542.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VNS SENTIVA GENERATOR SUP-270010003 CDM 270 RC inpatient 52073.25 51031.79 All Payors / Plans All Payors / Plans 52073.25 other 52073.25 52073.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VOLCANO EAGLE EYE PLATINUM IVUS CATHETER SUP-481000000 CDM 270 RC inpatient 739.5 724.71 All Payors / Plans All Payors / Plans 739.5 other 739.5 739.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VOLCANO REFINITY SUP-270000000 CDM 270 RC inpatient 1232.5 1207.85 All Payors / Plans All Payors / Plans 1232.5 other 1232.5 1232.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VOLCANO REFINITY IVUS CATHETER SUP-270000000 CDM 270 RC inpatient 1522.5 1492.05 All Payors / Plans All Payors / Plans 1522.5 other 1522.5 1522.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VOLCANO REFINITY ROTATIONAL IVUS CATHETER SUP-481000000 CDM 270 RC inpatient 1522.5 1492.05 All Payors / Plans All Payors / Plans 1522.5 other 1522.5 1522.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VSI .018 GUIDEWIRE SUP-481000000 CDM 270 RC inpatient 47.25 46.31 All Payors / Plans All Payors / Plans 47.25 other 47.25 47.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VSI TRU-TORQUE STRAIGHT TIP GUIDEWIRE 180CM SUP-481000000 CDM 270 RC inpatient 153.3 150.23 All Payors / Plans All Payors / Plans 153.3 other 153.3 153.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WARMER SCOPE SUP-270000000 CDM 270 RC inpatient 5.61 5.5 All Payors / Plans All Payors / Plans 5.61 other 5.61 5.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WASHER ORTHOPEDIC STAINLESS STEEL THK 1 MM OD 8 MM ID 4 MM STERILE SUP-270000000 CDM 270 RC inpatient 96.36 94.43 All Payors / Plans All Payors / Plans 96.36 other 96.36 96.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WATCHMAN FLX 27MM _62666_ SUP-481000000 CDM 270 RC inpatient 18500 18130 All Payors / Plans All Payors / Plans 18500 other 18500 18500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WATCHMAN FLX 35 _62668_ SUP-481000000 CDM 270 RC inpatient 21500 21070 All Payors / Plans All Payors / Plans 21500 other 21500 21500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WAX BONE 2.5 GM ABSORBABLE HEMOSTATIC AGENT SUP-270000000 CDM 270 RC inpatient 4.81 4.71 All Payors / Plans All Payors / Plans 4.81 other 4.81 4.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WAX BONE MONTAGE STERILE SUP-270000000 CDM 270 RC inpatient 3777.9 3702.34 All Payors / Plans All Payors / Plans 3777.9 other 3777.9 3777.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIDE SAW BLADE SUP-270000000 CDM 270 RC inpatient 369.2 361.82 All Payors / Plans All Payors / Plans 369.2 other 369.2 369.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIPE SURGICAL INSTRUMENT VISIWIPE L2 7/8 IN X W2 7/8 IN CLEAN SUP-270000000 CDM 270 RC inpatient 3.13 3.07 All Payors / Plans All Payors / Plans 3.13 other 3.13 3.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE FIXATION KIRSCHNER 150MM 2MM SS NS TROCAR POINT SUP-270010022 CDM 270 RC inpatient 16.91 16.57 All Payors / Plans All Payors / Plans 16.91 other 16.91 16.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE FIXATION KIRSCHNER COCR FLUTE L150MM OD 1.6MM DRILL TIP SUP-270000000 CDM 270 RC inpatient 91.98 90.14 All Payors / Plans All Payors / Plans 91.98 other 91.98 91.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE FIXATION KIRSCHNER EVOS L 225MM OD 2 MM TROCAR TIP SUP-270000000 CDM 270 RC inpatient 932.4 913.75 All Payors / Plans All Payors / Plans 932.4 other 932.4 932.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE FIXATION KIRSCHNER STAINLESS STEEL L 150MM OD 1.6MM TROCAR POINT STERILE SUP-270000000 CDM 270 RC inpatient 43.35 42.48 All Payors / Plans All Payors / Plans 43.35 other 43.35 43.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE FIXATION KIRSCHNER STAINLESS STEEL L 150MM OD 2MM TROCAR POINT STERILE SUP-270000000 CDM 270 RC inpatient 53.55 52.48 All Payors / Plans All Payors / Plans 53.55 other 53.55 53.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE FIXATION L 100 MM OD 1.4 MM TROCAR TIP SUP-270000000 CDM 270 RC inpatient 69.3 67.91 All Payors / Plans All Payors / Plans 69.3 other 69.3 69.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE PROTRACK PIGTAIL 0.025 IN DIAMETER 230 CM OVERALL LENGTH SUP-481000000 CDM 270 RC inpatient 493.5 483.63 All Payors / Plans All Payors / Plans 493.5 other 493.5 493.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE STERNAL SINGLE SUP-270000000 CDM 270 RC inpatient 5.6 5.49 All Payors / Plans All Payors / Plans 5.6 other 5.6 5.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE SUTURE DOUBLEWIRE 6 BE-3 1/2 CIRCLE BALL L54 MM STERNOTOMY SUP-270000000 CDM 270 RC inpatient 184.17 180.49 All Payors / Plans All Payors / Plans 184.17 other 184.17 184.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WRAP THERAPEUTIC ACTIVEWRAP PLUSH LARGE XL OD16+ IN LEG KNEE THERMAL SUPPORT GEL PACK POST OPERATIVE NONSTERILE LATEX FREE SUP-270000000 CDM 270 RC inpatient 36.43 35.7 All Payors / Plans All Payors / Plans 36.43 other 36.43 36.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WRENCH PACEMAKER 2 BIDRECTIONAL TORQUE STERILE SUP-270000000 CDM 270 RC inpatient 105 102.9 All Payors / Plans All Payors / Plans 105 other 105 105 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WRENCH SURGICAL HEXAGON LEAD SUP-270000000 CDM 270 RC inpatient 47.25 46.31 All Payors / Plans All Payors / Plans 47.25 other 47.25 47.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility .035 180CM INQWIRE WIRE J TIP SUP-481000000 CDM 270 RC outpatient 12.98 12.72 All Payors / Plans All Payors / Plans 12.98 other 12.98 12.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility .035 NAVILYST GUIDEWIRE 175J SUP-481000000 CDM 270 RC outpatient 24.18 23.7 All Payors / Plans All Payors / Plans 24.18 other 24.18 24.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "1.1MM TROCAR TIP WIRE 2X ENDED, 150MM" SUP-270000000 CDM 270 RC outpatient 1103.76 1081.68 All Payors / Plans All Payors / Plans 1103.76 other 1103.76 1103.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 1.25MM X 150MM K-WIRE SUP-270000000 CDM 270 RC outpatient 91.98 90.14 All Payors / Plans All Payors / Plans 91.98 other 91.98 91.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 1.25MMX150MM TROCAR TIP SUP-270000000 CDM 270 RC outpatient 517.14 506.8 All Payors / Plans All Payors / Plans 517.14 other 517.14 517.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 1.8MM SHORT DRILL BIT SUP-270000000 CDM 270 RC outpatient 175.5 171.99 All Payors / Plans All Payors / Plans 175.5 other 175.5 175.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 10.5F PRELUDE SNAP SUP-270010030 CDM 270 RC outpatient 174.3 170.81 All Payors / Plans All Payors / Plans 174.3 other 174.3 174.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 12.0MM REAMER HEAD FOR RIA 2 STERILE SUP-270000000 CDM 270 RC outpatient 1643.9 1611.02 All Payors / Plans All Payors / Plans 1643.9 other 1643.9 1643.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 14.5MM REAMER HEAD FOR RIA 2 SUP-270000000 CDM 270 RC outpatient 1643.9 1611.02 All Payors / Plans All Payors / Plans 1643.9 other 1643.9 1643.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.0 DRILL TIP KWIRE SUP-270000000 CDM 270 RC outpatient 1103.76 1081.68 All Payors / Plans All Payors / Plans 1103.76 other 1103.76 1103.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.0 FENESTRATION DRILL SUP-270000000 CDM 270 RC outpatient 403 394.94 All Payors / Plans All Payors / Plans 403 other 403 403 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.0 X 150MM K-WIRE DRILL TIP SUP-270000000 CDM 270 RC outpatient 438 429.24 All Payors / Plans All Payors / Plans 438 other 438 438 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "2.0MM DRILL TIP WIRE, 150MM" SUP-270000000 CDM 270 RC outpatient 2207.52 2163.37 All Payors / Plans All Payors / Plans 2207.52 other 2207.52 2207.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.0MM LOND DRILLS SUP-270000000 CDM 270 RC outpatient 221.76 217.32 All Payors / Plans All Payors / Plans 221.76 other 221.76 221.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.3 KWIRE SUP-270000000 CDM 270 RC outpatient 54.6 53.51 All Payors / Plans All Payors / Plans 54.6 other 54.6 54.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.4 DRILL SUP-270000000 CDM 270 RC outpatient 403 394.94 All Payors / Plans All Payors / Plans 403 other 403 403 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.5 PERCUTANEOUS DRILL BIT SUP-270000000 CDM 270 RC outpatient 453.6 444.53 All Payors / Plans All Payors / Plans 453.6 other 453.6 453.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.5MM CALIBRATED DRILL BIT SUP-270000000 CDM 270 RC outpatient 462 452.76 All Payors / Plans All Payors / Plans 462 other 462 462 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "2.7MM DRILL, 130MM" SUP-270000000 CDM 270 RC outpatient 176.4 172.87 All Payors / Plans All Payors / Plans 176.4 other 176.4 176.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 2.8 DRILL SUP-270000000 CDM 270 RC outpatient 403 394.94 All Payors / Plans All Payors / Plans 403 other 403 403 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 25+ FINESSE FLEX LOOP SUP-270000000 CDM 270 RC outpatient 267.83 262.47 All Payors / Plans All Payors / Plans 267.83 other 267.83 267.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 260 J WIRE SUP-270000000 CDM 270 RC outpatient 31.62 30.99 All Payors / Plans All Payors / Plans 31.62 other 31.62 31.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 3.8 DRILL SUP-270000000 CDM 270 RC outpatient 903.5 885.43 All Payors / Plans All Payors / Plans 903.5 other 903.5 903.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 3.9MM SWIVELOCK ANCHOR SUP-270000000 CDM 270 RC outpatient 787.5 771.75 All Payors / Plans All Payors / Plans 787.5 other 787.5 787.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 4.0MM RAD60 BLADE SUP-270000000 CDM 270 RC outpatient 640.92 628.1 All Payors / Plans All Payors / Plans 640.92 other 640.92 640.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 4.5 LOCKING SCREW 58MM SUP-270000000 CDM 270 RC outpatient 518.7 508.33 All Payors / Plans All Payors / Plans 518.7 other 518.7 518.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 4.6 DRILL SUP-270000000 CDM 270 RC outpatient 903.5 885.43 All Payors / Plans All Payors / Plans 903.5 other 903.5 903.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 40CC SENSATION PLUS IABP CATHETER SUP-270000000 CDM 270 RC outpatient 2217.08 2172.74 All Payors / Plans All Payors / Plans 2217.08 other 2217.08 2217.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 4F MICROPUNCTURE INTRODUCER SET 10CM SUP-481000000 CDM 270 RC outpatient 27.77 27.21 All Payors / Plans All Payors / Plans 27.77 other 27.77 27.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 5.5F PRONTO V4 EXTRACTION CATHETER SUP-270000000 CDM 270 RC outpatient 699.3 685.31 All Payors / Plans All Payors / Plans 699.3 other 699.3 699.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 5F DXTERITY JL 3.5 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC outpatient 11.25 11.03 All Payors / Plans All Payors / Plans 11.25 other 11.25 11.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 5F DXTERITY JL 4.0 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC outpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 5F DXTERITY JL 4.5 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC outpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 5F DXTERITY JR 4.0 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC outpatient 11.25 11.03 All Payors / Plans All Payors / Plans 11.25 other 11.25 11.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 5F DXTERITY PIG STR DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC outpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F C-PIGTAIL PERFORMA SUP-270000000 CDM 270 RC outpatient 19 18.62 All Payors / Plans All Payors / Plans 19 other 19 19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F 145 PIGTAIL CATHETER 110CM SUP-481000000 CDM 270 RC outpatient 7.68 7.53 All Payors / Plans All Payors / Plans 7.68 other 7.68 7.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F AL1 DIAGNOSTIC CATHETER 100CM SUP-481000000 CDM 270 RC outpatient 9.69 9.5 All Payors / Plans All Payors / Plans 9.69 other 9.69 9.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F AL2 DIAGNOSTIC CATHETER 100CM SUP-481000000 CDM 270 RC outpatient 17.54 17.19 All Payors / Plans All Payors / Plans 17.54 other 17.54 17.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F C PIG PERFORMA SUP-270000000 CDM 270 RC outpatient 19 18.62 All Payors / Plans All Payors / Plans 19 other 19 19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F C PIGTAIL PERFORMA SUP-270000000 CDM 270 RC outpatient 19 18.62 All Payors / Plans All Payors / Plans 19 other 19 19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY 145 PIGTAIL DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC outpatient 15.3 14.99 All Payors / Plans All Payors / Plans 15.3 other 15.3 15.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY 3DRC DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC outpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY AR MOD DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC outpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY IMA DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC outpatient 9.18 9 All Payors / Plans All Payors / Plans 9.18 other 9.18 9.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY JL 3.5 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC outpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY JL 4.0 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC outpatient 9.18 9 All Payors / Plans All Payors / Plans 9.18 other 9.18 9.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY JL 4.5 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC outpatient 15.3 14.99 All Payors / Plans All Payors / Plans 15.3 other 15.3 15.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY JR 4.0 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC outpatient 9.18 9 All Payors / Plans All Payors / Plans 9.18 other 9.18 9.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY PIG STR DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC outpatient 9.18 9 All Payors / Plans All Payors / Plans 9.18 other 9.18 9.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F DXTERITY ULTRA 3.5 DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC outpatient 63 61.74 All Payors / Plans All Payors / Plans 63 other 63 63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F EXPORT ASPIRATION CATHETER SUP-270000000 CDM 270 RC outpatient 892.5 874.65 All Payors / Plans All Payors / Plans 892.5 other 892.5 892.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F FL3.5 DIAGNOSTIC CATHETER 100CM SUP-481000000 CDM 270 RC outpatient 12.79 12.53 All Payors / Plans All Payors / Plans 12.79 other 12.79 12.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F FR4 DIAGNOSTIC CATHETER 100CM SUP-481000000 CDM 270 RC outpatient 12.79 12.53 All Payors / Plans All Payors / Plans 12.79 other 12.79 12.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F FR5 DIAGNOSTIC CATHETER 100CM SUP-481000000 CDM 270 RC outpatient 25.87 25.35 All Payors / Plans All Payors / Plans 25.87 other 25.87 25.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F GUIDELINER SUP-270000000 CDM 270 RC outpatient 676.6 663.07 All Payors / Plans All Payors / Plans 676.6 other 676.6 676.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F IM DIAGNOSTIC CATHETER 100CM SUP-481000000 CDM 270 RC outpatient 16.28 15.95 All Payors / Plans All Payors / Plans 16.28 other 16.28 16.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F PERFORMA PIGTAIL CATHETER SUP-481000000 CDM 270 RC outpatient 23.53 23.06 All Payors / Plans All Payors / Plans 23.53 other 23.53 23.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F PIGTAIL CATHETER 110CM SUP-481000000 CDM 270 RC outpatient 7.68 7.53 All Payors / Plans All Payors / Plans 7.68 other 7.68 7.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6F VISTA GUIDE XB 3.5 S/H SUP-481000000 CDM 270 RC outpatient 91.35 89.52 All Payors / Plans All Payors / Plans 91.35 other 91.35 91.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 6FR OPTISEAL 13CM SUP-275000000 CDM 270 RC outpatient 121.58 119.15 All Payors / Plans All Payors / Plans 121.58 other 121.58 121.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 7 FR SWAN S-TIP THERMODILUTION CATHETER SUP-481000000 CDM 270 RC outpatient 207.9 203.74 All Payors / Plans All Payors / Plans 207.9 other 207.9 207.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 7.0 DRILL SUP-270000000 CDM 270 RC outpatient 902.2 884.16 All Payors / Plans All Payors / Plans 902.2 other 902.2 902.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 7FR OPTISEAL 13CM SUP-275000000 CDM 270 RC outpatient 150.19 147.19 All Payors / Plans All Payors / Plans 150.19 other 150.19 150.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 8817791002 TUNNELING DEVICE KIT SUP-270000000 CDM 270 RC outpatient 267.19 261.85 All Payors / Plans All Payors / Plans 267.19 other 267.19 267.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility 8F PRELUDE SNAP SUP-481000000 CDM 270 RC outpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "8F, 45 DEGREE FIXED-CURVE TRANSSEPTAL GUIDING SHEATH" SUP-481000000 CDM 270 RC outpatient 163.2 159.94 All Payors / Plans All Payors / Plans 163.2 other 163.2 163.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACCESS VERSACROSS STEERABLE 0.035 IN. 230 PIGTAIL CM RF WIRE 71CM BI-DIRECTIONAL STEERABLE SHEATH MEDIUM D1 CURVE 8.5 FRENCH SUP-481000000 CDM 270 RC outpatient 3727.5 3652.95 All Payors / Plans All Payors / Plans 3727.5 other 3727.5 3727.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACIST NAVVUS CATHETER SUP-481000000 CDM 270 RC outpatient 1312.5 1286.25 All Payors / Plans All Payors / Plans 1312.5 other 1312.5 1312.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACTIS COLLARED HIGH STEM SIZE 5 SUP-270010024 CDM 270 RC outpatient 7980 7820.4 All Payors / Plans All Payors / Plans 7980 other 7980 7980 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACUFEX ACCESS ADV POSITIONING KIT SUP-270000000 CDM 270 RC outpatient 520.41 510 All Payors / Plans All Payors / Plans 520.41 other 520.41 520.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACUITY SUP-481000000 CDM 270 RC outpatient 249 244.02 All Payors / Plans All Payors / Plans 249 other 249 249 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACUITY PRO SUP-481000000 CDM 270 RC outpatient 504.9 494.8 All Payors / Plans All Payors / Plans 504.9 other 504.9 504.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ACUSON ACUNAV ULTRASOUND CATHETER CONNECTOR COVER SUP-270000000 CDM 270 RC outpatient 13.6 13.33 All Payors / Plans All Payors / Plans 13.6 other 13.6 13.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADAPTER ANGIOGRAPHY NAMIC OPTION 125 200 PSI 3/8 IN 24 THREAD ID .125 IN ID SEC .1 IN 3 STERILE SUP-270000000 CDM 270 RC outpatient 2.64 2.59 All Payors / Plans All Payors / Plans 2.64 other 2.64 2.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADAPTER BRONCHOSCOPE ILLUMISITE STERILE LATEX FREE REUSABLE OLYMPUS BRONCHOSCOPE SUP-270000000 CDM 270 RC outpatient 180.6 176.99 All Payors / Plans All Payors / Plans 180.6 other 180.6 180.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADAPTER BRONCHOSCOPE PNEUPAC OD15 MM 2 AXIS SWIVEL FIBER OPTIC O2 STERILE LATEX FREE DISPOSABLE BLUE SUP-270000000 CDM 270 RC outpatient 13.18 12.92 All Payors / Plans All Payors / Plans 13.18 other 13.18 13.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADAPTER DRAINAGE OD20-40 FR TUBING MULTIPURPOSE SUP-270000000 CDM 270 RC outpatient 27.25 26.71 All Payors / Plans All Payors / Plans 27.25 other 27.25 27.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADAPTER FEMORAL GMK 5 MM OFFSET KNEE REVISION CONNECTOR SUP-270010024 CDM 270 RC outpatient 31743.5 31108.63 All Payors / Plans All Payors / Plans 31743.5 other 31743.5 31743.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADAPTER SMOKE EVACUATOR OPTIMUMM OD1 1/3-3/8 IN PREFILTER NONSTERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 3.61 3.54 All Payors / Plans All Payors / Plans 3.61 other 3.61 3.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADHESIVE LIQUID MASTISOL STYRAX GUM MASTIC ALCOHOL METHYL SALICYLATE 2/3 ML SKIN VIAL AMPULE PREP STERILE LATEX FREE NONHAZARDOUS SUP-270000000 CDM 270 RC outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADHESIVE SKIN CLOSURE DERMABOND ADVANCED .7ML 2 OCTYL CYANOACRYLATE MICROBIAL BARRIER APPLICATOR FLEXIBLE LIQUID SUP-270000000 CDM 270 RC outpatient 19.38 18.99 All Payors / Plans All Payors / Plans 19.38 other 19.38 19.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADHESIVE SKIN CLOSURE DERMABOND MINI .36 ML 2-OCTYL CYANOACRYLATE HIGH VISCOSITY LIQUID APPLICATOR MICROBIAL BARRIER STERILE SUP-270000000 CDM 270 RC outpatient 11.1 10.88 All Payors / Plans All Payors / Plans 11.1 other 11.1 11.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADHESIVE SKIN CLOSURE DERMABOND PRINEO 2 OCTYL CYANOACRYLATE L22 CM 3.8 ML TOPICAL MESH APPLICATOR LIQUID DISPENSER STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 176.26 172.73 All Payors / Plans All Payors / Plans 176.26 other 176.26 176.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADHESIVE SKIN CLOSURE DERMABOND PROPEN 2 OCTYL CYANOACRYLATE XL .75 ML HIGH VISCOSITY LIQUID STRONG FLEXIBLE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 153.76 150.68 All Payors / Plans All Payors / Plans 153.76 other 153.76 153.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADHESIVE SKIN CLOSURE LIQUIBAND BUTYL .5 ML TOPICAL FLOW CONTROL MICROBIAL BARRIER PROTECTION UNIQUE WING APPLICATOR STERILE CLEAR SUP-270000000 CDM 270 RC outpatient 27.05 26.51 All Payors / Plans All Payors / Plans 27.05 other 27.05 27.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADHESIVE SURGICAL BIOGLUE BOVINE SERUM ALBUMIN GLUTARALDEHYDE L12 MM 10 ML SOFT TISSUE PREFILL SYRINGE PLUNGER 3 SPREADER 4 STANDARD TIP STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 2278 2232.44 All Payors / Plans All Payors / Plans 2278 other 2278 2278 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADHESIVE SURGICAL BIOGLUE L 12 MM SYRINGE SPREADER TIP SUP-270000000 CDM 270 RC outpatient 1300 1274 All Payors / Plans All Payors / Plans 1300 other 1300 1300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADPATER ANGIOGRAPHY NAMIC OPTION 125 200 PSI 3/8 IN 24 THREAD ID .125 IN STERILE SUP-270000000 CDM 270 RC outpatient 48.27 47.3 All Payors / Plans All Payors / Plans 48.27 other 48.27 48.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ADPATER TITANIUM FOR TRANSFER KIT SUP-270000000 CDM 270 RC outpatient 220.5 216.09 All Payors / Plans All Payors / Plans 220.5 other 220.5 220.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AGENT HEMOSTATIC CELLERATERX COLLAGEN 5 GM POWDER BOTTLE SUP-270000000 CDM 270 RC outpatient 3139.5 3076.71 All Payors / Plans All Payors / Plans 3139.5 other 3139.5 3139.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AGENT HEMOSTATIC CELLERATERX HYDROLYZED BOVINE COLLAGEN POWDER SUP-270000000 CDM 270 RC outpatient 1039.5 1018.71 All Payors / Plans All Payors / Plans 1039.5 other 1039.5 1039.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AGENT HEMOSTATIC SURGIFLO THROMBIN 8 ML KIT MATRIX STERILE SUP-270000000 CDM 270 RC outpatient 184.9 181.2 All Payors / Plans All Payors / Plans 184.9 other 184.9 184.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AGILIS HISPTRO SLITTER SUP-270010030 CDM 270 RC outpatient 73.5 72.03 All Payors / Plans All Payors / Plans 73.5 other 73.5 73.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AIRSEAL 8MM ACCESS PORT AND OBTURATOR SUP-270000000 CDM 270 RC outpatient 193.48 189.61 All Payors / Plans All Payors / Plans 193.48 other 193.48 193.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALCOHOL 70% ISOPROPYL 16OZ SUP-270000000 CDM 270 RC outpatient 1.56 1.53 All Payors / Plans All Payors / Plans 1.56 other 1.56 1.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "ALLOGRAFT OATS DISPOSABLE KIT, 22.5MM" SUP-270000000 CDM 270 RC outpatient 2520 2469.6 All Payors / Plans All Payors / Plans 2520 other 2520 2520 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOSYNC EXPAND 10CC SUP-270000000 CDM 270 RC outpatient 1219.92 1195.52 All Payors / Plans All Payors / Plans 1219.92 other 1219.92 1219.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOSYNC EXPAND 1CC SUP-270000000 CDM 270 RC outpatient 520 509.6 All Payors / Plans All Payors / Plans 520 other 520 520 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ALLOSYNC EXPAND 5CC SUP-270000000 CDM 270 RC outpatient 1275 1249.5 All Payors / Plans All Payors / Plans 1275 other 1275 1275 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANCHOR SUTURE PUSHLOCK BIOCOMPOSITE SHORT L12.5 MM OD2.9 MM CANNULATED EYELET HANDLE INSERTER STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 840 823.2 All Payors / Plans All Payors / Plans 840 other 840 840 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANCHOR SUTURE SWIVELOCK C BIOCOMPOSITE PEEK L19.1 MM OD4.75 MM CLOSED EYELET VENT STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 840 823.2 All Payors / Plans All Payors / Plans 840 other 840 840 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANESTHESIA SET SMART SITE 2 CHECKVALVES 4 NEEDLE-FREE VALVES 3 PORT MANIFOLD VENTED/NONVENTED SUP-270000000 CDM 270 RC outpatient 39.51 38.72 All Payors / Plans All Payors / Plans 39.51 other 39.51 39.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANESTHESIA TUBING SUP-270000000 CDM 270 RC outpatient 4.52 4.43 All Payors / Plans All Payors / Plans 4.52 other 4.52 4.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANGIOSCULPT SCORING BALLOON 2.0 X 6 SUP-481000000 CDM 270 RC outpatient 1680 1646.4 All Payors / Plans All Payors / Plans 1680 other 1680 1680 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ANGIOSCULPT SCORING BALLOON 2.5 X 10 MM SUP-481000000 CDM 270 RC outpatient 1680 1646.4 All Payors / Plans All Payors / Plans 1680 other 1680 1680 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLICATOR ENDOSCOPIC SURGIFLO 34CM DISPOSABLE STERILE LF SUP-270000000 CDM 270 RC outpatient 105.98 103.86 All Payors / Plans All Payors / Plans 105.98 other 105.98 105.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLICATOR LAPAROSCOPIC VISTASEAL L45 CM DUAL APPLICATOR FLEXIBLE SUP-270000000 CDM 270 RC outpatient 168.97 165.59 All Payors / Plans All Payors / Plans 168.97 other 168.97 168.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLICATOR LAPROSCOPIC VISTASEAL L 35CM DUAL SUP-270000000 CDM 270 RC outpatient 66.29 64.96 All Payors / Plans All Payors / Plans 66.29 other 66.29 66.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLICATOR PREP CHLORAPREP FREPP ENTURIA 70% ISOPROPYL ALCOHOL 2% CHLORHEXIDINE GLUCONATE 1.5 ML 1 STEP AMPULE DRIP RESISTANT STERILE LATEX FREE DISPOSABLE SUP-270009040 CDM 270 RC outpatient 10.26 10.05 All Payors / Plans All Payors / Plans 10.26 other 10.26 10.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLICATOR PREP CHLORAPREP HI-LITE ORANGE 70% ISOPROPYL ALCOHOL 2% CHLORHEXIDINE GLUCONATE 10.5 ML ANTIMICROBIAL 1 STEP DEHP FREE STERILE LATEX FREE DISPOSABLE SUP-270009040 CDM 270 RC outpatient 3.42 3.35 All Payors / Plans All Payors / Plans 3.42 other 3.42 3.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLICATOR PREP CHLORAPREP HI-LITE ORANGE 70% ISOPROPYL ALCOHOL 2% CHLORHEXIDINE GLUCONATE 26 ML ANTIMICROBIAL 1 STEP DEHP FREE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 6.51 6.38 All Payors / Plans All Payors / Plans 6.51 other 6.51 6.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLIER INTERNAL CLIP 30D MED 11.5IN TITANIUM MULTIPLE LIGATE LIGACLIP STERILE LF SUP-270009085 CDM 270 RC outpatient 68.68 67.31 All Payors / Plans All Payors / Plans 68.68 other 68.68 68.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLIER INTERNAL CLIP ATRICLIP PRO2 GILLINOV-COSGROVE L40 MM PRELOAD STERILE LATEX FREE DISPOSABLE LEFT ATRIAL APPENDAGE EXCLUSION SYSTEM SUP-270000000 CDM 270 RC outpatient 9880 9682.4 All Payors / Plans All Payors / Plans 9880 other 9880 9880 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLIER INTERNAL CLIP ENDO CLIP TITANIUM 19 MEDIUM LARGE L10 MM CARTRIDGE STERILE LATEX FREE DISPOSABLE K2 SUP-270000000 CDM 270 RC outpatient 55.59 54.48 All Payors / Plans All Payors / Plans 55.59 other 55.59 55.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLIER INTERNAL CLIP LIGACLIP 30D MED 11.5IN TITANIUM DISPOSABLE STERILE LF LIGATE MULTIPLE OPEN 20 CLIP SUP-270009085 CDM 270 RC outpatient 68.68 67.31 All Payors / Plans All Payors / Plans 68.68 other 68.68 68.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLIER INTERNAL CLIP LIGACLIP SM 23.8CM TITANIUM DISPOSABLE STERILE LF LIGATE MULTIPLE OPEN SUP-270009085 CDM 270 RC outpatient 68.68 67.31 All Payors / Plans All Payors / Plans 68.68 other 68.68 68.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLIER INTERNAL CLIP LIGAMAX LIGACLIP MED LG 8.8MM 10MM TITANIUM DISPOSABLE STERILE LF VASCULAR ANGLE JAW DISTAL TIP SUP-270009088 CDM 270 RC outpatient 132.68 130.03 All Payors / Plans All Payors / Plans 132.68 other 132.68 132.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLIER INTERNAL CLIP LIGAMAX MED LG 5MM TITANIUM DISPOSABLE STERILE ANGLE JAW DISTAL TIP CLOSE ANTIBACKUP LAST LOCKOUT SUP-270000000 CDM 270 RC outpatient 159.17 155.99 All Payors / Plans All Payors / Plans 159.17 other 159.17 159.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility APPLIER INTERNAL CLIP WECK HEM-O-LOK AUTO ENDO5 POLYMER 5 MM BOW STRAIGHT L33 CM AUTOMATIC CLOSURE MEDIUM LARGE CLIP LOCK NONABSORBABLE STERILE LATEX FREE DISPOSABLE ENDO SURGERY SUP-270000000 CDM 270 RC outpatient 234.36 229.67 All Payors / Plans All Payors / Plans 234.36 other 234.36 234.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AQUAMANTYS 2.3 BIPOLAR SEALER SUP-270000000 CDM 270 RC outpatient 1038.87 1018.09 All Payors / Plans All Payors / Plans 1038.87 other 1038.87 1038.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ARRAY TRACKER VELYS KNEEE SET SUP-270010025 CDM 270 RC outpatient 339.66 332.87 All Payors / Plans All Payors / Plans 339.66 other 339.66 339.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AVAFLEX CURVED NEEDLE SUP-270000000 CDM 270 RC outpatient 1288.72 1262.95 All Payors / Plans All Payors / Plans 1288.72 other 1288.72 1288.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AXS INFINITY SHEATH 90CM SUP-270000000 CDM 270 RC outpatient 1102.5 1080.45 All Payors / Plans All Payors / Plans 1102.5 other 1102.5 1102.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility AXS VECTA 046 CATH 125CM - US SUP-270000000 CDM 270 RC outpatient 3815.7 3739.39 All Payors / Plans All Payors / Plans 3815.7 other 3815.7 3815.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BAG 24"" DOME LARGE" SUP-270000000 CDM 270 RC outpatient 2.91 2.85 All Payors / Plans All Payors / Plans 2.91 other 2.91 2.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAG DRAINAGE ROUND TEARDROP 2000ML DISPOSABLE STERILE LF ANTIREFLUX CHAMBER MICROBICIDAL OUTLET TUBE SUP-270009001 CDM 270 RC outpatient 3.34 3.27 All Payors / Plans All Payors / Plans 3.34 other 3.34 3.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAG DRAINAGE URINARY LATEX FREE 2000CC SUP-270009001 CDM 270 RC outpatient 5.41 5.3 All Payors / Plans All Payors / Plans 5.41 other 5.41 5.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAG DRAINAGE UROLOGY SEIMENS NONSTERILE W/ REDUCER SUP-270000000 CDM 270 RC outpatient 20.18 19.78 All Payors / Plans All Payors / Plans 20.18 other 20.18 20.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAG EQUIPMENT MICROSHIELD L40 IN X W20 IN OD40 IN CIRCULAR SEWN ELASTIC BAND STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 1.88 1.84 All Payors / Plans All Payors / Plans 1.88 other 1.88 1.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAG SPECIMEN POLYETHYLENE L14 IN X W8 IN TRANSPORT STERILE SUP-270000000 CDM 270 RC outpatient 2.85 2.79 All Payors / Plans All Payors / Plans 2.85 other 2.85 2.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAG SPECIMEN RETRIEVAL AMI L5 MM 100 ML ABDOMEN TROCAR STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 152.25 149.21 All Payors / Plans All Payors / Plans 152.25 other 152.25 152.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAG SPECIMEN RETRIEVAL ENDOPOUCH PLASTIC LARGE L6 IN X W4 IN OD10 MM 224 ML INTRODUCER TUBE FLEXIBLE THUMB RING HANDLE SYRINGE MOTION DEPLOYMENT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 51.51 50.48 All Payors / Plans All Payors / Plans 51.51 other 51.51 51.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAG TISSUE RETRIEVAL ANCHOR C4000 ML 25 MM L38.1 CM OD16.5 CM INTRODUCER TROCAR SUP-270000000 CDM 270 RC outpatient 551.75 540.72 All Payors / Plans All Payors / Plans 551.75 other 551.75 551.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALL COTTON SILK SMALL L15 IN OD1/2 IN 2 STRUNG RADIOPAQUE STERILE LATEX FREE BLUE SUP-270000000 CDM 270 RC outpatient 2.13 2.09 All Payors / Plans All Payors / Plans 2.13 other 2.13 2.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALL TIP GUIDE WIRE SUP-270000000 CDM 270 RC outpatient 643.5 630.63 All Payors / Plans All Payors / Plans 643.5 other 643.5 643.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALLOON - STERLING OTW 5.0X20 SUP-272C17251 CDM 270 RC outpatient 525 514.5 All Payors / Plans All Payors / Plans 525 other 525 525 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALLOON DISSECTOR LAPAROSCOPIC SPACEMAKER PLUS BTT ENDO LUBE FOAM OVAL PREPERITONEAL 3 VALVE RIGID SPRING GRIP LOCK COLLAR BLUNT TIP TROCAR LATEX DISPOSABLE HERNIA SUP-270000000 CDM 270 RC outpatient 1570.01 1538.61 All Payors / Plans All Payors / Plans 1570.01 other 1570.01 1570.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALLOON PRESTERILIZED LATEX SUP-270000000 CDM 270 RC outpatient 45.9 44.98 All Payors / Plans All Payors / Plans 45.9 other 45.9 45.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALLOON RETRIEVAL EXTRACTOR PRO XL 200CM 6-7FR 12-15MM DISPOSABLE STERILE LATEX BILIARY 3 LUMEN BELOW INJECTION SQUARE SUP-270000000 CDM 270 RC outpatient 217.22 212.88 All Payors / Plans All Payors / Plans 217.22 other 217.22 217.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALLOON RETRIEVAL EXTRACTOR PRO XL 200CM 6-7FR 9-12MM DISPOSABLE STERILE LATEX BILIARY 3 LUMEN ABOVE INJECTION SQUARE SUP-270000000 CDM 270 RC outpatient 106.43 104.3 All Payors / Plans All Payors / Plans 106.43 other 106.43 106.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BALLOON RETRIEVAL EXTRACTOR PRO XL 200CM 6-7FR 9-12MM DISPOSABLE STERILE LATEX BILIARY 3 LUMEN BELOW INJECTION SQUARE SUP-270000000 CDM 270 RC outpatient 105.51 103.4 All Payors / Plans All Payors / Plans 105.51 other 105.51 105.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAND BAG SUP-270000000 CDM 270 RC outpatient 12.5 12.25 All Payors / Plans All Payors / Plans 12.5 other 12.5 12.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAND COMPRESSION TRANSRADIAL BAND LG INFLATOR SUP-270000000 CDM 270 RC outpatient 31.25 30.63 All Payors / Plans All Payors / Plans 31.25 other 31.25 31.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAND COMPRESSION TRANSRADIAL BAND STD INFLATOR SUP-270000000 CDM 270 RC outpatient 42.5 41.65 All Payors / Plans All Payors / Plans 42.5 other 42.5 42.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE ADHESIVE COVERLET 3X2IN FABRIC STERILE LF PATCH XL WOUND PAD ABSORBENT ELASTIC SUP-270009017 CDM 270 RC outpatient 3.84 3.76 All Payors / Plans All Payors / Plans 3.84 other 3.84 3.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE ADHESIVE L5 YD X W4 IN SELF ADHERENT NONSTERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE COMPRESSION REB L5 YD X W3 IN REINFORCE ELASTIC LIGHTWEIGHT STRETCH LATEX FREE STANDARD SUP-270000000 CDM 270 RC outpatient 1.24 1.22 All Payors / Plans All Payors / Plans 1.24 other 1.24 1.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE COMPRESSION REB L5 YD X W4 IN REINFORCE ELASTIC LIGHTWEIGHT STRETCH LATEX FREE STANDARD SUP-270000000 CDM 270 RC outpatient 1.29 1.26 All Payors / Plans All Payors / Plans 1.29 other 1.29 1.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE COMPRESSION REB L5 YD X W6 IN REINFORCE ELASTIC LIGHTWEIGHT STRETCH LATEX FREE STANDARD SUP-270000000 CDM 270 RC outpatient 2.76 2.7 All Payors / Plans All Payors / Plans 2.76 other 2.76 2.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE COMPRESSION SOFT-WRAP 5YDX4IN BEIGE POLYESTER COTTON STERILE LF ELASTIC CLIP CLOSURE STRETCH BREATHABLE SUP-270000000 CDM 270 RC outpatient 7.37 7.22 All Payors / Plans All Payors / Plans 7.37 other 7.37 7.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE COMPRESSION SOFT-WRAP 5YDX6IN BEIGE POLYESTER COTTON STERILE LF ELASTIC CLIP CLOSURE STRETCH BREATHABLE SUP-270000000 CDM 270 RC outpatient 2.16 2.12 All Payors / Plans All Payors / Plans 2.16 other 2.16 2.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE ELASTIC ESMARK STERILE 4X12 LF SUP-270000000 CDM 270 RC outpatient 5.95 5.83 All Payors / Plans All Payors / Plans 5.95 other 5.95 5.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE GAUZE KERLIX LG 4 1/8YDX4.5IN COTTON STERILE LF 6 PLY ABSORBENT SOFT POUCH LINT FREE SUP-270000000 CDM 270 RC outpatient 1.17 1.15 All Payors / Plans All Payors / Plans 1.17 other 1.17 1.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE HEMOSTATIC INTERVENTIONAL QUICKCLOT SUP-270000000 CDM 270 RC outpatient 42 41.16 All Payors / Plans All Payors / Plans 42 other 42 42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE HEMOSTATIC THROMBIX SILVER LF TOPICAL PATCH SUP-270000000 CDM 270 RC outpatient 26.52 25.99 All Payors / Plans All Payors / Plans 26.52 other 26.52 26.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE SELF ADHESIVE 4IN X 5YD LATEX FREE STERILE SUP-270009185 CDM 270 RC outpatient 3.4 3.33 All Payors / Plans All Payors / Plans 3.4 other 3.4 3.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BANDAGE SELF ADHESIVE 6IN X 5YD LATEX FREE STERILE SUP-270009185 CDM 270 RC outpatient 3.4 3.33 All Payors / Plans All Payors / Plans 3.4 other 3.4 3.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BAR EXTERNAL FIXATION L225 MM OD6 MM SUP-270000000 CDM 270 RC outpatient 317.52 311.17 All Payors / Plans All Payors / Plans 317.52 other 317.52 317.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BARRIER ADHESION INTERCEED L4 IN X W3 IN PELVIS ABSORBABLE STERILE SUP-270000000 CDM 270 RC outpatient 674.31 660.82 All Payors / Plans All Payors / Plans 674.31 other 674.31 674.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BASEPLATE TIBIAL ATTUNE SIZE 4 CEMENTED SUP-270010025 CDM 270 RC outpatient 6720 6585.6 All Payors / Plans All Payors / Plans 6720 other 6720 6720 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BASEPLATE TIBIAL ATTUNE SIZE 5 CEMENTED SUP-270010025 CDM 270 RC outpatient 6720 6585.6 All Payors / Plans All Payors / Plans 6720 other 6720 6720 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BASEPLATE TIBIAL ATTUNE SIZE 8 CEMENTED SUP-270010025 CDM 270 RC outpatient 3264 3198.72 All Payors / Plans All Payors / Plans 3264 other 3264 3264 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BASKET STONE RETRIEVAL ZEROTIP NITINOL L120 CM OD16 MM ODSEC3 FR URETERAL 4 WIRE FLAT DISTAL SURFACE KNOT TIPLESS STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 405.15 397.05 All Payors / Plans All Payors / Plans 405.15 other 405.15 405.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BASKET ZERO TIP 1.9 FR SUP-270000000 CDM 270 RC outpatient 460.34 451.13 All Payors / Plans All Payors / Plans 460.34 other 460.34 460.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BATTERY BIOMET THINFLAP PLATING SYSTEM SUP-270000000 CDM 270 RC outpatient 99.96 97.96 All Payors / Plans All Payors / Plans 99.96 other 99.96 99.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BATTERY SURGICAL DRIVER MATRIXPRO STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 959.7 940.51 All Payors / Plans All Payors / Plans 959.7 other 959.7 959.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "BAYLIS GROUNDING PAD 10' CABLE, ADULT" SUP-270000000 CDM 270 RC outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BETADINE 5% STERILE OPTHALMIC PREP SOLUTION SUP-270000000 CDM 270 RC outpatient 10.46 10.25 All Payors / Plans All Payors / Plans 10.46 other 10.46 10.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BINDER ABDOMINAL 30-45X12IN 4 ELASTIC PANEL COMFORT CONTACT CLOSURE MED SUP-270009158 CDM 270 RC outpatient 18.59 18.22 All Payors / Plans All Payors / Plans 18.59 other 18.59 18.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BINDER ABDOMINAL 46-62X12IN 4 ELASTIC PANEL CONTACT CLOSURE COMFORT LG LATEX SUP-270009158 CDM 270 RC outpatient 18.59 18.22 All Payors / Plans All Payors / Plans 18.59 other 18.59 18.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BINDER ABDOMINAL COMFORT LARGE L46-62 IN X W12 IN 4 ELASTIC PANEL CONTACT CLOSURE LATEX SUP-270009158 CDM 270 RC outpatient 18.59 18.22 All Payors / Plans All Payors / Plans 18.59 other 18.59 18.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BINDER ABDOMINAL MEDIUM L30-45 IN X W12 IN 4 ELASTIC PANEL COMFORT CONTACT CLOSURE SUP-270009158 CDM 270 RC outpatient 18.59 18.22 All Payors / Plans All Payors / Plans 18.59 other 18.59 18.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BINDER ABDOMINAL PROCARE XL 12IN 62-74IN FLANNEL COTTON 4 PANEL ELASTIC CONTACT CLOSURE SUP-270009158 CDM 270 RC outpatient 18.59 18.22 All Payors / Plans All Payors / Plans 18.59 other 18.59 18.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIOGEL PI INDICATOR SYNTHETIC UNDERGLOVE SIZE 7 BOX SUP-270000000 CDM 270 RC outpatient 2.74 2.69 All Payors / Plans All Payors / Plans 2.74 other 2.74 2.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIOPSY NEEDLE KIT SUP-270000000 CDM 270 RC outpatient 1155.16 1132.06 All Payors / Plans All Payors / Plans 1155.16 other 1155.16 1155.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL 110MM 2.5MM GOLD NS QUICK COUPLING SUP-270010022 CDM 270 RC outpatient 319.52 313.13 All Payors / Plans All Payors / Plans 319.52 other 319.52 319.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL 110MM 3.5MM NS QUICK COUPLING SUP-270010022 CDM 270 RC outpatient 181.58 177.95 All Payors / Plans All Payors / Plans 181.58 other 181.58 181.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL 2.5MM SUP-270000000 CDM 270 RC outpatient 178.5 174.93 All Payors / Plans All Payors / Plans 178.5 other 178.5 178.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL 2MM SUP-270000000 CDM 270 RC outpatient 199.5 195.51 All Payors / Plans All Payors / Plans 199.5 other 199.5 199.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL CRANIAL 5.8MM SUP-270000000 CDM 270 RC outpatient 142.95 140.09 All Payors / Plans All Payors / Plans 142.95 other 142.95 142.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL EVOS OD1.8MM RADIUS DISTAL AO QUICK CONNECT STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 361.76 354.52 All Payors / Plans All Payors / Plans 361.76 other 361.76 361.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL L 155 MM OD 2.7MM CANNULATED DISPOSABLE SUP-270000000 CDM 270 RC outpatient 728.28 713.71 All Payors / Plans All Payors / Plans 728.28 other 728.28 728.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL SURGICAL EVOS LARGE OD 2.5 MM TARGETER AO QUICK STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 469.35 459.96 All Payors / Plans All Payors / Plans 469.35 other 469.35 469.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BIT DRILL TRIGEN LONG OD 4 MM AO PILOT STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 125 122.5 All Payors / Plans All Payors / Plans 125 other 125 125 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE OPHTHALMIC ASB HOCKEY STICK SHARP ALL AROUND SUP-270000000 CDM 270 RC outpatient 35.55 34.84 All Payors / Plans All Payors / Plans 35.55 other 35.55 35.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE OPHTHALMIC GRIESHABER DSP OD25 GA MVR DISPOSABLE SUP-270000000 CDM 270 RC outpatient 46.03 45.11 All Payors / Plans All Payors / Plans 46.03 other 46.03 46.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE OSCILLATOR SUP-270000000 CDM 270 RC outpatient 37.8 37.04 All Payors / Plans All Payors / Plans 37.8 other 37.8 37.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE REAMER NEXGEN STAINLESS STEEL OD41 MM KNEE PATELLA PILOT HOLE NONSTERILE SUP-270010025 CDM 270 RC outpatient 260 254.8 All Payors / Plans All Payors / Plans 260 other 260 260 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE REAMER PATELLA WITH PILOT HOLE SIZE 41 SUP-270000000 CDM 270 RC outpatient 210 205.8 All Payors / Plans All Payors / Plans 210 other 210 210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW BONE SAGITTAL COARSE MICRO STERILE 5.5 X 25.5 X 0.4MM SUP-270000000 CDM 270 RC outpatient 33.6 32.93 All Payors / Plans All Payors / Plans 33.6 other 33.6 33.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW GIGLI STAINLESS STEEL L510 MM STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 26.53 26 All Payors / Plans All Payors / Plans 26.53 other 26.53 26.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW L90 MM X W18 MM X H1.19 MM SAGITTAL 2 CUT STERILE SUP-270000000 CDM 270 RC outpatient 51.18 50.16 All Payors / Plans All Payors / Plans 51.18 other 51.18 51.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW L90 MM X W21 MM X H1.19 MM SAGITTAL SUP-270000000 CDM 270 RC outpatient 59.8 58.6 All Payors / Plans All Payors / Plans 59.8 other 59.8 59.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW MICRO 100 MICROPOWER L25.5 MM X W9.5 MM X H.4 MM SAGITTAL FINE TOOTH STERILE SUP-270000000 CDM 270 RC outpatient 22.64 22.19 All Payors / Plans All Payors / Plans 22.64 other 22.64 22.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW SAGITTAL HEAVY DUTY SUP-270000000 CDM 270 RC outpatient 40 39.2 All Payors / Plans All Payors / Plans 40 other 40 40 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW SHORT THIN XWIDE SAGITTAL SUP-270000000 CDM 270 RC outpatient 58.13 56.97 All Payors / Plans All Payors / Plans 58.13 other 58.13 58.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW STAINLESS STEEL L70 MM X W12.5 MM X H.8 MM 2 SIDED RECIPROCATING STERILE LATEX FREE ARTHROPLASTY SUP-270000000 CDM 270 RC outpatient 30.6 29.99 All Payors / Plans All Payors / Plans 30.6 other 30.6 30.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW STAINLESS STEEL LONG L75 MM X W12 MM X H.8 MM RECIPROCATING HEAVY DUTY STERILE SUP-270000000 CDM 270 RC outpatient 30.6 29.99 All Payors / Plans All Payors / Plans 30.6 other 30.6 30.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW STAINLESS STEEL THK.05 IN L3.543 IN X W.709 IN 2 CUT SAGITTAL STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 103.24 101.18 All Payors / Plans All Payors / Plans 103.24 other 103.24 103.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW STAINLESS STEEL THK.64 MM XSHORT NARROW THIN L24.5 MM X W9 MM SAGITTAL STERILE SUP-270000000 CDM 270 RC outpatient 47.06 46.12 All Payors / Plans All Payors / Plans 47.06 other 47.06 47.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW STAINLESS STEEL THK.8 MM MEDIUM NARROW L73.8 MM X W18.6 MM SAGITTAL STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 28.23 27.67 All Payors / Plans All Payors / Plans 28.23 other 28.23 28.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW STAINLESS STEEL THK1.19 MM NARROW THICK L81.5 MM X W12.5 MM SAGITTAL STERILE SUP-270000000 CDM 270 RC outpatient 28.23 27.67 All Payors / Plans All Payors / Plans 28.23 other 28.23 28.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW STAINLESS STEEL THK1.37 MM L90 MM X W25 MM SAGITTAL 2 CUT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 51.18 50.16 All Payors / Plans All Payors / Plans 51.18 other 51.18 51.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW THK.64 MM D33 MM THIN W9.4 MM STERNUM STERILE SUP-270000000 CDM 270 RC outpatient 16.22 15.9 All Payors / Plans All Payors / Plans 16.22 other 16.22 16.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW THK1.27 MM L90 MM X W18 MM SAGITTAL STERILE SUP-270000000 CDM 270 RC outpatient 53.24 52.18 All Payors / Plans All Payors / Plans 53.24 other 53.24 53.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SAW VELYS SUP-270010025 CDM 270 RC outpatient 57.12 55.98 All Payors / Plans All Payors / Plans 57.12 other 57.12 57.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SHAVER MCDEB OD4 MM AGGRESSIVE IRRIGATE SERRATE STERILE SUP-270000000 CDM 270 RC outpatient 245.41 240.5 All Payors / Plans All Payors / Plans 245.41 other 245.41 245.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SHAVER QUADCUT L13 CM OD4.3 MM SUP-270000000 CDM 270 RC outpatient 695.1 681.2 All Payors / Plans All Payors / Plans 695.1 other 695.1 695.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SHAVER SABRETOOTH COOLCUT STAINLESS STEEL CURVE L13 CM OD4 MM RESECTION STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 77.7 76.15 All Payors / Plans All Payors / Plans 77.7 other 77.7 77.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SHAVER TORPEDO CURVE 13CM 4MM SUP-270000000 CDM 270 RC outpatient 212.1 207.86 All Payors / Plans All Payors / Plans 212.1 other 212.1 212.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLADE SURGICAL CLIPPER DISPOSABLE NS LF SPECIALTY SURGICAL COARSE HAIR SUP-270000000 CDM 270 RC outpatient 9.97 9.77 All Payors / Plans All Payors / Plans 9.97 other 9.97 9.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLANKET WARMING 3M BAIR HUGGER 60X36IN WHITE POLYMER DISPOSABLE STERILE LF ADULT 4OZ LOWER BODY AIR SYSTEM LIGHTWEIGHT SUP-270000000 CDM 270 RC outpatient 4.51 4.42 All Payors / Plans All Payors / Plans 4.51 other 4.51 4.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLANKET WARMING L10.5 IN X W10.5 IN KNEE SHOULDER COLD MOTORIZED PORTABLE NONSTERILE SUP-270000000 CDM 270 RC outpatient 44.35 43.46 All Payors / Plans All Payors / Plans 44.35 other 44.35 44.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BLOCK LORDOTIC SR CORTICAL 8X14X11MM SUP-270010012 CDM 270 RC outpatient 1995 1955.1 All Payors / Plans All Payors / Plans 1995 other 1995 1995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BODY CONE RESTORATION +10 MM OD21 MM HIP MODULAR REVISION SUP-270010024 CDM 270 RC outpatient 4034.4 3953.71 All Payors / Plans All Payors / Plans 4034.4 other 4034.4 4034.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOSTON SCIENTIFIC EMERGE BALLOON 2.50 X 12MM SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOSTON SCIENTIFIC EMERGE BALLOON 3.00 X 15MM SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOSTON SCIENTIFIC NC EMERGE 2.25 X 8MM SUP-481000000 CDM 270 RC outpatient 127.5 124.95 All Payors / Plans All Payors / Plans 127.5 other 127.5 127.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOSTON SCIENTIFIC NC EMERGE 2.50 X 12MM SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOSTON SCIENTIFIC NC EMERGE 3.00 X 12MM SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOTTLE MEDICINE PLASTIC TALL 1 L GRADUATE PITCHER STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOWL CEMENT MIXING ORTHOPAEDIC STERILE WITH SPATULA DISPOSABLE SUP-270009196 CDM 270 RC outpatient 60.12 58.92 All Payors / Plans All Payors / Plans 60.12 other 60.12 60.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOWL GUIDEWIRE 5 TAB BASIN RING GRASPABLE STERILE LATEX SUP-481000000 CDM 270 RC outpatient 12.45 12.2 All Payors / Plans All Payors / Plans 12.45 other 12.45 12.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BOWL SOLUTION LG 32OZ LIGHT BLUE PLASTIC STERILE LF GRADUATED NO AUTOCLAVABLE SUP-270000000 CDM 270 RC outpatient 1.59 1.56 All Payors / Plans All Payors / Plans 1.59 other 1.59 1.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRA ELIZABETH PINK SURGICAL SIZE 3XL SUP-270009195 CDM 270 RC outpatient 45.24 44.34 All Payors / Plans All Payors / Plans 45.24 other 45.24 45.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRA ELIZABETH PINK SURGICAL SIZE EXTRA LARGE SUP-270009195 CDM 270 RC outpatient 45.24 44.34 All Payors / Plans All Payors / Plans 45.24 other 45.24 45.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRA ELIZABETH PINK SURGICAL SIZE LARGE SUP-270009195 CDM 270 RC outpatient 45.24 44.34 All Payors / Plans All Payors / Plans 45.24 other 45.24 45.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRA ELIZABETH PINK SURGICAL SIZE MED SUP-270009195 CDM 270 RC outpatient 45.24 44.34 All Payors / Plans All Payors / Plans 45.24 other 45.24 45.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRACE ORTHOPEDIC REGULAR FOAM KNEE STREAMLINED HINGE TELE-FIT: SLIDING MECHANISM POSTOPERATIVE BREATHABLE TROM ADVANCE SUP-270000000 CDM 270 RC outpatient 196.14 192.22 All Payors / Plans All Payors / Plans 196.14 other 196.14 196.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRAIN LAB SPHERES 41773B SUP-270000000 CDM 270 RC outpatient 35.84 35.12 All Payors / Plans All Payors / Plans 35.84 other 35.84 35.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRUSH CYTOLOGY COMBO CATH L200 CM X W2.1 MM OD8 FR BILIARY RAPID EXCHANGE DISPOSABLE ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 187.36 183.61 All Payors / Plans All Payors / Plans 187.36 other 187.36 187.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRUSH CYTOLOGY CONMED L230 CM OD3 MM ODSEC2.1 MM GASTROINTESTINE SHEATH BRISTLE POSITIVE STOP THUMB RING STERILE LATEX FREE DISPOSABLE COLONOSCOPE SUP-270000000 CDM 270 RC outpatient 22.5 22.05 All Payors / Plans All Payors / Plans 22.5 other 22.5 22.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRUSH CYTOLOGY SUPERDIMENSION 115MM 10MM 1.9MM 3 NEEDLE SUP-270000000 CDM 270 RC outpatient 459.68 450.49 All Payors / Plans All Payors / Plans 459.68 other 459.68 459.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRUSH CYTOLOGY SUPERTRAX INREACH L120 CM L2 MM OD1.7 MM METAL TIPPED SHEATH STERILE DISPOSABLE TOOL SUP-270000000 CDM 270 RC outpatient 60.18 58.98 All Payors / Plans All Payors / Plans 60.18 other 60.18 60.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BRUSH ERCP ENDOSCOPIC INFINITY NITINOL L200 CM OD3 MM DRIVE WIRE STIFFER SOFTER BRISTLE STERILE LATEX FREE DISPOSABLE LONG SHORT GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 294 288.12 All Payors / Plans All Payors / Plans 294 other 294 294 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BULKAMID URETHRAL BULKING SYSTEM SUP-270000000 CDM 270 RC outpatient 2205 2160.9 All Payors / Plans All Payors / Plans 2205 other 2205 2205 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BURR ROUND FLUTED SOFT TOUCH 2.0 MM SUP-270000000 CDM 270 RC outpatient 145.96 143.04 All Payors / Plans All Payors / Plans 145.96 other 145.96 145.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BURR SHAVER COOLCUT FLUSHCUT 12 FLUTE OVAL L13 CM OD5 MM SUP-270000000 CDM 270 RC outpatient 77.7 76.15 All Payors / Plans All Payors / Plans 77.7 other 77.7 77.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BURR SURGICAL MICROPOWER MICRO100 HALL CARBIDE 8 MM LONG L8 MM OD4 MM SMALL BONE OVAL FLUTED STERILE SUP-270000000 CDM 270 RC outpatient 38.25 37.49 All Payors / Plans All Payors / Plans 38.25 other 38.25 38.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUTTON GASTROSTOMY MIC-KEY SECUR-LOK 4CM 20FR 5ML SILICONE DISPOSABLE STERILE LF ENTERAL RADIOPAQUE LOW PROFILE TAPER SUP-270000000 CDM 270 RC outpatient 193.28 189.41 All Payors / Plans All Payors / Plans 193.28 other 193.28 193.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility BUTTON SUCTION BRONCHOSCOPE SUP-270000000 CDM 270 RC outpatient 19.95 19.55 All Payors / Plans All Payors / Plans 19.95 other 19.95 19.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CABLE BIPOLAR 12FT DISPOSABLE BIPOLAR BOVIE CONMED VALLEYLAB SUP-270000000 CDM 270 RC outpatient 10.66 10.45 All Payors / Plans All Payors / Plans 10.66 other 10.66 10.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CABLE CATHETER COAXIAL UMBILICAL DISPOSABLE SUP-270000000 CDM 270 RC outpatient 141.67 138.84 All Payors / Plans All Payors / Plans 141.67 other 141.67 141.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CABLE CRYOTHERAPY DISPOSABLE STERILE LF ELECTRICAL UMBILICAL SUP-270000000 CDM 270 RC outpatient 283.33 277.66 All Payors / Plans All Payors / Plans 283.33 other 283.33 283.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CABLE PACING SJM L 12FT TEMPORARY EXTENSION STERILE LAXTEX FREE DISPOSABLE SUP-275000000 CDM 270 RC outpatient 48.45 47.48 All Payors / Plans All Payors / Plans 48.45 other 48.45 48.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CABLE SILVERGLIDE BIPOLAR SUP-270000000 CDM 270 RC outpatient 4.89 4.79 All Payors / Plans All Payors / Plans 4.89 other 4.89 4.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CABLE/SLEEVE ORTHOPEDIC DALL-MILES VITALLIUM OD2 MM HIP SET SUP-270000000 CDM 270 RC outpatient 631.26 618.63 All Payors / Plans All Payors / Plans 631.26 other 631.26 631.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANISTER SUCTION BERKELEY SAFETOUCH BOTTLE SEAL CAP DISPOSABLE SUP-270000000 CDM 270 RC outpatient 9.42 9.23 All Payors / Plans All Payors / Plans 9.42 other 9.42 9.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANISTER SUCTION BERKELEY SAFETOUCH GAUZE SEAL CAP O RING STERILE SUP-270000000 CDM 270 RC outpatient 2.45 2.4 All Payors / Plans All Payors / Plans 2.45 other 2.45 2.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANISTER SUCTION MEDI-VAC GUARDIAN 90 D 2000 ML LOCK LID OVERFLOW SHUTOFF VALVE POUR SPOUT FILTER LATEX FREE DISPOSABLE SUP-270009176 CDM 270 RC outpatient 3 2.94 All Payors / Plans All Payors / Plans 3 other 3 3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANISTER SUCTION MEDI-VAC GUARDIAN 90D 3000ML DISPOSABLE LF SHUT OFF VALVE POUR SPOUT SUP-270009176 CDM 270 RC outpatient 3 2.94 All Payors / Plans All Payors / Plans 3 other 3 3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANISTER WOUND DRAIN INFOVAC C500 ML GEL TUBE CLAMP CONNECTOR CHARCOAL FILTER STERILE DISPOSABLE SUP-270009209 CDM 270 RC outpatient 35.92 35.2 All Payors / Plans All Payors / Plans 35.92 other 35.92 35.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANISTER WOUND DRAIN VAC ATS 500 ML TUBING CLAMP CONNECTOR GEL STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 146.9 143.96 All Payors / Plans All Payors / Plans 146.9 other 146.9 146.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA ARTHROSCOPIC POLYCARBONATE L75 MM ID7 MM 3 SEAL DAM THREAD OBTURATOR PRESSURE CONTROL STERILE LATEX FREE DISPOSABLE CLEAR SUP-270000000 CDM 270 RC outpatient 83.46 81.79 All Payors / Plans All Payors / Plans 83.46 other 83.46 83.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA ARTHROSCOPIC POLYCARBONATE L75 MM ID8.5 MM 3 SEAL DAM THREAD OBTURATOR STABILITY PRESSURE CONTROL STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 77.28 75.73 All Payors / Plans All Payors / Plans 77.28 other 77.28 77.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA BONE CEMENT VERTEPORT OD10 GA PRECISE CONTROL TACTILE FEEL STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 191.01 187.19 All Payors / Plans All Payors / Plans 191.01 other 191.01 191.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA BUTTON PASSPORT SILICONE CURVE LOW PROFILE L3 CM ID8 MM HIP 1 PIECE MOLD 2 DAM DESIGN 2 FLANGE FLEXIBLE SOFT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 67.2 65.86 All Payors / Plans All Payors / Plans 67.2 other 67.2 67.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA BUTTON PASSPORT SILICONE CURVE LOW PROFILE L4 CM ID8 MM HIP 1 PIECE MOLD 2 DAM DESIGN 2 FLANGE FLEXIBLE SOFT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 67.2 65.86 All Payors / Plans All Payors / Plans 67.2 other 67.2 67.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA ERCP CONTOUR TAPER L210 CM OD5 FR BILIARY DISPOSABLE ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 124.15 121.67 All Payors / Plans All Payors / Plans 124.15 other 124.15 124.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA OPHTHALMIC ANGLED L4 MM OD27 GA ANTERIOR CHAMBER IRRIGATION STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 13.71 13.44 All Payors / Plans All Payors / Plans 13.71 other 13.71 13.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA OPHTHALMIC ATKINSON L32 MM OD.5 MM RETROBULBAR PERIBULBAR ANESTHESIA SUP-270000000 CDM 270 RC outpatient 12.78 12.52 All Payors / Plans All Payors / Plans 12.78 other 12.78 12.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA OPHTHALMIC GRIESHABER SHORT OD25 GA ODSEC.8 MM SOFT TIP STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 21.89 21.45 All Payors / Plans All Payors / Plans 21.89 other 21.89 21.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA OPHTHALMIC OD25 GA CHANDELIER STERILE SUP-270000000 CDM 270 RC outpatient 174.83 171.33 All Payors / Plans All Payors / Plans 174.83 other 174.83 174.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA OPHTHALMIC SHORT OD23 GA SOFT TIP STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 21.89 21.45 All Payors / Plans All Payors / Plans 21.89 other 21.89 21.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA OPHTHALMIC SILICONE OD23 GA SOFT TIP DISPOSABLE SUP-270000000 CDM 270 RC outpatient 45.91 44.99 All Payors / Plans All Payors / Plans 45.91 other 45.91 45.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA PERFUSION VENOUS IRRIGATION BEVELED TIP SUP-270000000 CDM 270 RC outpatient 22.24 21.8 All Payors / Plans All Payors / Plans 22.24 other 22.24 22.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CANNULA SUCTION POLYTIP SUP-270000000 CDM 270 RC outpatient 100.8 98.78 All Payors / Plans All Payors / Plans 100.8 other 100.8 100.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAP DRAINAGE PLEURX THORACIC VALVE CAP KIT LATEX FREE DISPOSABLE PLEURAL EFFUSION SUP-270000000 CDM 270 RC outpatient 30.44 29.83 All Payors / Plans All Payors / Plans 30.44 other 30.44 30.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAP PROTECTIVE L1.1 MM OD.045 IN ORTHOPEDIC HEAD STERILE WHITE .045 IN PIN SUP-270000000 CDM 270 RC outpatient 5.79 5.67 All Payors / Plans All Payors / Plans 5.79 other 5.79 5.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAP SYRINGE COLEMAN LUER LOCK STERILE SUP-270000000 CDM 270 RC outpatient 2.31 2.26 All Payors / Plans All Payors / Plans 2.31 other 2.31 2.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAPSULE VIDEO PILLCAM SB 3 156D 434.1MHZ 26.2MM 11.4MM WHITE PLASTIC 3GM 4 LIGHT EMIT DIODE BATTERY SUP-270000000 CDM 270 RC outpatient 535.81 525.09 All Payors / Plans All Payors / Plans 535.81 other 535.81 535.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARDINALHEALTH MEDI-TRACE R2 PADS (GREEN) SUP-270000000 CDM 270 RC outpatient 40.6 39.79 All Payors / Plans All Payors / Plans 40.6 other 40.6 40.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CARTRIDGE OIL MAESTRO CORE SUP-270000000 CDM 270 RC outpatient 23.56 23.09 All Payors / Plans All Payors / Plans 23.56 other 23.56 23.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION BARRX 360 L3 CM L85 CM L4 CM OD7 MM ODSEC28 MM ESOPHAGEAL BIPOLAR ELECTRODE BALLOON RADIOFREQUENCY SUP-270000000 CDM 270 RC outpatient 3281.27 3215.64 All Payors / Plans All Payors / Plans 3281.27 other 3281.27 3281.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION DECANAV 2MM 2-8-2 MM F CURVE L115CM OD 7 FR 10 POLE TIP SUP-270000000 CDM 270 RC outpatient 1938 1899.24 All Payors / Plans All Payors / Plans 1938 other 1938 1938 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION DECANAV CARTO 3 2 MM 2-8-2 MM D CURVE L115CM OD 7 FR 10 PLE SUP-270000000 CDM 270 RC outpatient 1162.8 1139.54 All Payors / Plans All Payors / Plans 1162.8 other 1162.8 1162.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION FLEXABILITY SENSOR ENABLED ENSITE PRECISION MEDIGUIDE 1-4-1 SPACE D-F CURVE L 115CM L 4MM OD 8FR BI-DIRECTIONAL HANDLE IRRIGATE SUP-481000000 CDM 270 RC outpatient 3885 3807.3 All Payors / Plans All Payors / Plans 3885 other 3885 3885 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION FLEXABILITY SENSOR ENABLED ENSITE PRECISION MEDIGUIDE 1-4-1 SPACE F-J CURVE L 115CM L 4MM OD 8FR BI-DIRECTIONAL HANDLE IRRIGATE SUP-481000000 CDM 270 RC outpatient 1887 1849.26 All Payors / Plans All Payors / Plans 1887 other 1887 1887 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION SMARTTOUCH THERMOCOOL SF D-F CURVE OD 8 FR BIODIRECTIONAL THERMOCOUPLE SUP-270000000 CDM 270 RC outpatient 3853.56 3776.49 All Payors / Plans All Payors / Plans 3853.56 other 3853.56 3853.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION SMARTTOUCH THERMOCOOL SF F CURVE UNIDIRECTIONAL THERMOCOUPLE SUP-270000000 CDM 270 RC outpatient 7518 7367.64 All Payors / Plans All Payors / Plans 7518 other 7518 7518 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION TACTICATH SENSOR ENABLED 2-2-2MM SPACE F-J CURVE L115CM L 3.5MM OD 8 FR IRRIGATE BIDIRECTIONAL SUP-270000000 CDM 270 RC outpatient 5670 5556.6 All Payors / Plans All Payors / Plans 5670 other 5670 5670 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION TACTIFLEX SE BIDIRECTIONAL CURVE D-F SENSOR ENABLED SUP-481000000 CDM 270 RC outpatient 6630 6497.4 All Payors / Plans All Payors / Plans 6630 other 6630 6630 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ABLATION TACTIFLEX SE BIDIRECTIONAL CURVE F-J SENSOR ENABLED SUP-481000000 CDM 270 RC outpatient 8190 8026.2 All Payors / Plans All Payors / Plans 8190 other 8190 8190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CATHETER ABLATION THERMOCOOLSF 2-5-2 SPACE 3.5MM D-F CURVE, L 115 CMOD 8 FR 6 ELECTRODE TIP BI-DIRECTIONAL NON-NAVIGATIONAL" SUP-481000000 CDM 270 RC outpatient 4029.9 3949.3 All Payors / Plans All Payors / Plans 4029.9 other 4029.9 4029.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC ARROW L60 CM OD5 FR ODSEC7 MM .75 CC 1 LUMEN BALLOON WEDGE PRESSURE TAPER TIP ACCEPTS .025 IN GUIDEWIRE 5 FR INTRODUCER SUP-270000000 CDM 270 RC outpatient 252 246.96 All Payors / Plans All Payors / Plans 252 other 252 252 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC EXPO FEMORAL LEFT 5 CURVE OD6 FR SUP-481000000 CDM 270 RC outpatient 15.8 15.48 All Payors / Plans All Payors / Plans 15.8 other 15.8 15.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC EXPO TRILON FEMORAL RIGHT 4 CURVE L100 CM OD5 FR ID.045 IN ROBUST SHAFT FULL LENGTH WIRE BRAID SUPER SOFT TIP VASCULAR ACCESS SUP-481000000 CDM 270 RC outpatient 18.82 18.44 All Payors / Plans All Payors / Plans 18.82 other 18.82 18.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC EXPO TRILON PIGTAIL CURVE FULL LENGTH L110 CM OD5 FR ID.041 IN VENTRICLE WIRE BRAIDING SUP-481000000 CDM 270 RC outpatient 15.8 15.48 All Payors / Plans All Payors / Plans 15.8 other 15.8 15.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC EXPO WILLIAMS RIGHT CURVE 100CM 6FR .056IN SUP-481000000 CDM 270 RC outpatient 15.8 15.48 All Payors / Plans All Payors / Plans 15.8 other 15.8 15.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC GLIDECATH GLIDE TECHNOLOGY STAINLESS STEEL HYDROPHILIC ANGLE L65 CM L15 CM OD4 FR ID.041 IN 2 BRAID SUP-270000000 CDM 270 RC outpatient 101.96 99.92 All Payors / Plans All Payors / Plans 101.96 other 101.96 101.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC GLIDECATH GLIDE TECHNOLOGY STAINLESS STEEL HYDROPHILIC ANGLE L65 CM L25 CM OD5 FR ID.047 IN 1 BRAID SUP-270000000 CDM 270 RC outpatient 49.57 48.58 All Payors / Plans All Payors / Plans 49.57 other 49.57 49.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC GLIDECATH GLIDE TECHNOLOGY STAINLESS STEEL HYDROPHILIC COBRA 2 CURVE L65 CM L25 CM OD5 FR ID.047 IN 1 BRAID SUP-270000000 CDM 270 RC outpatient 102.06 100.02 All Payors / Plans All Payors / Plans 102.06 other 102.06 102.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC GLIDECATH HYDROPHILIC NYLON SIM2 CURVE L100 CM L15 CM OD4 FR 2 STAINLESS STEEL BRAIDED POLYURETHANE JACKET ACCEPTS .038 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 102.06 100.02 All Payors / Plans All Payors / Plans 102.06 other 102.06 102.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC GLIDECATH STAINLESS STEEL HYDROPHILIC L100 CM L15 CM OD4 FR ID.041 IN 2 BRAID ANGLE TIP STERILE LATEX FREE ACCEPTS .038 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 82.54 80.89 All Payors / Plans All Payors / Plans 82.54 other 82.54 82.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC INFINITI THRULUMEN INTERNAL MAMMARY CURVE 100CM 5FR VESTAN RADIOPAQUE THIN WALL TORQUE CONTROL LG SUP-481000000 CDM 270 RC outpatient 17.54 17.19 All Payors / Plans All Payors / Plans 17.54 other 17.54 17.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC INFINITI VESTAN PIGTAIL CURVE STRAIGHT L110 CM OD6 FR VENTRICULAR 6 SIDEHOLE ACCEPTS .038 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 18.38 18.01 All Payors / Plans All Payors / Plans 18.38 other 18.38 18.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC PERFORMA .035 IN VERT CURVE L100 CM OD5 FR ID.046 IN SUP-270000000 CDM 270 RC outpatient 22.26 21.81 All Payors / Plans All Payors / Plans 22.26 other 22.26 22.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC PERFORMA PEBAX POLYCARBONATE NYLON STRAIGHT PIGTAIL CURVE L110 CM OD6 FR CARDIAC 5 SIDEHOLE RADIOPAQUE BRAID STERILE ACCEPTS .038 IN GUIDEWIRE SUP-481000000 CDM 270 RC outpatient 19.01 18.63 All Payors / Plans All Payors / Plans 19.01 other 19.01 19.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC SLIP-CATH HYDROPHILIC BEACON C2 CURVE L100 CM OD4 FR VISCERA ACCEPTS .038 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 87.2 85.46 All Payors / Plans All Payors / Plans 87.2 other 87.2 87.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC SOFT-VU KUMPE CURVE ANGLE L40 CM OD4 FR NONBRAIDED SOFT RADIOPAQUE TIP HIGH TORQUE SHAFT SELECTIVE STERILE DISPOSABLE .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 45.84 44.92 All Payors / Plans All Payors / Plans 45.84 other 45.84 45.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC SOFT-VU OMNI FLUSH 0 CURVE L90 CM OD5 FR HIGH TORQUE SHAFT SOFT RADIOPAQUE TIP ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 22.47 22.02 All Payors / Plans All Payors / Plans 22.47 other 22.47 22.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC SOFT-VU SOS OMNI 0 CURVE L80 CM OD4 FR VISCERAL BRAID ULTRA TORQUE SHAFT SOFT RADIOPAQUE TIP SELECTIVE ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 37.3 36.55 All Payors / Plans All Payors / Plans 37.3 other 37.3 37.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC SOFT-VU SOS OMNI2 CURVE 80CM 5FR DISPOSABLE STERILE VISCERA BRAID ULTRA TORQUE SHAFT RADIOPAQUE SUP-270000000 CDM 270 RC outpatient 48.38 47.41 All Payors / Plans All Payors / Plans 48.38 other 48.38 48.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC SOUNDSTAR OD 8 FR SUP-270000000 CDM 270 RC outpatient 2748.9 2693.92 All Payors / Plans All Payors / Plans 2748.9 other 2748.9 2748.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC TORCON NB ADVANTAGE BEACON TIP ANGLE SIMMONS 2 CURVE 100CM 5FR SS NYLON CEREBRAL MULTIPURPOSE SUP-270000000 CDM 270 RC outpatient 31.79 31.15 All Payors / Plans All Payors / Plans 31.79 other 31.79 31.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC TORCON NB ADVANTAGE BEACON TIP NYLON .035 IN RIM CURVE L65 CM OD4 FR LOW PROFILE HUB TO TIP TAPERED TIP OPTIMAL STEERABILITY SUP-270000000 CDM 270 RC outpatient 25.73 25.22 All Payors / Plans All Payors / Plans 25.73 other 25.73 25.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC TORCON NB ADVANTAGE NYLON STAINLESS STEEL .038 IN H1 CURVE L 100CM OD 5FR CEREBRAL FLEXIBLE ATRAUMATIC TIP SUP-270000000 CDM 270 RC outpatient 40.8 39.98 All Payors / Plans All Payors / Plans 40.8 other 40.8 40.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ANGIOGRAPHIC TORCON NB ADVANTAGEBEACON TIP STAINLESS STEEL NYLON WEINBERG CEREBRAL CURVE LOW PROFILE TAPER L100CM OD 5FR RADIOPAQUE ACCEPTS .038 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 26.52 25.99 All Payors / Plans All Payors / Plans 26.52 other 26.52 26.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ARTERIAL LINE SWAN-GANZ HEPARIN POLYMER L110 CM OD5 FR PULMONARY 2 LUMEN SUP-270000000 CDM 270 RC outpatient 218.4 214.03 All Payors / Plans All Payors / Plans 218.4 other 218.4 218.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ASPIRATION AXS VECTA 71 L115 CM OD.082-.085 IN ID.071 IN SCOUT INTRODUCER STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 4302.7 4216.65 All Payors / Plans All Payors / Plans 4302.7 other 4302.7 4302.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ATHERECTOMY SHOCKWAVE C2 IVL 2.5 X 12 MM SUP-270000000 CDM 270 RC outpatient 19740 19345.2 All Payors / Plans All Payors / Plans 19740 other 19740 19740 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION COYOTE 150CM 220MM 3MM NYBAX LUBRICIOUS BIOSLIDE OTW ULTRA LOW PROFILE ACCEPTS .014IN SUP-270000000 CDM 270 RC outpatient 829.5 812.91 All Payors / Plans All Payors / Plans 829.5 other 829.5 829.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION COYOTE ES 145CM 40MM 6FR 4MM OTW LOW PROFILE ACCEPTS .014IN GUIDEWIRE 4FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC outpatient 467.5 458.15 All Payors / Plans All Payors / Plans 467.5 other 467.5 467.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA 142CM 12MM 3MM ULTRA-SLIM DURA-TRAC STERILE LF RAPID EXCHANGE RADIOPAQUE FEMALE LUER SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA POWERTRAC ULTRA-SLIM DURA-TRAC L142 CM L10 MM OD2.1-2.5 FR ODSEC2 MM RAPID EXCHANGE TAPER SHAFT RADIOPAQUE FEMALE LUER PTCA SUP-481000000 CDM 270 RC outpatient 76.5 74.97 All Payors / Plans All Payors / Plans 76.5 other 76.5 76.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA POWERTRAC ULTRA-SLIM DURA-TRAC L142 CM L10 MM OD2.1-2.5 FR ODSEC2.5 MM RAPID EXCHANGE TAPER SHAFT RADIOPAQUE FEMALE LUER PTCA SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA POWERTRAC ULTRA-SLIM DURA-TRAC L142 CM L12 MM OD2.1-2.5 FR ODSEC2 MM RAPID EXCHANGE TAPER SHAFT RADIOPAQUE FEMALE LUER PTCA SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA POWERTRAC ULTRA-SLIM DURA-TRAC L142 CM L12 MM OD2.1-2.5 FR ODSEC2.5 MM RAPID EXCHANGE TAPER SHAFT RADIOPAQUE FEMALE LUER PTCA SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA POWERTRAC ULTRA-SLIM DURA-TRAC L142 CM L15 MM OD2.1-2.5 FR ODSEC2 MM RAPID EXCHANGE TAPER SHAFT RADIOPAQUE FEMALE LUER PTCA SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA POWERTRAC ULTRA-SLIM DURA-TRAC L142 CM L15 MM OD2.1-2.5 FR ODSEC2.5 MM RAPID EXCHANGE TAPER SHAFT RADIOPAQUE FEMALE LUER PTCA SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA POWERTRAC ULTRA-SLIM DURA-TRAC L142 CM L15 MM OD2.1-2.5 FR ODSEC3 MM RAPID EXCHANGE TAPER SHAFT RADIOPAQUE FEMALE LUER PTCA SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA ULTRA SLIM DURA TRAC 142CM L 12 MM ODSEC 2.25 MM RAPID EXCHANGE TAPER SHAFT LOW PROFILE RADIOPAQUE LATEX FREE PTCA SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA ULTRA SLIM DURA TRAC 142CM L 20 MM ODSEC 3.0 MM RAPID EXCHANGE TAPER SHAFT LOW PROFILE RADIOPAQUE LATEX FREE PTCA SUP-481000000 CDM 270 RC outpatient 195 191.1 All Payors / Plans All Payors / Plans 195 other 195 195 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION EUPHORA ULTRA SLIM DURA TRAC 142CM L 20 MM ODSEC 3.5 MM RAPID EXCHANGE TAPER SHAFT LOW PROFILE RADIOPAQUE LATEX FREE PTCA SUP-481000000 CDM 270 RC outpatient 195 191.1 All Payors / Plans All Payors / Plans 195 other 195 195 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MINI TREK SLIM SEAL 8MM 2MM TUNGSTEN CORONARY RAPID EXCHANGE ULTRA LOW PROFILE RADIOPAQUE SUP-481000000 CDM 270 RC outpatient 235.2 230.5 All Payors / Plans All Payors / Plans 235.2 other 235.2 235.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG 135CM 20MM 4MM NYBAX HIGH PRESSURE ACCEPTS .035IN GUIDEWIRE 5FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC outpatient 346.5 339.57 All Payors / Plans All Payors / Plans 346.5 other 346.5 346.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG 135CM 20MM 8MM 6FR NYBAX MEDIGLIDE HIGH PRESSURE SUP-270000000 CDM 270 RC outpatient 346.5 339.57 All Payors / Plans All Payors / Plans 346.5 other 346.5 346.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG 75CM 40MM 6MM NYBAX HIGH PRESSURE ACCEPTS .035IN GUIDEWIRE 5FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC outpatient 323 316.54 All Payors / Plans All Payors / Plans 323 other 323 323 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG 75CM 40MM 7MM NYBAX HIGH PRESSURE ACCEPTS .035IN GUIDEWIRE 5FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC outpatient 323 316.54 All Payors / Plans All Payors / Plans 323 other 323 323 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG 75CM 40MM 8MM NYBAX HIGH PRESSURE ACCEPTS .035IN GUIDEWIRE 6FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC outpatient 399 391.02 All Payors / Plans All Payors / Plans 399 other 399 399 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG 75CM 40MM 9MM NYBAX HIGH PRESSURE ACCEPTS .035IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 323 316.54 All Payors / Plans All Payors / Plans 323 other 323 323 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG NYBAX .035 IN L135 CM L20 MM ODSEC8 MM HIGH PRESSURE SUP-270000000 CDM 270 RC outpatient 346.5 339.57 All Payors / Plans All Payors / Plans 346.5 other 346.5 346.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG NYBAX .035 IN L135 CM L40 MM ODSEC4 MM HIGH PRESSURE SUP-270000000 CDM 270 RC outpatient 399 391.02 All Payors / Plans All Payors / Plans 399 other 399 399 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG NYBAX .035 IN L40 CM L40 MM ODSEC7 MM HIGH PRESSURE SUP-270000000 CDM 270 RC outpatient 399 391.02 All Payors / Plans All Payors / Plans 399 other 399 399 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG NYBAX .035 IN L75 CM L20 MM ODSEC10 MM HIGH PRESSURE SUP-270000000 CDM 270 RC outpatient 346.5 339.57 All Payors / Plans All Payors / Plans 346.5 other 346.5 346.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG NYBAX .035 IN L75 CM L40 MM ODSEC10 MM HIGH PRESSURE SUP-270000000 CDM 270 RC outpatient 346.5 339.57 All Payors / Plans All Payors / Plans 346.5 other 346.5 346.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION MUSTANG NYBAX .035 IN L75 CM L40 MM ODSEC5 MM HIGH PRESSURE SUP-270000000 CDM 270 RC outpatient 399 391.02 All Payors / Plans All Payors / Plans 399 other 399 399 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 12MM 2.5MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 12MM 2MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 12MM 3.25MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 12MM 3.5MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 12MM 3MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 12MM 4MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC outpatient 127.5 124.95 All Payors / Plans All Payors / Plans 127.5 other 127.5 127.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 15MM 2MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 15MM 3.5MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC outpatient 195 191.1 All Payors / Plans All Payors / Plans 195 other 195 195 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 15MM 3MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 20MM 2.5MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 20MM 3.5MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC outpatient 195 191.1 All Payors / Plans All Payors / Plans 195 other 195 195 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 8MM 2.5MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 8MM 3.5MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 8MM 3.75MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION NC EUPHORA 142CM 8MM 3MM DURATRAC NYLON PLATINUM IRIDIUM STERILE LF RAPID EXCHANGE SUP-481000000 CDM 270 RC outpatient 127.5 124.95 All Payors / Plans All Payors / Plans 127.5 other 127.5 127.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION SAPPHIRE II PRO 3.0 X 10MM SEMICOMPLIANT SUP-481000000 CDM 270 RC outpatient 199.5 195.51 All Payors / Plans All Payors / Plans 199.5 other 199.5 199.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION STERLING .018 IN L135 MM L60 MM OD6 FR ODSEC6 MM OTW LOW PROFILE INFLATION PORT GUIDEWIRE ANGIOPLASTY ACCEPTS 4 FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC outpatient 467.5 458.15 All Payors / Plans All Payors / Plans 467.5 other 467.5 467.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION STERLING L135 CM L20 MM OD6 FR ODSEC6 MM OTW INFLATION PORT TAPER TIP ACCEPTS .018 IN GUIDEWIRE 5 FR SHEATH PTA SUP-270000000 CDM 270 RC outpatient 467.5 458.15 All Payors / Plans All Payors / Plans 467.5 other 467.5 467.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION STERLING MONORAIL PEBAX BIOSLIDE L80 CM L40 MM ODSEC5 MM PERIPHERAL TAPER TIP LOW PROFILE INFLATE PORT ACCEPTS .018 IN GUIDEWIRE 4 FR SHEATH 6 FR GUIDE CATHETER PTA SUP-270000000 CDM 270 RC outpatient 525 514.5 All Payors / Plans All Payors / Plans 525 other 525 525 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION STERLING MONORAIL PEBAX BIOSLIDE TAPER L135 CM L20 MM OD3.8-3.4 FR ODSEC5 MM RAPID EXCHANGE INFLATION PORT LOW PROFILE ACCEPTS .018 IN GUIDEWIRE 4 FR SHEATH PTA SUP-270000000 CDM 270 RC outpatient 577.5 565.95 All Payors / Plans All Payors / Plans 577.5 other 577.5 577.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION STERLING PEBAX BIOSLIDE L135 CM L40 MM OD6 FR ODSEC6 MM ID4 FR OTW LOW PROFILE INFLATION WIRE PORT ACCEPTS .018 IN GUIDEWIRE PTA SUP-270000000 CDM 270 RC outpatient 577.5 565.95 All Payors / Plans All Payors / Plans 577.5 other 577.5 577.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION STERLING PEBAX BIOSLIDE LOW PROFILE TAPER L135 CM L40 MM OD3.8 FR ODSEC7 MM OTW INFLATION PORT ACCEPTS .018 IN GUIDEWIRE 4 FR SHEATH PTA SUP-270000000 CDM 270 RC outpatient 577.5 565.95 All Payors / Plans All Payors / Plans 577.5 other 577.5 577.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION TAKERU L12MMOD SEC 1.5MM RAPID EXCHANGE LOW ENTRY PROFILE PTCA SUP-481000000 CDM 270 RC outpatient 483 473.34 All Payors / Plans All Payors / Plans 483 other 483 483 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION TREK SLIM SEAL 8MM 2.5MM CROSSFLEX2 TUNGSTEN CORONARY RAPID EXCHANGE ULTRA LOW PROFILE SUP-481000000 CDM 270 RC outpatient 235.2 230.5 All Payors / Plans All Payors / Plans 235.2 other 235.2 235.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION TRUE L110 CM L4.5 CM OD12 FR ODSEC22 MM AORTA 2 LUMEN 2 RADIOPAQUE OTW COAXIAL STERILE DISPOSABLE ACCEPTS .035 IN GUIDEWIRE VALVULOPLASTY SUP-481000000 CDM 270 RC outpatient 2725.38 2670.87 All Payors / Plans All Payors / Plans 2725.38 other 2725.38 2725.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON DILATATION WOLVERINE CUTTING BALLOON MONORAIL Z-GLIDE L 10CM OD 2.75 MM BUMPER TIP ATHEROTOME RADIOPAQUE MIDSHAFT SUP-270000000 CDM 270 RC outpatient 1471.68 1442.25 All Payors / Plans All Payors / Plans 1471.68 other 1471.68 1471.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON OCCLUSION GORE 10-37 MM L90 CM L4 CM MOLD STENT GRAFT OPTIMIZE SEAL ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 1391 1363.18 All Payors / Plans All Payors / Plans 1391 other 1391 1391 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER BALLOON OCCLUSION TRANSFORM L7 MM OD7 MM 1 LUMEN SUPER COMPLIANT STERILE LATEX FREE DISPOSABLE ACCEPTS .014 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 2949.5 2890.51 All Payors / Plans All Payors / Plans 2949.5 other 2949.5 2949.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER CENTRAL VENOUS 36CM 19FR HEPARIN TAL PALINDROME EMERALD SPORTPACK VENATRAC SUP-270000000 CDM 270 RC outpatient 362.5 355.25 All Payors / Plans All Payors / Plans 362.5 other 362.5 362.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER CENTRAL VENOUS TAL PALINDROME EMERALD HEPARIN L36 CM OD19 FR SPORTPACK VENATRAC SUP-270000000 CDM 270 RC outpatient 253.02 247.96 All Payors / Plans All Payors / Plans 253.02 other 253.02 253.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER CENTRAL VENOUS TAL PALINDROME EMERALD HEPARIN L40 CM OD23 FR SPORTPACK VENATRAC SUP-270000000 CDM 270 RC outpatient 421.69 413.26 All Payors / Plans All Payors / Plans 421.69 other 421.69 421.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER CRYOABLATION ARTIC FRONT ADVANCE PRO L23CM SUP-270000000 CDM 270 RC outpatient 9345 9158.1 All Payors / Plans All Payors / Plans 9345 other 9345 9345 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER CRYOABLATION ARTIC FRONT ADVANCE PRO L28CM SUP-270000000 CDM 270 RC outpatient 7565 7413.7 All Payors / Plans All Payors / Plans 7565 other 7565 7565 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DELIVERY SYSTEM NEURON SELECT STAINLESS STEEL POLYMER BERENSTEIN CURVE L130 CM L9 CM OD5 FR ID.04 IN LUMEN SOFT SHAFT RADIOPAQUE ACCEPTS .035/.038 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 262.5 257.25 All Payors / Plans All Payors / Plans 262.5 other 262.5 262.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DELIVERY SYSTEM NEURON SELECT STAINLESS STEEL POLYMER SIMMONS CURVE L125 CM L9 CM OD6 FR ODSEC5-5.6 FR ID.04 IN BRAID SOFT DISTAL SHAFT LATEX FREE ACCEPTS .035/.038 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 262.5 257.25 All Payors / Plans All Payors / Plans 262.5 other 262.5 262.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DELIVERY SYSTEM NEURON STAINLESS STEEL .038 IN SIMS CURVE L130 CM L9 CM OD5 FR ID.04 IN PROXIMAL DISTAL INTRACRANIAL LUMEN FULL LENGTHRADIOPAQUE MARKER SUP-270000000 CDM 270 RC outpatient 262.5 257.25 All Payors / Plans All Payors / Plans 262.5 other 262.5 262.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DIAGNOSTIC DXTERITY INSLIDE AMPLATZ LEFT 1 CURVE L100 CM OD 6 FR ID .056 IN LARGE LUMEN RADIOPAQUE 2 BRAID WIRE COLOR CODED HUB STERILE ACCEPTS .038 IN GUIDEWIRE SUP-481000000 CDM 270 RC outpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DIAGNOSTIC DXTERITY INSLIDE JUDKINS LEFT 5 CURVE L100 CM OD 6 FR ID .056 IN LARGE LUMEN RADIOPAQUE 2 BRAID WIRE COLOR CODED HUB STERILE ACCEPTS .038 IN GUIDEWIRE SUP-481000000 CDM 270 RC outpatient 15.3 14.99 All Payors / Plans All Payors / Plans 15.3 other 15.3 15.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DIAGNOSTIC DXTERITY INSLIDE LEFT CORONARY BYPASS CURVE L100 CM OD 6 FR ID .056 IN LARGE LUMEN RADIOPAQUE 2 BRAID WIRE COLOR CODED HUB STERILE ACCEPTS .038 IN GUIDEWIRE SUP-481000000 CDM 270 RC outpatient 9.18 9 All Payors / Plans All Payors / Plans 9.18 other 9.18 9.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DIAGNOSTIC DXTERITY INSLIDE MULTIPURPOSE A CURVE L100 CM OD 6 FR ID .056 IN LARGE LUMEN RADIOPAQUE 2 BRAID WIRE COLOR CODED HUB STERILE ACCEPTS .038 IN GUIDEWIRE SUP-481000000 CDM 270 RC outpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DRAINAGE AMPLATZ ULTRATHANE UNIVERSAL L50 CM OD10.2 FR 6 SIDEPORT STERILE DISPOSABLE ACCEPTS .038 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 482.96 473.3 All Payors / Plans All Payors / Plans 482.96 other 482.96 482.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DRAINAGE APD FLEXIMA LOOP 25CM 8FR METAL HYDROPHILIC DISPOSABLE STERILE REGULAR DUROMETER STIFF CANNULA LG SUP-270000000 CDM 270 RC outpatient 81.86 80.22 All Payors / Plans All Payors / Plans 81.86 other 81.86 81.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DRAINAGE APD FLEXIMA METAL HYDROPHILIC LOOP L25 CM OD10 FR REGULAR DUROMETER FLEXIBLE STIFF CANNULA LARGE LUMEN STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 81.86 80.22 All Payors / Plans All Payors / Plans 81.86 other 81.86 81.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DRAINAGE ARGYLE SENTINEL LINE SENTINEL EYE STRAIGHT 20IN 28FR CLEAR PVC DISPOSABLE STERILE LF THORACIC SMOOTH SUP-270009136 CDM 270 RC outpatient 6.47 6.34 All Payors / Plans All Payors / Plans 6.47 other 6.47 6.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DRAINAGE ARGYLE STRAIGHT 20IN 24FR CLEAR PVC DISPOSABLE STERILE THORACIC SMOOTH SIDE EYE RADIOPAQUE OPEN DISTAL SUP-270009136 CDM 270 RC outpatient 6.47 6.34 All Payors / Plans All Payors / Plans 6.47 other 6.47 6.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DRAINAGE FLEXIMA PIGTAIL CURVE L35 CM OD8 FR BILIARY FLEXIBLE STIFF CANNULA LOCK DUROMETER LARGE HOLE SUP-270000000 CDM 270 RC outpatient 168.53 165.16 All Payors / Plans All Payors / Plans 168.53 other 168.53 168.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DRAINAGE FLEXIMA PIGTAIL CURVE L35 CM OD8 FR BILIARY REGULAR DUROMETER FLEXIBLE STIFF CANNULA LOCK LARGE HOLE SUP-270000000 CDM 270 RC outpatient 232.73 228.08 All Payors / Plans All Payors / Plans 232.73 other 232.73 232.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER DRAINAGE SILICONE STRAIGHT L20 IN OD20 FR THORACIC 5 EYELET KINK RESISTANT RADIOPAQUE STRIPE TAPERED TIP STERILE LATEX FREE DISPOSABLE CLEAR SUP-270000000 CDM 270 RC outpatient 21.51 21.08 All Payors / Plans All Payors / Plans 21.51 other 21.51 21.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROHEMOSTASIS GOLD PROBE 300CM 7FR HEMOGLIDE DISPOSABLE STERILE BIPOLAR ROUND DISTAL TIP FIRM SHAFT SUP-270000000 CDM 270 RC outpatient 302.82 296.76 All Payors / Plans All Payors / Plans 302.82 other 302.82 302.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROHEMOSTASIS GOLD PROBE HEMOGLIDE L300 CM OD10 FR BIPOLAR STANDARD PLUG CONNECTOR STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 168.51 165.14 All Payors / Plans All Payors / Plans 168.51 other 168.51 168.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY 2-5-2 MM SPACING LARGE L110 CM OD6 FR DECAPOLAR STEERABLE SUP-270000000 CDM 270 RC outpatient 346.8 339.86 All Payors / Plans All Payors / Plans 346.8 other 346.8 346.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY 2-8-2 MM SPACE P CURVE L 60CM L 1MM OD 5 FR DECAPOLAR FIX AUTO ID SUP-270000000 CDM 270 RC outpatient 304.98 298.88 All Payors / Plans All Payors / Plans 304.98 other 304.98 304.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY ACHIEVE 3D L20 MM MAPPING LOOP SUP-270000000 CDM 270 RC outpatient 1275 1249.5 All Payors / Plans All Payors / Plans 1275 other 1275 1275 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY CARTO 3 THERMOCOOL SF D-F CURVE OD 7.5 FR BIDRIECTIONAL DEFLECTABLE TIP STEERABLE MULTIELECTRODE STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 6961.5 6822.27 All Payors / Plans All Payors / Plans 6961.5 other 6961.5 6961.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY INQUIRY 2-5-2 MM SPACING LARGE CURVE L110 CM L2 MM OD6 FR MAPPING QUADRIPOLAR STEERABLE SUP-270000000 CDM 270 RC outpatient 295.8 289.88 All Payors / Plans All Payors / Plans 295.8 other 295.8 295.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY OCTARAY 3-3-3-3-3 MM SPCAE D CURVE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 2601 2548.98 All Payors / Plans All Payors / Plans 2601 other 2601 2601 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY OCTARAY 3-3-3-3-3 MM SPCAE F CURVE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 5355 5247.9 All Payors / Plans All Payors / Plans 5355 other 5355 5355 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY OD6 FR CSF10 PIN AUTO ID DODECAPOLAR SUP-270000000 CDM 270 RC outpatient 534.48 523.79 All Payors / Plans All Payors / Plans 534.48 other 534.48 534.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY PENTARRAY 2-6-2 MM D CURVE OD 7 FR NAVIGATION ELECTRODE SUP-270000000 CDM 270 RC outpatient 4363.8 4276.52 All Payors / Plans All Payors / Plans 4363.8 other 4363.8 4363.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY REDEL WEBSTER 10MM SPACE REGULAR D CURVE L 92CM L 1MM OD 6FR DEFLECTABLE QUADRAPOLAR AUTO ID SUP-270000000 CDM 270 RC outpatient 724.5 710.01 All Payors / Plans All Payors / Plans 724.5 other 724.5 724.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY RESPONSE 1 MM 5 MM SPACE JSN CURVE L120 CM OD6 FR QUADRIPOLAR SUPERB TORQUE CONTROL BAND ELECTRODE CONVENIENT CABLE SUP-270000000 CDM 270 RC outpatient 92.82 90.96 All Payors / Plans All Payors / Plans 92.82 other 92.82 92.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ELECTROPHYSIOLOGY RESPONSE 2-8-2 MM SPACING CSL CURVE L65 CM OD6 FR DECAPOLAR SUP-270000000 CDM 270 RC outpatient 367.2 359.86 All Payors / Plans All Payors / Plans 367.2 other 367.2 367.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER EMBOLECTOMY L60 CM OD2 FR ODSEC4.5 MM .5 ML 1 LUMEN BALLOON LATEX SUP-270000000 CDM 270 RC outpatient 144.9 142 All Payors / Plans All Payors / Plans 144.9 other 144.9 144.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER EMBOLECTOMY LEMAITRE L80 CM OD3 FR ODSEC8 MM .20 ML STERILE LATEX DISPOSABLE SUP-270000000 CDM 270 RC outpatient 144.9 142 All Payors / Plans All Payors / Plans 144.9 other 144.9 144.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER EMBOLECTOMY LEMAITRE L80 CM OD4 FR ODSEC10.5 MM 75 ML STERILE LATEX DISPOSABLE SUP-270000000 CDM 270 RC outpatient 144.9 142 All Payors / Plans All Payors / Plans 144.9 other 144.9 144.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER EXTERNAL DRAINAGE EDM SILICONE L80 CM LUMBAR CLOSED TIP BARIUM IMPREGNATED STERILE SUP-270000000 CDM 270 RC outpatient 252.63 247.58 All Payors / Plans All Payors / Plans 252.63 other 252.63 252.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER FLUSH PIGTAIL NO BRAIDED 4F .04X65CM SUP-270000000 CDM 270 RC outpatient 28.6 28.03 All Payors / Plans All Payors / Plans 28.6 other 28.6 28.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING CPS AIM CARDIAC VALVE BYPASS TOOL SUP-270000000 CDM 270 RC outpatient 73.5 72.03 All Payors / Plans All Payors / Plans 73.5 other 73.5 73.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING CXI 90CM 2.6FR SS HYDROPHILIC POLYMER DISPOSABLE STERILE LOW PROFILE ANGLE TIP BRAID RADIOPAQUE ACCEPTS SUP-270000000 CDM 270 RC outpatient 427.2 418.66 All Payors / Plans All Payors / Plans 427.2 other 427.2 427.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING CXI STAINLESS STEEL HYDROPHILIC STRAIGHT L65 CM OD2.3 FR MARKER BAND RADIOPAQUE BRAID KINK RESISTANT .018 IN ACCEPTS GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 427.2 418.66 All Payors / Plans All Payors / Plans 427.2 other 427.2 427.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER AR1 CURVE L100 CM OD6 FR CORONARY SIDEHOLE SUP-481000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER HS1 CURVE L100 CM OD6 FR CORONARY SUP-481000000 CDM 270 RC outpatient 71.4 69.97 All Payors / Plans All Payors / Plans 71.4 other 71.4 71.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER JL5 CURVE L100 CM OD8 FR ID.09 IN CORONARY SIDEHOLE SUP-481000000 CDM 270 RC outpatient 109.2 107.02 All Payors / Plans All Payors / Plans 109.2 other 109.2 109.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON AMPLATZ 1 LEFT CORONARY CURVE L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL SIDEHOLE STERILE DISPOSABLE SUP-481000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON AMPLATZ 1 RIGHT CORONARY CURVE L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON AMPLATZ 2 RIGHT CORONARY CURVE L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON EXTRA BACKUP 3 LEFT CURVE L100 CM OD6 FR ID.071 IN CORONARY LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC outpatient 71.4 69.97 All Payors / Plans All Payors / Plans 71.4 other 71.4 71.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON EXTRA BACKUP 3.5 LEFT CURVE L100 CM OD6 FR ID.071 IN CORONARY LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC outpatient 71.4 69.97 All Payors / Plans All Payors / Plans 71.4 other 71.4 71.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON EXTRA BACKUP 3.75 LEFT CURVE L100 CM OD6 FR ID.071 IN CORONARY LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON EXTRA BACKUP 4 LEFT CURVE L100 CM OD6 FR ID.071 IN CORONARY LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON EXTRA BACKUP 4.5 LEFT CURVE L100 CM OD6 FR ID.071 IN CORONARY LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON HS2 CURVE OD6 FR ID.071 IN CORONARY MULTIPURPOSE LARGE LUMEN FLEXIBLE DISTAL SEGMENT FULL WALL TECHNOLOGY RADIOPAQUE MARKER BAND STERILE DISPOSABLE SUP-481000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON JUDKINS CORONARY 3 LEFT CURVE STANDARD L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON JUDKINS CORONARY 3.5 LEFT CURVE STANDARD L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON JUDKINS CORONARY 4 LEFT CURVE STANDARD L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC outpatient 71.4 69.97 All Payors / Plans All Payors / Plans 71.4 other 71.4 71.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON JUDKINS CORONARY 4 RIGHT CURVE STANDARD L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON JUDKINS CORONARY 4 RIGHT CURVE STANDARD L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL SIDEHOLE STERILE DISPOSABLE SUP-481000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON LEFT CORONARY BYPASS CURVE L100 CM OD6 FR ID.071 IN LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-481000000 CDM 270 RC outpatient 42.84 41.98 All Payors / Plans All Payors / Plans 42.84 other 42.84 42.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON MULTIPURPOSE 1 CURVE L100 CM OD6 FR ID.071 IN CORONARY LARGE LUMEN RADIOPAQUE FULL WALL FLEXIBLE DISTAL SEGMENT STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 71.4 69.97 All Payors / Plans All Payors / Plans 71.4 other 71.4 71.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING LAUNCHER NYLON STANDARD FR4 CURVE L100CM OD 6 FR CORONARY LARGE LUMEN RADIOPAQUE FLEXIBLE DISTAL SEGMENT STERILE LATEX FREE SUP-481000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING VISTA BRITE TIP TRUELUMEN LONG EXTRA BACKUP 3.5 CURVE 100CM .62IN 5FR .056IN BLUE YELLOW SS NYLON PTFE SUP-270000000 CDM 270 RC outpatient 92.4 90.55 All Payors / Plans All Payors / Plans 92.4 other 92.4 92.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER GUIDING VISTA BRITE TIP TRUELUMEN REGULAR XBLAD4 CURVE 100CM .1IN 6FR .07IN BLUE YELLOW SS NYLON PTFE SUP-481000000 CDM 270 RC outpatient 91.35 89.52 All Payors / Plans All Payors / Plans 91.35 other 91.35 91.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER HEMODIALYSIS GLIDEPATH POLYURETHANE STRAIGHT L55 CM L50 CM OD14.5 FR STANDARD KIT AIRGUARD VALVED INTRODUCER SYMMETRIC TIP PRELOADED LONG TERM NONSTERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 283.25 277.59 All Payors / Plans All Payors / Plans 283.25 other 283.25 283.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER HEMODIALYSIS PALINDROME VENATRAC L50 CM OD33 FR SPORTPACK SUP-270000000 CDM 270 RC outpatient 401.16 393.14 All Payors / Plans All Payors / Plans 401.16 other 401.16 401.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER IAB SENSATION PLUS L6 IN OD8 FR 50 ML CARDIOVASCULAR 2 STATLOCK DEVICE FIBER OPTIC INSERTION KIT INTRODUCER EXTENDER DATASCOPE SYSTEM SUP-270000000 CDM 270 RC outpatient 2350.53 2303.52 All Payors / Plans All Payors / Plans 2350.53 other 2350.53 2350.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ICE WITH 4 WAY STEERING SUP-270000000 CDM 270 RC outpatient 3570 3498.6 All Payors / Plans All Payors / Plans 3570 other 3570 3570 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER INFUSION CRAGG-MCNAMARA CRAGG-MICROVALVE L135 CM L20 CM OD4 FR 1 LUMEN RADIOPAQUE SIDEHOLE VALVE TIP ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 319.97 313.57 All Payors / Plans All Payors / Plans 319.97 other 319.97 319.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER INFUSION DIREXION FATHOM NITINOL .016 IN MICRO BERN L130 CM L180 CM OD2.4 FR TORQUEABLE FLEXIBLE GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 2088.66 2046.89 All Payors / Plans All Payors / Plans 2088.66 other 2088.66 2088.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER INFUSION MARKSMAN L160 CM SUP-270000000 CDM 270 RC outpatient 3076.5 3014.97 All Payors / Plans All Payors / Plans 3076.5 other 3076.5 3076.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER INFUSION MARKSMAN MICRO L160 CM L10 CM OD2.8-3.2 FR ID.027 IN ACCEPTS .021 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 3171 3107.58 All Payors / Plans All Payors / Plans 3171 other 3171 3171 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER INFUSION PHENOM L120 CM OD.061 IN ODSEC.055 IN ID.044 IN ROUND DISTAL TIP SUP-270000000 CDM 270 RC outpatient 4305 4218.9 All Payors / Plans All Payors / Plans 4305 other 4305 4305 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER IV PROTECTIV PLUS STRAIGHT .75IN 24GA YELLOW POLYURETHANE DISPOSABLE STERILE LF PERIPHERAL RADIOPAQUE SAFETY SUP-270000000 CDM 270 RC outpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER IV PROTECTIV PLUS STRAIGHT 1.25IN 16GA GRAY POLYURETHANE DISPOSABLE STERILE LF PERIPHERAL RADIOPAQUE SUP-270000000 CDM 270 RC outpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER IV PROTECTIV PLUS STRAIGHT 1.25IN 20GA PINK POLYURETHANE DISPOSABLE STERILE LF PERIPHERAL RADIOPAQUE SAFETY SUP-270000000 CDM 270 RC outpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER IV PROTECTIV PLUS STRAIGHT 1IN 22GA BLUE POLYURETHANE DISPOSABLE STERILE LF PERIPHERAL RADIOPAQUE SAFETY SUP-270000000 CDM 270 RC outpatient 3.38 3.31 All Payors / Plans All Payors / Plans 3.38 other 3.38 3.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER KUMPE 5FR 65CM SUP-270000000 CDM 270 RC outpatient 56.1 54.98 All Payors / Plans All Payors / Plans 56.1 other 56.1 56.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER MAPPING ADVISOR HD GRID SENSOR ENABLED BI-D SUP-270000000 CDM 270 RC outpatient 1989 1949.22 All Payors / Plans All Payors / Plans 1989 other 1989 1989 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER MAPPING OPTRELL DF CURVE 36 ELECTRODE SUP-270000000 CDM 270 RC outpatient 7207.2 7063.06 All Payors / Plans All Payors / Plans 7207.2 other 7207.2 7207.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER PACING BARD 1CM PROXIMAL 110CM 5FR NATURAL RUBBER DISPOSABLE STERILE LATEX ELECTRODE BIPOLAR DISTAL TIP BALLOON SUP-270000000 CDM 270 RC outpatient 340.71 333.9 All Payors / Plans All Payors / Plans 340.71 other 340.71 340.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER PULMONARY ARTERY SWAN-GANZ 110CM 7FR DISPOSABLE STERILE PULMONARY 2 LUMEN MONITOR SUP-270000000 CDM 270 RC outpatient 106.08 103.96 All Payors / Plans All Payors / Plans 106.08 other 106.08 106.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER PULMONARY ARTERY SWAN-GANZ CCO VIP 110CM 7.5FR HEPARIN POLYMER PULMONARY SUP-270009130 CDM 270 RC outpatient 148.18 145.22 All Payors / Plans All Payors / Plans 148.18 other 148.18 148.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER PULMONARY ARTERY SWAN-GANZ VIP STANDARD L110 CM OD7.5 FR 5 LUMEN THERMODILUTION VOLUMETRIC LATEX SUP-270009129 CDM 270 RC outpatient 195.5 191.59 All Payors / Plans All Payors / Plans 195.5 other 195.5 195.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER REPERFUSION RED 43 .043 IN L160 CM OD1.52 MM SUP-270000000 CDM 270 RC outpatient 5187 5083.26 All Payors / Plans All Payors / Plans 5187 other 5187 5187 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER SPECIMEN RETRIEVAL TRI-EX .035IN 200CM 7-5FR 8.5MM 1.5ML PURPLE DISPOSABLE STERILE LATEX BILE DUCT 3 LUMEN SUP-270000000 CDM 270 RC outpatient 338.1 331.34 All Payors / Plans All Payors / Plans 338.1 other 338.1 338.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER SUCTION 71 L132 CM LARGE BORE SUP-270000000 CDM 270 RC outpatient 5250 5145 All Payors / Plans All Payors / Plans 5250 other 5250 5250 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER SUPPORT CXI 150CM 2.6FR SS POLYMER HYDROPHILIC DISPOSABLE STERILE LOW PROFILE ANGLE TIP BRAID RADIOPAQUE SUP-270000000 CDM 270 RC outpatient 373.98 366.5 All Payors / Plans All Payors / Plans 373.98 other 373.98 373.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER THROMBECTOMY RED 68 L132 CM REPERFUSION CATHETER PENUMBRA ASPIRATION TUBING NO CE STERILE SUP-270000000 CDM 270 RC outpatient 5953.5 5834.43 All Payors / Plans All Payors / Plans 5953.5 other 5953.5 5953.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER THROMBECTOMY RED 72 L132 CM REPERFUSION CATHETER PENUMBRA ASPIRATION TUBING NO CE STERILE SUP-270000000 CDM 270 RC outpatient 5953.5 5834.43 All Payors / Plans All Payors / Plans 5953.5 other 5953.5 5953.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER ULTRASOUND SOUNDSTAR OD10 FR INTRACARDIAC STEERING HANDLE GE SUP-270000000 CDM 270 RC outpatient 2748.9 2693.92 All Payors / Plans All Payors / Plans 2748.9 other 2748.9 2748.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETERAL FLEXI-TIP AQ OD.05 IN L50 CM OD6/10 FR ODSEC.04 IN 2 LUMEN STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 133.14 130.48 All Payors / Plans All Payors / Plans 133.14 other 133.14 133.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETERAL FLEXI-TIP STANDARD L70 CM OD5 FR OPEN END LATEX FREE ACCEPTS .038 IN GUIDEWIRE RETROGRADE PYELOGRAM SUP-270000000 CDM 270 RC outpatient 30 29.4 All Payors / Plans All Payors / Plans 30 other 30 30 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETERAL PLASTIC WHISTLE L65 CM OD4 FR 2 STAGGER EYE LUER FIT ADAPTER COLOR CODED XRAY OPAQUE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 18.29 17.92 All Payors / Plans All Payors / Plans 18.29 other 18.29 18.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETERAL ROYAL FLUSH PLUS NYLON BEACON TIP VCF CURVE SPIRAL L65 CM OD4 FR 8 SIDEPORT HIGH FLOW RADIOPAQUE ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 31.21 30.59 All Payors / Plans All Payors / Plans 31.21 other 31.21 31.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX IC 12FR 5CC BACTI-GUARD NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 2 WAY FOLEY BALLOON SUP-270009003 CDM 270 RC outpatient 4.9 4.8 All Payors / Plans All Payors / Plans 4.9 other 4.9 4.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX IC 14FR 5CC BACTI-GUARD NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 2 WAY FOLEY BALLOON SUP-270009003 CDM 270 RC outpatient 4.9 4.8 All Payors / Plans All Payors / Plans 4.9 other 4.9 4.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX IC 16FR 5CC BACTI-GUARD NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 2 WAY FOLEY BALLOON SUP-270009003 CDM 270 RC outpatient 4.9 4.8 All Payors / Plans All Payors / Plans 4.9 other 4.9 4.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX IC 20FR 30CC BACTI-GUARD NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 2 WAY FOLEY BALLOON SUP-270009003 CDM 270 RC outpatient 4.9 4.8 All Payors / Plans All Payors / Plans 4.9 other 4.9 4.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX IC BACTI-GUARD NATURAL RUBBER HYDROGEL OD18 FR 5 CC 2 WAY FOLEY BALLOON ATRAUMATIC INSERTION STERILE LATEX DISPOSABLE SUP-270009003 CDM 270 RC outpatient 4.9 4.8 All Payors / Plans All Payors / Plans 4.9 other 4.9 4.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX LUBRICATH 14FR 5CC RED NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 2 WAY FOLEY 1 DRAINAGE SUP-270000000 CDM 270 RC outpatient 21.63 21.2 All Payors / Plans All Payors / Plans 21.63 other 21.63 21.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX LUBRICATH 16FR 5CC RED NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 2 WAY FOLEY 2 OPPOSING SUP-270000000 CDM 270 RC outpatient 25.28 24.77 All Payors / Plans All Payors / Plans 25.28 other 25.28 25.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX LUBRICATH 18FR 5CC RED NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 2 WAY FOLEY 1 DRAINAGE SUP-270000000 CDM 270 RC outpatient 21.42 20.99 All Payors / Plans All Payors / Plans 21.42 other 21.42 21.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX LUBRICATH STANDARD 20FR 5CC NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 3 WAY FOLEY 2 SUP-270009008 CDM 270 RC outpatient 11.33 11.1 All Payors / Plans All Payors / Plans 11.33 other 11.33 11.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX LUBRICATH STANDARD 22FR 30CC NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 3 WAY FOLEY 2 SUP-270000000 CDM 270 RC outpatient 19.71 19.32 All Payors / Plans All Payors / Plans 19.71 other 19.71 19.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL BARDEX LUBRICATH STANDARD 24FR 30CC NATURAL RUBBER HYDROGEL DISPOSABLE STERILE LATEX 3 WAY FOLEY 2 SUP-270000000 CDM 270 RC outpatient 17.82 17.46 All Payors / Plans All Payors / Plans 17.82 other 17.82 17.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL DOVER SILICONE L16 IN OD14 FR 5 CC 2 WAY FOLEY COLOR CODED INFLATION VALVE REINFORCE TIP LATEX FREE SUP-270009003 CDM 270 RC outpatient 4.9 4.8 All Payors / Plans All Payors / Plans 4.9 other 4.9 4.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CATHETER URETHRAL DOVER SILICONE NONPOROUS L16 IN OD16 FR 5 CC 2 WAY FOLEY COLOR CODED INFLATION VALVE REINFORCE TIP LATEX FREE SUP-270000000 CDM 270 RC outpatient 7.44 7.29 All Payors / Plans All Payors / Plans 7.44 other 7.44 7.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CAUTERY BATTERY DIAGNOSTICK L2 IN OPHTHALMIC PENCIL CORDLESS HIGH TEMPERATURE LOOP STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 52.47 51.42 All Payors / Plans All Payors / Plans 52.47 other 52.47 52.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CELLSAVER CHARGE SUP-270010026 CDM 270 RC outpatient 362.9 355.64 All Payors / Plans All Payors / Plans 362.9 other 362.9 362.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEMENT BONE PALACOS R 40 GM GREEN SUP-270000000 CDM 270 RC outpatient 55.08 53.98 All Payors / Plans All Payors / Plans 55.08 other 55.08 55.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEMENT BONE SIMPLEX P RADIOPAQUE FULL DOSE STERILE SUP-270000000 CDM 270 RC outpatient 98.6 96.63 All Payors / Plans All Payors / Plans 98.6 other 98.6 98.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEMENT BONE SIMPLEX P SPEEDSET RADIOPAQUE STERILE SUP-270000000 CDM 270 RC outpatient 243.6 238.73 All Payors / Plans All Payors / Plans 243.6 other 243.6 243.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CEMENT BONE SIMPLEX P TOBRAMYCIN FULL DOSE RADIOPAQUE PREBLEND STERILE SUP-270000000 CDM 270 RC outpatient 494.55 484.66 All Payors / Plans All Payors / Plans 494.55 other 494.55 494.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CF DELIVERY DEVICE CAPSULE BRAVO X 5 SUP-270000000 CDM 270 RC outpatient 672 658.56 All Payors / Plans All Payors / Plans 672 other 672 672 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHARGE NEUROMONITORING PROCEDURE-ALL SERVICES EXCEPT NEURO SUP-270010017 CDM 270 RC outpatient 336 329.28 All Payors / Plans All Payors / Plans 336 other 336 336 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHARGE NEUROMONITORING PROCEDURE-NEURO SUP-270010017 CDM 270 RC outpatient 326.4 319.87 All Payors / Plans All Payors / Plans 326.4 other 326.4 326.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CHICAGO TIP 12FR SELFCLEANING DISP SUCTION SUP-270000000 CDM 270 RC outpatient 32.64 31.99 All Payors / Plans All Payors / Plans 32.64 other 32.64 32.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CIRCUIT ANESTHESIA ADULT SUP-270000000 CDM 270 RC outpatient 8.16 8 All Payors / Plans All Payors / Plans 8.16 other 8.16 8.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLAMP ELECTROSURGICAL ISOLATOR TRANSPOLAR L6.3 MM ELECTRODE SUP-270000000 CDM 270 RC outpatient 2754 2698.92 All Payors / Plans All Payors / Plans 2754 other 2754 2754 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLAMP EXTERNAL FIXATION JET-X MINI 2 PIN BALL JOINT SUP-270000000 CDM 270 RC outpatient 2880.36 2822.75 All Payors / Plans All Payors / Plans 2880.36 other 2880.36 2880.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLEANER ELECTRO LUBE ROBOTIC SUP-270000000 CDM 270 RC outpatient 30.04 29.44 All Payors / Plans All Payors / Plans 30.04 other 30.04 30.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP ENDOSCOPIC MANTIS TRUGRIP L235 CM L2.8 MM 3 STEP ANCHOR PRONG CLOSURE MINIMAL SLIPPAG SUP-270000000 CDM 270 RC outpatient 827.4 810.85 All Payors / Plans All Payors / Plans 827.4 other 827.4 827.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP EXTERNAL DISPOSABLE STERILE SCALP 10 CLIP 20 CARTRIDGE SUP-270000000 CDM 270 RC outpatient 32.56 31.91 All Payors / Plans All Payors / Plans 32.56 other 32.56 32.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP HEMOSTATIC RESOLUTION 360 L235 CM BRAID TACTILE FEEDBACK SUP-270000000 CDM 270 RC outpatient 225.74 221.23 All Payors / Plans All Payors / Plans 225.74 other 225.74 225.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP INTERNAL LIGACLIP EXTRA LG 6.2MM YELLOW TITANIUM DISPOSABLE STERILE LF LIGATE OPEN SUP-270000000 CDM 270 RC outpatient 7.64 7.49 All Payors / Plans All Payors / Plans 7.64 other 7.64 7.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP INTERNAL LIGACLIP EXTRA SM BLUE TITANIUM DISPOSABLE STERILE LF LIGATE OPEN ENDOSCOPIC SUP-270000000 CDM 270 RC outpatient 7.14 7 All Payors / Plans All Payors / Plans 7.14 other 7.14 7.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP INTERNAL WECK HEM-O-LOK LG CHEVRON HEART PURPLE POLYMER DISPOSABLE STERILE LF LIGATE NONABSORBABLE CARTRIDGE SUP-270000000 CDM 270 RC outpatient 40 39.2 All Payors / Plans All Payors / Plans 40 other 40 40 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP INTERNAL WECK HEM-O-LOK XL CHEVRON HEART GOLD POLYMER DISPOSABLE STERILE LF LIGATE NONABSORBABLE CARTRIDGE SUP-270000000 CDM 270 RC outpatient 51.85 50.81 All Payors / Plans All Payors / Plans 51.85 other 51.85 51.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP LIGATING ENDOSCOPIC HEMOLOK POLYMER GREEN MEDIUM LARGE 5.0MM SUP-270000000 CDM 270 RC outpatient 54.9 53.8 All Payors / Plans All Payors / Plans 54.9 other 54.9 54.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP LIGATION RESOLUTION 360 ULTRA 17 MM OPEN L235 CM BRAID ROTATION CONTROL KNOB SUP-270000000 CDM 270 RC outpatient 505.1 495 All Payors / Plans All Payors / Plans 505.1 other 505.1 505.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP PADLOCK DEFECT CLOSURE SYSTEM SUP-270000000 CDM 270 RC outpatient 1375 1347.5 All Payors / Plans All Payors / Plans 1375 other 1375 1375 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP SURGICAL DLP L3 MM CORONARY ARTERY RETRACTION SUP-270000000 CDM 270 RC outpatient 98.81 96.83 All Payors / Plans All Payors / Plans 98.81 other 98.81 98.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CLIP SURGICAL STEALTH 6MM STERILE ATRAUMATIC OCCLUSION FIBRA SPRING SUP-270000000 CDM 270 RC outpatient 46.2 45.28 All Payors / Plans All Payors / Plans 46.2 other 46.2 46.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COHEN-BENNER CONTACT LENS SUP-270000000 CDM 270 RC outpatient 102.9 100.84 All Payors / Plans All Payors / Plans 102.9 other 102.9 102.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COIL TARGET DETACHABLE 360 NANO 1.5MM X 3CM SUP-270000000 CDM 270 RC outpatient 5369.7 5262.31 All Payors / Plans All Payors / Plans 5369.7 other 5369.7 5369.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COLLAR CERVICAL LG 18.5INX3IN FOAM VELCRO FIRM DENSITY STOCKINETTE COVER SUP-270009109 CDM 270 RC outpatient 4.09 4.01 All Payors / Plans All Payors / Plans 4.09 other 4.09 4.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COLLAR CERVICAL MED LOW CONTOUR 17.5INX3IN FOAM VELCRO FIRM DENSITY STOCKINETTE COVER SUP-270009109 CDM 270 RC outpatient 4.09 4.01 All Payors / Plans All Payors / Plans 4.09 other 4.09 4.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COLLAR CERVICAL VISTA ADULT UNIVERSAL SET REPLACEMENT PAD LATEX FREE SUP-270009108 CDM 270 RC outpatient 54 52.92 All Payors / Plans All Payors / Plans 54 other 54 54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COLLECTOR SPECIMEN VACUTAINER BD BBL ANAEROBIC SWAB NEEDLE SYRINGE STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 6.26 6.13 All Payors / Plans All Payors / Plans 6.26 other 6.26 6.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT FEMORAL ATTUNE SIZE 5 CEMENTED NARROW CRUCIATE RETAINING COBALT CHROMIUM RIGHT SUP-270010025 CDM 270 RC outpatient 6720 6585.6 All Payors / Plans All Payors / Plans 6720 other 6720 6720 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT FEMORAL GMK 23 KNEE RIGHT SPHERE CEMENTED SUP-270010025 CDM 270 RC outpatient 7035 6894.3 All Payors / Plans All Payors / Plans 7035 other 7035 7035 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT FEMORAL GMK SPHERIKA 5 KNEE LEFT CEMENT STERILE LATEX FREE SUP-270010025 CDM 270 RC outpatient 7560 7408.8 All Payors / Plans All Payors / Plans 7560 other 7560 7560 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT FEMORAL LPS-FLEX GENDER SOLUTIONS OPTION NEXGEN COCR G KNEE RIGHT SUP-270010025 CDM 270 RC outpatient 6090 5968.2 All Payors / Plans All Payors / Plans 6090 other 6090 6090 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT FEMORAL NEXGEN LCCK OPTION ZIMALOY F L72 MM X W65.5 MM KNEE RIGHT SET SCREW CEMENTED REVISION STERILE SUP-270010025 CDM 270 RC outpatient 14642.1 14349.26 All Payors / Plans All Payors / Plans 14642.1 other 14642.1 14642.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT FEMORAL NEXGEN LPS OPTION E KNEE RIGHT SUP-270010025 CDM 270 RC outpatient 7455 7305.9 All Payors / Plans All Payors / Plans 7455 other 7455 7455 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT FEMORAL NEXGEN LPS OPTION F KNEE RIGHT SUP-270010025 CDM 270 RC outpatient 6300 6174 All Payors / Plans All Payors / Plans 6300 other 6300 6300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT FEMORAL NEXGEN LPS OPTION G KNEE RIGHT SUP-270010025 CDM 270 RC outpatient 7540 7389.2 All Payors / Plans All Payors / Plans 7540 other 7540 7540 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT GLENOID UNIVERS REVERS +4 OD33 MM ODSEC24 MM SHOULDER LATERALIZE GLENOSPHERE TAPER BASEPLATE MODULAR SUP-270010030 CDM 270 RC outpatient 15540 15229.2 All Payors / Plans All Payors / Plans 15540 other 15540 15540 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT TIBIAL TRAY GMK 2 RIGHT CEMENTED FIXED PRIMARY SUP-270010025 CDM 270 RC outpatient 5695 5581.1 All Payors / Plans All Payors / Plans 5695 other 5695 5695 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT TIBIAL TRAY GMK 3 LEFT CEMENTED FIXED PRIMARY SUP-270010025 CDM 270 RC outpatient 9360 9172.8 All Payors / Plans All Payors / Plans 9360 other 9360 9360 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT TIBIAL TRAY GMK 4 RIGHT PRIMARY CEMENTED FIXED SUP-270010025 CDM 270 RC outpatient 9360 9172.8 All Payors / Plans All Payors / Plans 9360 other 9360 9360 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT TIBIAL TRAY GMK 5 LEFT PRIMARY CEMENTED FIXED SUP-270010025 CDM 270 RC outpatient 7560 7408.8 All Payors / Plans All Payors / Plans 7560 other 7560 7560 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT TIBIAL TRAY GMK 5 RIGHT PRIMARY CEMENTED FIXED SUP-270010025 CDM 270 RC outpatient 7035 6894.3 All Payors / Plans All Payors / Plans 7035 other 7035 7035 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COMPONENT TIBIAL TRAY GMK 6 RIGHT PRIMARY CEMENTED FIXED SUP-270010025 CDM 270 RC outpatient 5695 5581.1 All Payors / Plans All Payors / Plans 5695 other 5695 5695 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CONNECTOR DRAINAGE BLAKE 2:1 3/8.5MMX3/16IN WHITE SILICONE DISPOSABLE STERILE LF CARDIAC 4 CHANNEL RADIOPAQUE SOLID CORE SUP-270000000 CDM 270 RC outpatient 35.12 34.42 All Payors / Plans All Payors / Plans 35.12 other 35.12 35.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CONNECTOR DRAINAGE BLAKE 3:1 3/8.5MMX3/16IN WHITE SILICONE DISPOSABLE STERILE LF CARDIAC 4 CHANNEL RADIOPAQUE SOLID CORE SUP-270000000 CDM 270 RC outpatient 17.06 16.72 All Payors / Plans All Payors / Plans 17.06 other 17.06 17.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CONNECTOR WOUND DRAIN TRAC Y DRESSING SYSTEM STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 1.73 1.7 All Payors / Plans All Payors / Plans 1.73 other 1.73 1.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CONQUEST PTA BALLOON DILATION CATHETER SUP-481000000 CDM 270 RC outpatient 1470 1440.6 All Payors / Plans All Payors / Plans 1470 other 1470 1470 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CONTAINER SPECIMEN 4OZ POLYPROPYLENE STERILE LF LEAK RESISTANT SCREW ON LID GRADUATED SUP-270000000 CDM 270 RC outpatient 1.18 1.16 All Payors / Plans All Payors / Plans 1.18 other 1.18 1.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COOK 16F CHECK-FLO PERFORMER SHEATH 30CM SUP-270000000 CDM 270 RC outpatient 123.65 121.18 All Payors / Plans All Payors / Plans 123.65 other 123.65 123.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COOK 8F DILATOR 20CM SUP-270000000 CDM 270 RC outpatient 8.25 8.09 All Payors / Plans All Payors / Plans 8.25 other 8.25 8.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "CORETEMP FLUID WARMING DRAPE 56""X56""" SUP-270000000 CDM 270 RC outpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER BURR HOLE MATRIXNEURO TITANIUM H.4 MM OD15 MM CRANIOMAXILLOFACIAL NONSTERILE BLUE SUP-270010013 CDM 270 RC outpatient 2028.6 1988.03 All Payors / Plans All Payors / Plans 2028.6 other 2028.6 2028.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER BURR HOLE MATRIXNEURO TITANIUM H.4 MM OD17 MM CRANIOMAXILLOFACIAL BLUE SUP-270010013 CDM 270 RC outpatient 635 622.3 All Payors / Plans All Payors / Plans 635 other 635 635 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER BURR HOLE MATRIXNEURO TITANIUM H.4 MM OD24 MM CRANIOMAXILLOFACIAL NONSTERILE BLUE SHUNT SUP-270010013 CDM 270 RC outpatient 1066.8 1045.46 All Payors / Plans All Payors / Plans 1066.8 other 1066.8 1066.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER BURR HOLE MATRIXNEURO TITANIUM OD17 MM SHUNT NONSTERILE BLUE SUP-270010013 CDM 270 RC outpatient 603.75 591.68 All Payors / Plans All Payors / Plans 603.75 other 603.75 603.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER BURR HOLE MATRIXNEURO TITANIUM OD24 MM CRANIAL BLUE SUP-270010013 CDM 270 RC outpatient 1066.8 1045.46 All Payors / Plans All Payors / Plans 1066.8 other 1066.8 1066.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER ENDOSCOPE TIP HOT SHEARS DA VINCI ENDOWRIST 8 MM STANDARD CAUTERY MONOPOLAR DISPOSABLE SUP-270000000 CDM 270 RC outpatient 21.42 20.99 All Payors / Plans All Payors / Plans 21.42 other 21.42 21.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER INLINE CAMERA SUP-270000000 CDM 270 RC outpatient 114.02 111.74 All Payors / Plans All Payors / Plans 114.02 other 114.02 114.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER PROBE CIV-FLEX L58 IN X W5.5 IN EXTENDED LENGTH STERILE LATEX FREE SUP-481000000 CDM 270 RC outpatient 9.97 9.77 All Payors / Plans All Payors / Plans 9.97 other 9.97 9.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER PROBE SITE-RITE L48 IN PREGEL LATEX FREE SUP-270000000 CDM 270 RC outpatient 15.62 15.31 All Payors / Plans All Payors / Plans 15.62 other 15.62 15.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility COVER TABLE SMS STANDARD L90 IN X W60 IN REINFORCE HEAVY DUTY STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 5.5 5.39 All Payors / Plans All Payors / Plans 5.5 other 5.5 5.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CPS DIRECT 10F SUP-270010030 CDM 270 RC outpatient 1155 1131.9 All Payors / Plans All Payors / Plans 1155 other 1155 1155 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRADLE POSITIONING FOAM L24IN X W5 IN XH3 IN ARM CONVOLUTE LATEX FREE LAMINECTOMY SUP-270000000 CDM 270 RC outpatient 3.09 3.03 All Payors / Plans All Payors / Plans 3.09 other 3.09 3.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRE PRO CATHETER BALLOON DILATATION CRE PEBAX 2.8 MM 3.2 MM L240 CM L5.5 CM OD10-11-12 MM ODSEC7.5 FR ESOPHAGEAL PYLORIC BILIARY LOW PROFILE GUIDEWIRE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 405.49 397.38 All Payors / Plans All Payors / Plans 405.49 other 405.49 405.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRE PRO CATHETER BALLOON DILATATION CRE PEBAX 2.8 MM 3.2 MM L240 CM L5.5 CM OD11-13.5-15 MM ODSEC7.5 FR ESOPHAGEAL PYLORIC BILIARY BALLOON LOW PROFILE GUIDEWIRE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 405.49 397.38 All Payors / Plans All Payors / Plans 405.49 other 405.49 405.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRE PRO CATHETER BALLOON DILATATION CRE PEBAX 2.8 MM 3.2 MM L240 CM L5.5 CM OD6-7-8 MM ESOPHAGEAL PYLORIC BILIARY LOW PROFILE RADIOPACQUE GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 299.39 293.4 All Payors / Plans All Payors / Plans 299.39 other 299.39 299.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRE PRO CATHETER BALLOON DILATION CRE PEBAX L240 CM L5.5 CM OD15-16.5-18 MM ODSEC7.5 FR ESOPHAGEAL PYLORIC BILIARY BALLOON LOW PROFILE GUIDEWIRE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 244.3 239.41 All Payors / Plans All Payors / Plans 244.3 other 244.3 244.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRE PRO DILATOR ENDOSCOPIC CRE PEBAX 2.8 MM 3.2 MM 3.7 MM 4.2 MM L240 CM L5.5 CM OD18-19-20 MM ODSEC7.5 FR ESOPHAGEAL PYLORIC BILIARY BALLOON LOW PROFILE GUIDEWIRE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 502.97 492.91 All Payors / Plans All Payors / Plans 502.97 other 502.97 502.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRE PRO DILATOR ENDOSCOPIC CRE PEBAX 2.8 MM 3.2 MM L240 CM L5.5 CM OD8-9-10 MM ODSEC7.5 FR ESOPHAGEAL PYLORIC BILIARY BALLOON LOW PROFILE GUIDEWIRE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 502.97 492.91 All Payors / Plans All Payors / Plans 502.97 other 502.97 502.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CRT-P PERCEPTA MRI QUAD DEVICE SUP-275000000 CDM 270 RC outpatient 7237 7092.26 All Payors / Plans All Payors / Plans 7237 other 7237 7237 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUFF TOURNIQUET ATS 3000 CYLINDER L12 IN X W3.5 IN 2 PORT 1 BLADDER POSITIVE LOCK CONNECTOR CONTACT CLOSURE STERILE LATEX FREE DISPOSABLE BLACK SUP-270000000 CDM 270 RC outpatient 28.89 28.31 All Payors / Plans All Payors / Plans 28.89 other 28.89 28.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUFF TOURNIQUET ATS 3000 CYLINDER L18 IN X W4 IN 2 PORT 1 BLADDER POSITIVE LOCK CONNECTOR CONTACT CLOSURE STERILE LATEX FREE DISPOSABLE RED SUP-270000000 CDM 270 RC outpatient 28.89 28.31 All Payors / Plans All Payors / Plans 28.89 other 28.89 28.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUFF TOURNIQUET ATS 3000 CYLINDER L24 IN X W4 IN 2 PORT 1 BLADDER POSITIVE LOCK CONNECTOR CONTACT CLOSURE STERILE LATEX FREE DISPOSABLE GREEN SUP-270000000 CDM 270 RC outpatient 28.89 28.31 All Payors / Plans All Payors / Plans 28.89 other 28.89 28.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUFF TOURNIQUET ATS 3000 CYLINDER L30 IN X W4 IN 2 PORT 1 BLADDER POSITIVE LOCK CONNECTOR CONTACT CLOSURE STERILE LATEX FREE DISPOSABLE BLUE SUP-270000000 CDM 270 RC outpatient 16.83 16.49 All Payors / Plans All Payors / Plans 16.83 other 16.83 16.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUFF TOURNIQUET ATS 3000 CYLINDER L34 IN X W4 IN 2 PORT 1 BLADDER POSITIVE LOCK CONNECTOR CONTACT CLOSURE STERILE LATEX FREE DISPOSABLE BROWN SUP-270000000 CDM 270 RC outpatient 17.33 16.98 All Payors / Plans All Payors / Plans 17.33 other 17.33 17.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUFF TOURNIQUET ATS 3000 CYLINDER L42 IN X W4 IN 2 PORT 1 BLADDER POSITIVE LOCK CONNECTOR CONTACT CLOSURE STERILE LATEX FREE DISPOSABLE RUBY SUP-270000000 CDM 270 RC outpatient 35.69 34.98 All Payors / Plans All Payors / Plans 35.69 other 35.69 35.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUP ACETABULAR PINNACLE 52MM 3-HOLE PRIMARY SECTOR GRIPTION SUP-270010024 CDM 270 RC outpatient 8295 8129.1 All Payors / Plans All Payors / Plans 8295 other 8295 8295 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUP ARTHREX UNIVERSAL REVERSE SUTURE 39 +2 RIGHT SUP-270000000 CDM 270 RC outpatient 12650 12397 All Payors / Plans All Payors / Plans 12650 other 12650 12650 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CURETTE VACUUM CURVE 12MM CLEAR PLASTIC DISPOSABLE STERILE UTERINE OPEN TIP MOLD MARK FROST SOUND LINE SUP-270000000 CDM 270 RC outpatient 2.84 2.78 All Payors / Plans All Payors / Plans 2.84 other 2.84 2.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUSHION POSITIONING PRONEVIEW INSITE FOAM ADULT LARGE INSERT LATEX FREE OR SUP-270000000 CDM 270 RC outpatient 25.5 24.99 All Payors / Plans All Payors / Plans 25.5 other 25.5 25.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility CUTTER ENDARTERECTOMY MOLLRING L44 CM OD9 MM TRANSECTION DEVICE REMOTE SUP-270000000 CDM 270 RC outpatient 6297.9 6171.94 All Payors / Plans All Payors / Plans 6297.9 other 6297.9 6297.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEBRILLATOR CARDIAC COBALT XT CRT-D DF-1 PIN PLUG RADIOPAQUE STERILE RESYNCHRONIZATION SUP-275000000 CDM 270 RC outpatient 18065 17703.7 All Payors / Plans All Payors / Plans 18065 other 18065 18065 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DECANTER FLUID EMPTY BOTTLE NONSTERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 1.47 1.44 All Payors / Plans All Payors / Plans 1.47 other 1.47 1.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DECANTER FLUID L9 IN BAG LATEX SUP-270000000 CDM 270 RC outpatient 1.61 1.58 All Payors / Plans All Payors / Plans 1.61 other 1.61 1.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEFIBRILLATOR CARDIAC ACTICOR 7 HF-T SUP-270000000 CDM 270 RC outpatient 22950 22491 All Payors / Plans All Payors / Plans 22950 other 22950 22950 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEFIBRILLATOR CARDIAC COBALT XT CRT-D DF4 CONNECTOR RADIOPAQUE STERILE RESYNCHRONIZATION SUP-275000000 CDM 270 RC outpatient 27065 26523.7 All Payors / Plans All Payors / Plans 27065 other 27065 27065 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEFIBRILLATOR CARDIAC COBALT XT CRT-D QUAD DF4 CONNECTOR RADIOPAQUE STERILE RESYNCHRONIZATION SUP-275000000 CDM 270 RC outpatient 30103 29500.94 All Payors / Plans All Payors / Plans 30103 other 30103 30103 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEFIBRILLATOR CARDIAC GALLANT 2 CHAMBER IS-1 DF4 CONNECTOR SUP-275000000 CDM 270 RC outpatient 12118 11875.64 All Payors / Plans All Payors / Plans 12118 other 12118 12118 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEFIBRILLATOR VIGILANT EL DR DF4 DUAL CHAMBER SUP-275000000 CDM 270 RC outpatient 19256 18870.88 All Payors / Plans All Payors / Plans 19256 other 19256 19256 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DERMACARRIERS SUP-270000000 CDM 270 RC outpatient 44 43.12 All Payors / Plans All Payors / Plans 44 other 44 44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE AZURE XT DR MRI SURESCAN SUP-275000000 CDM 270 RC outpatient 3330 3263.4 All Payors / Plans All Payors / Plans 3330 other 3330 3330 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE BLOWER/MISTER ACCUMIST ATTACHED TUBING SET SUP-270000000 CDM 270 RC outpatient 94.5 92.61 All Payors / Plans All Payors / Plans 94.5 other 94.5 94.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CARDIAC ASSERT-IQ THK 4.4MM EL + L 9.4MM X H 49MM ICM SUP-270000000 CDM 270 RC outpatient 5079.6 4978.01 All Payors / Plans All Payors / Plans 5079.6 other 5079.6 5079.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE ANGIO-SEAL VIP BONDEK-PLUS POLYGLYD L70 CM OD8 FR ODSEC.038 IN VASCULAR HEMOSTATIC BIOABSORBABLE INSERTION SHEATH GUIDEWIRE STERILE LATEX FREE DISPOSABLE SUP-481000000 CDM 270 RC outpatient 430.5 421.89 All Payors / Plans All Payors / Plans 430.5 other 430.5 430.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE ANGIO-SEAL VIP COLLAGEN .035 IN L70 CM OD6 FR VASCULAR VALUELINK GUIDEWIRE INSERTION SHEATH J STRAIGHTENER SUP-481000000 CDM 270 RC outpatient 209.1 204.92 All Payors / Plans All Payors / Plans 209.1 other 209.1 209.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE ATRICLIP 45D 35MM 6CM NITINOL POLYESTER FLEXIBLE SHAFT PLUNGER GRIP LEFT ATRIAL APPENDAGE EXCLUSION SUP-270000000 CDM 270 RC outpatient 1224 1199.52 All Payors / Plans All Payors / Plans 1224 other 1224 1224 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE ATRICLIP 45D 40MM 6CM NITINOL POLYESTER FLEXIBLE SHAFT PLUNGER GRIP LEFT ATRIAL APPENDAGE EXCLUSION SUP-270000000 CDM 270 RC outpatient 1224 1199.52 All Payors / Plans All Payors / Plans 1224 other 1224 1224 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE ATRICLIP 45D 45MM 6CM NITINOL TITANIUM POLYESTER FLEXIBLE SHAFT PLUNGER GRIP LEFT ATRIAL APPENDAGE SUP-270000000 CDM 270 RC outpatient 2520 2469.6 All Payors / Plans All Payors / Plans 2520 other 2520 2520 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE ATRICLIP FLEXV L35 MM 1 HAND SMALL FOOTPRINT SUTURE LESS CLIP DEPLOYMENT STERILE LATEX FREE DISPOSABLE LEFT ATRIAL APPENDAGE EXCLUSION SYSTEM SUP-270000000 CDM 270 RC outpatient 3885 3807.3 All Payors / Plans All Payors / Plans 3885 other 3885 3885 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE ATRICLIP PRO2 GILLINOV-COSGROVE L35 MM STERILE LATEX FREE DISPOSABLE LEFT ATRIAL APPENDAGE EXCLUSION SYSTEM SUP-270000000 CDM 270 RC outpatient 9880 9682.4 All Payors / Plans All Payors / Plans 9880 other 9880 9880 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE ATRICLIP PRO2 GILLINOV-COSGROVE L45 MM STERILE LATEX FREE DISPOSABLE LEFT ATRIAL APPENDAGE EXCLUSION SYSTEM SUP-270000000 CDM 270 RC outpatient 6460 6330.8 All Payors / Plans All Payors / Plans 6460 other 6460 6460 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE CARTER-THOMASON XL PILOT GUIDES 5MM 10-12 MM SUP-270000000 CDM 270 RC outpatient 219.7 215.31 All Payors / Plans All Payors / Plans 219.7 other 219.7 219.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE EXOSEAL OD5 FR FEMORAL ARTERY ABSORBABLE PLUG APPLIER HANDLE DELIVERY SHAFT STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 153 149.94 All Payors / Plans All Payors / Plans 153 other 153 153 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE EXOSEAL OD6 FR FEMORAL ARTERY ABSORBABLE PLUG APPLIER HANDLE DELIVERY SHAFT STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 289 283.22 All Payors / Plans All Payors / Plans 289 other 289 289 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE MYNX 6FR7FR SUP-270000000 CDM 270 RC outpatient 246.84 241.9 All Payors / Plans All Payors / Plans 246.84 other 246.84 246.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE MYNX CONTROL VCD 6/7 FRENCH SUP-270000000 CDM 270 RC outpatient 391 383.18 All Payors / Plans All Payors / Plans 391 other 391 391 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE MYNXGRIP OD5 FR VASCULAR SUP-270000000 CDM 270 RC outpatient 508.2 498.04 All Payors / Plans All Payors / Plans 508.2 other 508.2 508.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE PERCLOSE OD6 FR VASCULAR SUTURE MEDIATE KNOT PUSH STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 256.02 250.9 All Payors / Plans All Payors / Plans 256.02 other 256.02 256.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE SYNETURE V-LOC 1 GS-21 L 9IN ABSORBABLE BLUE SUP-270000000 CDM 270 RC outpatient 76.67 75.14 All Payors / Plans All Payors / Plans 76.67 other 76.67 76.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE VASCULAR MANTA 14 FR SUP-481000000 CDM 270 RC outpatient 1995 1955.1 All Payors / Plans All Payors / Plans 1995 other 1995 1995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE VASCULAR MANTA 18 FR SUP-481000000 CDM 270 RC outpatient 1615 1582.7 All Payors / Plans All Payors / Plans 1615 other 1615 1615 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 180 0 GS-21 12IN GREEN ABSORBABLE TAPER POINT SUP-270000000 CDM 270 RC outpatient 22.13 21.69 All Payors / Plans All Payors / Plans 22.13 other 22.13 22.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 180 0 GS-21 L15 CM L37 MM ABSORBABLE GREEN SUP-270000000 CDM 270 RC outpatient 45.56 44.65 All Payors / Plans All Payors / Plans 45.56 other 45.56 45.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 180 2-0 GS-21 12IN GREEN ABSORBABLE TAPER POINT SUP-270000000 CDM 270 RC outpatient 45.56 44.65 All Payors / Plans All Payors / Plans 45.56 other 45.56 45.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 180 2-0 GS-22 1/2 CIRCLE L6 IN L27 MM TAPER POINT ABSORBABLE GREEN SUP-270000000 CDM 270 RC outpatient 35.34 34.63 All Payors / Plans All Payors / Plans 35.34 other 35.34 35.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 180 2-0 V-20 1/2 CIRCLE L18 IN L26 MM TAPER POINT ABSORBABLE GREEN SUP-270000000 CDM 270 RC outpatient 43.22 42.36 All Payors / Plans All Payors / Plans 43.22 other 43.22 43.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 180 3-0 P-14 18IN CLEAR ABSORBABLE PREMIUM REVERSE CUT SUP-270000000 CDM 270 RC outpatient 46.05 45.13 All Payors / Plans All Payors / Plans 46.05 other 46.05 46.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 180 SURGALLOY 3-0 V-20 1/2 CIRCLE L9 IN L26 MM TAPER POINT ABSORBABLE GREEN SUP-270000000 CDM 270 RC outpatient 43.65 42.78 All Payors / Plans All Payors / Plans 43.65 other 43.65 43.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 3-0 NON ABSORBABLE WOUND CLOSURE DEVICE SUP-270000000 CDM 270 RC outpatient 43.65 42.78 All Payors / Plans All Payors / Plans 43.65 other 43.65 43.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 90 3-0 SC-2 STRAIGHT L45 CM L60 MM 2 ANGLE CUT ABSORBABLE BARB UNDYED SUP-270000000 CDM 270 RC outpatient 67.7 66.35 All Payors / Plans All Payors / Plans 67.7 other 67.7 67.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 90 4-0 SC-2 STRAIGHT L45 CM L60 MM 2 ANGLE CUT ABSORBABLE BARB UNDYED SUP-270000000 CDM 270 RC outpatient 36.91 36.17 All Payors / Plans All Payors / Plans 36.91 other 36.91 36.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 90 SURGALLOY 2-0 P-12 3/8 CIRCLE L 12IN L19MM REVERSE CUT ABSORBABLE 2 ANGLE CUT BARB PATTERN UNDYED SUP-270000000 CDM 270 RC outpatient 138.14 135.38 All Payors / Plans All Payors / Plans 138.14 other 138.14 138.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE V-LOC 90 SURGALLOY 3-0 P-12 3/8 CIRCLE L12IN L19MM REVERSE CUT ABSORBABLE 2 ANGLE CUT BARB PATTERN UNDYED SUP-270000000 CDM 270 RC outpatient 46.05 45.13 All Payors / Plans All Payors / Plans 46.05 other 46.05 46.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE WATCHMAN FLX PRO L 20 MM LEFT ATRIAL APPENDAGE STERILE LATEX FREE DISPOSABLE DELIVERY SYSTEM SUP-481000000 CDM 270 RC outpatient 35700 34986 All Payors / Plans All Payors / Plans 35700 other 35700 35700 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE WATCHMAN FLX PRO L 24 MM LEFT ATRIAL APPENDAGE STERILE LATEX FREE DISPOSABLE DELIVERY SYSTEM SUP-481000000 CDM 270 RC outpatient 35700 34986 All Payors / Plans All Payors / Plans 35700 other 35700 35700 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE WATCHMAN FLX PRO L 35MM LEFT ATRIAL APPENDAGE STERILE LATEX FREE DISPOSABLE DELIVERY SYSTEM SUP-481000000 CDM 270 RC outpatient 35700 34986 All Payors / Plans All Payors / Plans 35700 other 35700 35700 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE CLOSURE WATCHMAN FXD CURVE OD 15 FR ID 12 FR 2 CURVE ACCESS SYSTEM LEFT ATRIAL APPENDAGE SUP-481000000 CDM 270 RC outpatient 1020 999.6 All Payors / Plans All Payors / Plans 1020 other 1020 1020 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE COAGULATION EPI-SENSE L3 CM GUIDE ELECTRODE IRRIGATION PERFUSION LUMEN SUCTION 6130 SUP-270000000 CDM 270 RC outpatient 29900 29302 All Payors / Plans All Payors / Plans 29900 other 29900 29900 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE COMPRESSION PRELUDESYNC L24 CM BAND STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 73.5 72.03 All Payors / Plans All Payors / Plans 73.5 other 73.5 73.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE DRAINAGE STAYFIX OD12-22 FR FIXATION FASTEN SHOWERCAP PERCUTANEOUS CATHETER SUP-270000000 CDM 270 RC outpatient 14.88 14.58 All Payors / Plans All Payors / Plans 14.88 other 14.88 14.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE ELECTROSURGICAL LIGASURE MARYLAND 350 D L23 CM OPEN SEALER DIVIDER 1 STEP SEAL FORCETRIAD SUP-270000000 CDM 270 RC outpatient 1760.41 1725.2 All Payors / Plans All Payors / Plans 1760.41 other 1760.41 1760.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE ELECTROSURGICAL PLASMABLADE X STERILE LATEX FREE DISPOSABLE PINK 3.0S LIGHT SUP-270000000 CDM 270 RC outpatient 448.8 439.82 All Payors / Plans All Payors / Plans 448.8 other 448.8 448.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE EMBOLIZATION SURPASS STREAMLINE L20MM OD 4MM SUP-270000000 CDM 270 RC outpatient 25245 24740.1 All Payors / Plans All Payors / Plans 25245 other 25245 25245 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE ENDOSCOPIC PLUNGE BOB POLY OD10 MM PORT CLEANER Q TIP ABSORBENT OBTURATOR SUP-270000000 CDM 270 RC outpatient 7.63 7.48 All Payors / Plans All Payors / Plans 7.63 other 7.63 7.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE ENDOSCOPIC PLUNGE BOB POLY OD5 MM PORT CLEANER Q TIP ABSORBENT OBTURATOR SUP-270000000 CDM 270 RC outpatient 54.39 53.3 All Payors / Plans All Payors / Plans 54.39 other 54.39 54.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE FIXATION SECURESTRAP 5MM DISPOSABLE 25 ABSORBABLE STRAP MESH HERNIA REPAIR SUP-270000000 CDM 270 RC outpatient 999.27 979.28 All Payors / Plans All Payors / Plans 999.27 other 999.27 999.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE FIXATION SECURESTRAP L5 MM ABSORBABLE STRAP HERNIA REPAIR SUP-270000000 CDM 270 RC outpatient 684.35 670.66 All Payors / Plans All Payors / Plans 684.35 other 684.35 684.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE FLOW CONTROL FLOSWITCH 1050 PSI 1 WAY HIGH PRESSURE SUP-270000000 CDM 270 RC outpatient 9.01 8.83 All Payors / Plans All Payors / Plans 9.01 other 9.01 9.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE INFLATION CADENCE PRECISION 1 ML SYRINGE INJECTOR THREAD PLUNGER SUP-270000000 CDM 270 RC outpatient 126.89 124.35 All Payors / Plans All Payors / Plans 126.89 other 126.89 126.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE INFLATION CRE STERI-FLATE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 46.99 46.05 All Payors / Plans All Payors / Plans 46.99 other 46.99 46.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE INFLATION ENCORE 26 L3 IN OD12 FR 20 ML PRESSURE GAUGE LATEX FREE SUP-270000000 CDM 270 RC outpatient 30.6 29.99 All Payors / Plans All Payors / Plans 30.6 other 30.6 30.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE INFLATION GATEWAY ENCORE 26 ADVANTAGE Y 20 ML KIT ADAPTER TORQUE GUIDEWIRE INTRODUCER SUP-270000000 CDM 270 RC outpatient 32.31 31.66 All Payors / Plans All Payors / Plans 32.31 other 32.31 32.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE INFLATION L10 IN 20 ML STERILE LATEX FREE DISPOSABLE ROYAL BLUE ANGIO SUP-270000000 CDM 270 RC outpatient 65.25 63.95 All Payors / Plans All Payors / Plans 65.25 other 65.25 65.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE SECUREMENT STAYFIX SMALL OD5-14 FR DRAIN CATHETER FASTENER FIXATION STERILE LATEX FREE PERCUTANEOUS CATHETER SUP-270000000 CDM 270 RC outpatient 8.93 8.75 All Payors / Plans All Payors / Plans 8.93 other 8.93 8.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE SPECIMEN RETRIEVAL RAPTOR L230 CM OD2.4 MM HYBRID JAW CONFIGURATION FLEXIBLE DISTAL WIRE GRASP STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 224.4 219.91 All Payors / Plans All Payors / Plans 224.4 other 224.4 224.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE SPECIMEN RETRIEVAL TALON STAINLESS STEEL L160CM OD2.5MM 4 PRONG GRASP INWARD FACE ATRAUMATIC HOOK SHEATH LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 132.6 129.95 All Payors / Plans All Payors / Plans 132.6 other 132.6 132.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE SUTURE STRATAFIX PDO 1 CTX L36 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM VIOLET BIDIRECTIONAL SUP-270000000 CDM 270 RC outpatient 31.31 30.68 All Payors / Plans All Payors / Plans 31.31 other 31.31 31.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE SUTURE V-LOC 180 SURGALLOY 3-0 V-20 TAPER POINT L 6IN ABSORBABLE GREEN SUP-270000000 CDM 270 RC outpatient 43.65 42.78 All Payors / Plans All Payors / Plans 43.65 other 43.65 43.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE SUTURING COR-KNOT QUICK LOAD TITANIUM BLUNT CURVE RELOAD WIRE SNARE LEVER STERILE PURPLE WHITE SUP-270000000 CDM 270 RC outpatient 283.5 277.83 All Payors / Plans All Payors / Plans 283.5 other 283.5 283.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE SUTURING ENDO STITCH L15 IN OD10 MM SOFT TISSUE PUSH BUTTON GRIP HANDLE STERILE LATEX FREE DISPOSABLE ENDOSCOPIC SUP-270000000 CDM 270 RC outpatient 441.65 432.82 All Payors / Plans All Payors / Plans 441.65 other 441.65 441.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE THROMBECTOMY EMBOTRAP OD 5MM X L 21MM RADIOPAQUE SUP-270000000 CDM 270 RC outpatient 14490 14200.2 All Payors / Plans All Payors / Plans 14490 other 14490 14490 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE THROMBECTOMY EMBOTRAP OD5MM X L 33MM RADIOPAQUE SUP-270000000 CDM 270 RC outpatient 14490 14200.2 All Payors / Plans All Payors / Plans 14490 other 14490 14490 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE TISSUE REMOVAL AVETA HYSTEROSCOPE PEARL STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 496.6 486.67 All Payors / Plans All Payors / Plans 496.6 other 496.6 496.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE TISSUE REMOVAL AVETA OD2.9 MM RESECT FLEX STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 1950 1911 All Payors / Plans All Payors / Plans 1950 other 1950 1950 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE TISSUE REMOVAL AVETA OD2.9 MM RESECT SMOL STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE TORQUE GLIDECATH .010-.038 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 6.06 5.94 All Payors / Plans All Payors / Plans 6.06 other 6.06 6.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE TORQUE OLCOTT HYDROPHILIC .014-.045 IN 1 HAND GUIDEWIRE STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 20.98 20.56 All Payors / Plans All Payors / Plans 20.98 other 20.98 20.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DEVICE VACUUM EXTRACTION PALMPUMP KIWI OMNICUP NEONATE FLEXIBLE STEM LOW PROFILE CUP TRACTION FORCE INDICATOR SUP-270000000 CDM 270 RC outpatient 61.15 59.93 All Payors / Plans All Payors / Plans 61.15 other 61.15 61.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIFFUSER MAESTRO CORE SUP-270000000 CDM 270 RC outpatient 13.09 12.83 All Payors / Plans All Payors / Plans 13.09 other 13.09 13.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILATOR ENDOSCOPIC CRE L3 CM L75 CM OD10-11-12 MM PULMONARY BALLOON RADIOPAQUE RECTILINEAR SHOULDER STERILE DISPOSABLE ACCEPTS .035 IN JAGWIRE SUP-270000000 CDM 270 RC outpatient 746.19 731.27 All Payors / Plans All Payors / Plans 746.19 other 746.19 746.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILATOR VASCULAR MAC-LOC COONS ULTRATHANE HYDROPHILIC TAPER L20CM OD 16FR PERCUTANEOUS LOCK LOOP STERILE DISPOSABLE ACCEPTS .038IN GUIDEWIRE CECOSTOMY SUP-270000000 CDM 270 RC outpatient 17.67 17.32 All Payors / Plans All Payors / Plans 17.67 other 17.67 17.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILATOR VASCULAR STANDARD JCD CURVE 20CM 5FR DISPOSABLE STERILE RADIOPAQUE ACCEPTS .035IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 18.88 18.5 All Payors / Plans All Payors / Plans 18.88 other 18.88 18.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILATOR VASCULAR STANDARD JCD CURVE 20CM 6FR DISPOSABLE STERILE VESSEL RADIOPAQUE ACCEPTS .038IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 9.17 8.99 All Payors / Plans All Payors / Plans 9.17 other 9.17 9.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DILATOR VASCULAR STANDARD JCD CURVE 20CM 9FR DISPOSABLE STERILE VESSEL RADIOPAQUE ACCEPTS .038IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 18.88 18.5 All Payors / Plans All Payors / Plans 18.88 other 18.88 18.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DIRECT SUCTION TUBING SET-UROLOGY SUP-270000000 CDM 270 RC outpatient 84.77 83.07 All Payors / Plans All Payors / Plans 84.77 other 84.77 84.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DISH PETRI STERILE SUP-270000000 CDM 270 RC outpatient 2.19 2.15 All Payors / Plans All Payors / Plans 2.19 other 2.19 2.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DISP KIT RESECTOSCOPE SUP-270000000 CDM 270 RC outpatient 60.38 59.17 All Payors / Plans All Payors / Plans 60.38 other 60.38 60.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DISSECTOR ENDOSCOPIC COOLCUT CURVE L13 CM OD4 MM SERRATE TOOTH STERILE DISPOSABLE ARTHROSCOPY SUP-270000000 CDM 270 RC outpatient 77.7 76.15 All Payors / Plans All Payors / Plans 77.7 other 77.7 77.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DOPPLER PROBE VTI STERILE 8MHZ SUP-270000000 CDM 270 RC outpatient 468.04 458.68 All Payors / Plans All Payors / Plans 468.04 other 468.04 468.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAIN INCISION AXIOM SILICONE OD9 MM MEDIASTINAL EYE ON TOP NONSTERILE SUP-270009144 CDM 270 RC outpatient 14.3 14.01 All Payors / Plans All Payors / Plans 14.3 other 14.3 14.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAIN INCISION JACKSON-PRATT ROUND 10FR SILICONE DISPOSABLE STERILE LF PERFORATE END WITHOUT TROCAR RADIOPAQUE RESERVOIR SUP-270009031 CDM 270 RC outpatient 9.91 9.71 All Payors / Plans All Payors / Plans 9.91 other 9.91 9.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAIN INCISION JACKSON-PRATT SILICONE OD15 FR ROUND HUBLESS CHANNEL STERILE LATEX FREE DISPOSABLE WHITE SUP-270009031 CDM 270 RC outpatient 9.91 9.71 All Payors / Plans All Payors / Plans 9.91 other 9.91 9.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAIN INCISION JACKSON-PRATT SILICONE ROUND L3/16 IN OD15 FR END PERFORATE WITHOUT TROCAR RADIOPAQUE STERILE LATEX FREE DISPOSABLE SUP-270009031 CDM 270 RC outpatient 9.91 9.71 All Payors / Plans All Payors / Plans 9.91 other 9.91 9.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAIN INCISION JACKSON-PRATT SILICONE ROUND OD19 FR ROUND HUBLESS CHANNEL STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 20.45 20.04 All Payors / Plans All Payors / Plans 20.45 other 20.45 20.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAIN INCISION OASIS PLASTIC DISPOSABLE STERILE LF CHEST COLLECTION TUBE DRY SUCTION CONTROL CHAMBER SUP-270009127 CDM 270 RC outpatient 39.54 38.75 All Payors / Plans All Payors / Plans 39.54 other 39.54 39.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAIN WOUND JACKSON-PRATT SILICONE 3/4 FLUTE OD10 FR ODSEC19 FR ROUND HUBLESS CHANNEL TROCAR SUP-270009031 CDM 270 RC outpatient 9.91 9.71 All Payors / Plans All Payors / Plans 9.91 other 9.91 9.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAIN WOUND JACKSON-PRATT SILICONE FLAT L20 CM X W7 MM FULL PERFORATION WITHOUT TROCAR SUP-270009031 CDM 270 RC outpatient 9.91 9.71 All Payors / Plans All Payors / Plans 9.91 other 9.91 9.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE ARM SUP-270000000 CDM 270 RC outpatient 222.77 218.31 All Payors / Plans All Payors / Plans 222.77 other 222.77 222.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE COLUMN SUP-270000000 CDM 270 RC outpatient 38.56 37.79 All Payors / Plans All Payors / Plans 38.56 other 38.56 38.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE EQUIPMENT C-ARMOR EXPANDABLE COLLAPSIBLE STERILE C ARM FLUOROSCOPE SUP-270000000 CDM 270 RC outpatient 49.04 48.06 All Payors / Plans All Payors / Plans 49.04 other 49.04 49.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE EQUIPMENT PROXIMA SMS L53 IN X W24 IN MAYOSTAND COVER STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 1.31 1.28 All Payors / Plans All Payors / Plans 1.31 other 1.31 1.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE EQUIPMENT SMARTDRAPE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 39.37 38.58 All Payors / Plans All Payors / Plans 39.37 other 39.37 39.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE EQUIPMENT UNIVERSAL L96 IN X W7 IN VIDEO CAMERA TELESCOPIC FOLDED CUFF ADHESIVE CLOSURE STRIP NONSTERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 13.2 12.94 All Payors / Plans All Payors / Plans 13.2 other 13.2 13.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE EQUIPMENT VELYS SATELLITE STATION STERILE SUP-270000000 CDM 270 RC outpatient 49.67 48.68 All Payors / Plans All Payors / Plans 49.67 other 49.67 49.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE EQUIPMENT VELYS STERILE SUP-270000000 CDM 270 RC outpatient 76.04 74.52 All Payors / Plans All Payors / Plans 76.04 other 76.04 76.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE EQUIPMENT ZEISS CLEARLENS STANDARD L120 IN X W46 IN OD65 MM OCULAR COVER LENS PATENT GLARE REDUCE STEREO STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 38.51 37.74 All Payors / Plans All Payors / Plans 38.51 other 38.51 38.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE FAMILY FRIENDLY C-SECTION VIEWING SUP-270000000 CDM 270 RC outpatient 71.65 70.22 All Payors / Plans All Payors / Plans 71.65 other 71.65 71.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE MICRO SUP-270000000 CDM 270 RC outpatient 62.48 61.23 All Payors / Plans All Payors / Plans 62.48 other 62.48 62.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE PROBE ISOSILK STRAIGHT L96 IN X W5 IN FOLD TAPE STRIP GEL STERILE LATEX SUP-270000000 CDM 270 RC outpatient 18.91 18.53 All Payors / Plans All Payors / Plans 18.91 other 18.91 18.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SLUSH STERILE 44 X 66 SUP-270000000 CDM 270 RC outpatient 41.65 40.82 All Payors / Plans All Payors / Plans 41.65 other 41.65 41.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL 3M STERI-DRAPE 23X17IN CLEAR POLYETHYLENE DISPOSABLE STERILE LF ADHESIVE STRIP LG TOWEL MATTE FINISH SUP-270000000 CDM 270 RC outpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL 3M STERI-DRAPE 51X47IN CLEAR POLYETHYLENE DISPOSABLE STERILE LF ADHESIVE U DRAPE SUP-270000000 CDM 270 RC outpatient 3.55 3.48 All Payors / Plans All Payors / Plans 3.55 other 3.55 3.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL 3M STERI-DRAPE IOBAN PLASTIC LARGE L129 IN X W100 IN L27 IN X W12 IN 2 ANTIMICROBIAL INCISE FILM ISOLATION POUCH ADHESIVE STRIP STERILE CLEAR SUP-270000000 CDM 270 RC outpatient 26.41 25.88 All Payors / Plans All Payors / Plans 26.41 other 26.41 26.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL CONTROL PLUS L172 IN X W100 IN BEACH CHAIR ATTACHABLE FLUID COLLECTION POUCH SUCTION PORT STERILE SHOULDER ARTHROSCOPY SUP-270000000 CDM 270 RC outpatient 66.21 64.89 All Payors / Plans All Payors / Plans 66.21 other 66.21 66.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL CONTROL PLUS STANDARD L124 IN X W112 IN W30 IN FLUID COLLECTION POUCH HOOK LOOP TUBE ARMBOARD COVER LOW LINT STERILE LAPAROSCOPY SUP-270000000 CDM 270 RC outpatient 48.92 47.94 All Payors / Plans All Payors / Plans 48.92 other 48.92 48.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL CONVERTORS TIBURON L40 IN X W4 IN HIP REINFORCE EMERALD ADHESIVE STRIP SPLIT SHEET STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 24.81 24.31 All Payors / Plans All Payors / Plans 24.81 other 24.81 24.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL CONVERTORS TIBURON L55.5 IN X W28 IN OD8 IN HIP FENESTRATED ARMBOARD COVER TUBE HOLDER ABSORBENT IMPERVIOUS REINFORCEMENT PAD STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 11.82 11.58 All Payors / Plans All Payors / Plans 11.82 other 11.82 11.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL CONVERTORS TIBURON NEONATE L4 IN W3 IN L60 IN X W44 IN L19 IN X W18 1/2 IN REINFORCE FENESTRATE ABSORBENT ADHESIVE STRIP STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 2.94 2.88 All Payors / Plans All Payors / Plans 2.94 other 2.94 2.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL CONVERTORS TIBURON VELCRO L110 IN X W109 IN X H100 IN L18 IN X W16 IN FLUID CONTROL POUCH FENESTRATION ABSORBENT IMPERVIOUS REINFORCEMENT ARMBOARD COVER STERILE DISPOSABLE LAVH SUP-270000000 CDM 270 RC outpatient 22.01 21.57 All Payors / Plans All Payors / Plans 22.01 other 22.01 22.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL CVARTS CONTROL PLUS SMS L38 IN W84 IN L100 IN X W60 IN L76 IN X W60 IN HEAVY DUTY REINFORCEMENT STERILE LATEX UNIVERSAL SYSTEM SUP-270000000 CDM 270 RC outpatient 72.08 70.64 All Payors / Plans All Payors / Plans 72.08 other 72.08 72.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL PROXIMA SMS 3/4 L77 IN X W53 IN SHEET STERILE LATEX FREE DISPOSABLE BLUE SUP-270000000 CDM 270 RC outpatient 1.48 1.45 All Payors / Plans All Payors / Plans 1.48 other 1.48 1.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL PROXIMA SMS L122 IN X W102 IN X H78 IN ABDOMINAL ABSORBENT REINFORCE FENESTRATE MAJOR STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 13.1 12.84 All Payors / Plans All Payors / Plans 13.1 other 13.1 13.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL PROXIMA SMS L14 IN W4 IN CONTOUR L121 IN X W102 IN X H78 IN L29 IN X W29 IN FENESTRATE ABSORBENT REINFORCE HOOK LOOP CLOSURE STERILE LATEX FREE DISPOSABLE TRANSVERSE LAPAROTOMY SUP-270000000 CDM 270 RC outpatient 4.96 4.86 All Payors / Plans All Payors / Plans 4.96 other 4.96 4.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL PROXIMA SMS L5 IN W5 IN L121 IN X W78 IN L28 IN X W20 IN THYROID DIAMOND FENESTRATE ABSORBENT REINFORCE ADHESIVE CONTACT CLOSURE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 4.28 4.19 All Payors / Plans All Payors / Plans 4.28 other 4.28 4.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL PROXIMA SMS L76 IN X W54 IN L24 IN X W6 IN U DRAPE IMPERVIOUS SPLIT ADHESIVE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 2.31 2.26 All Payors / Plans All Payors / Plans 2.31 other 2.31 2.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL PROXIMA SMS L80 IN X W75 IN PERIGROIN PACK BILATERAL SPLIT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 4.99 4.89 All Payors / Plans All Payors / Plans 4.99 other 4.99 4.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL PROXIMA SMS PEDIATRIC L6 IN W6 IN L121 IN X W102 IN X H78 IN L20 IN X W18 IN FENESTRATE ABSORBENT REINFORCE T DRAPE ARMBOARD COVER STERILE LATEX FREE DISPOSABLE LAPAROTOMY SUP-270000000 CDM 270 RC outpatient 11.5 11.27 All Payors / Plans All Payors / Plans 11.5 other 11.5 11.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL SMS L108 IN X W77 IN L37 IN X W2.5 IN ADHESIVE IMPERVIOUS ULTRA LOW LINT PUNCTURE RESISTANT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 11.2 10.98 All Payors / Plans All Payors / Plans 11.2 other 11.2 11.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL SMS L128 IN X W121 IN X H90 IN EXTREMITY ABSORBENT REINFORCE CIRCULAR FENESTRATE ARMBOARD COVER HOOK LOOP LINE HOLDER STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 14.45 14.16 All Payors / Plans All Payors / Plans 14.45 other 14.45 14.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL SMS L44.5 IN X W40 IN L32 IN X W29 IN UNDER BUTTOCK POUCH BACK STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 2.15 2.11 All Payors / Plans All Payors / Plans 2.15 other 2.15 2.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE SURGICAL SMS T L121 IN X W102 IN X H78 IN L12 IN X W4 IN FENESTRATE ABSORBENT REINFORCE ARMBOARD COVER INSTRUMENT PAD STERILE LATEX FREE DISPOSABLE LAPAROTOMY T DRAPELAPAROTOMY T DRAPE SUP-270000000 CDM 270 RC outpatient 4.97 4.87 All Payors / Plans All Payors / Plans 4.97 other 4.97 4.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE TRANSPARENT 3M IOBAN 2 23X17IN FABRIC STERILE INCISE ANTIMICROBIAL SUP-270000000 CDM 270 RC outpatient 5.86 5.74 All Payors / Plans All Payors / Plans 5.86 other 5.86 5.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE TRANSPARENT 3M IOBAN 2 POLYETHYLENE XL L33 IN X W23 IN 2 ANTIMICROBIAL INCISE FILM IMPREGNATE SUP-270000000 CDM 270 RC outpatient 15.99 15.67 All Payors / Plans All Payors / Plans 15.99 other 15.99 15.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRAPE TRANSPARENT 3M STERI-DRAPE POLYETHYLENE LARGE L23 IN X W17 IN INCISE ADHESIVE FLEXIBLE FILM STERILE LATEX FREE DISPOSABLE CLEAR SUP-270000000 CDM 270 RC outpatient 6.44 6.31 All Payors / Plans All Payors / Plans 6.44 other 6.44 6.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING ADHESIVE KENDALL TELFA 8X4IN POLYESTER COTTON STERILE LF ISLAND ABSORBENT NONADHERENT FILM NONWOVEN SUP-270000000 CDM 270 RC outpatient 1.24 1.22 All Payors / Plans All Payors / Plans 1.24 other 1.24 1.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING FOAM MEPILEX BORDER POLYURETHANE L10 IN X W4 IN SELF ADHERENT SHOWER PROOF BREATHABLE STERILE ASSORTED SUP-270000000 CDM 270 RC outpatient 5.44 5.33 All Payors / Plans All Payors / Plans 5.44 other 5.44 5.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING GERMICIDAL BIOPATCH DISC 1IN 4MM WHITE CHG STERILE LF PERCUTANEOUS ANTIMICROBIAL ADHERENT CENTER HOLE SLIT SUP-481000000 CDM 270 RC outpatient 13.92 13.64 All Payors / Plans All Payors / Plans 13.92 other 13.92 13.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING KIT CENTRAL LINE WITH BIOPATCH AND SORBAVIEW DRESSING - CUSTOM KIT SUP-270000000 CDM 270 RC outpatient 21.46 21.03 All Payors / Plans All Payors / Plans 21.46 other 21.46 21.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING PEEL AND PLACE PREVENA 13CM SUP-270000000 CDM 270 RC outpatient 625.57 613.06 All Payors / Plans All Payors / Plans 625.57 other 625.57 625.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING PETROLATUM XEROFORM 3% BISMUTH TRIBROMOPHENATE GAUZE L8 IN X W1 IN NONADHERENT OCCLUSIVE BACTERIOSTATIC LOW PROFILE STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING PRESSURE SAFEGUARD L24 CM HEMOSTASIS SUP-270000000 CDM 270 RC outpatient 61.2 59.98 All Payors / Plans All Payors / Plans 61.2 other 61.2 61.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING SILVER POST OP MEPILEX 10 X 25 CM (4 X 10 INCH) SUP-270000000 CDM 270 RC outpatient 66.87 65.53 All Payors / Plans All Payors / Plans 66.87 other 66.87 66.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING SILVER POST OP MEPILEX 10 X 30 CM (4 X 12 INCH) SUP-270000000 CDM 270 RC outpatient 76.4 74.87 All Payors / Plans All Payors / Plans 76.4 other 76.4 76.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING TRANSPARENT 3M TEGADERM 8X6IN STERILE LF FRAME STYLE ADHESIVE HYPOALLERGENIC WATERPROOF SUP-270009020 CDM 270 RC outpatient 4.14 4.06 All Payors / Plans All Payors / Plans 4.14 other 4.14 4.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING TRANSPARENT 3M TEGADERM OVAL 4.5X4IN POLYURETHANE STERILE LF ADHESIVE WATERPROOF SUP-270000000 CDM 270 RC outpatient 1.49 1.46 All Payors / Plans All Payors / Plans 1.49 other 1.49 1.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING TRANSPARENT OPSITE HYDROCELLULAR FOAM L25 CM X W10 CM POSTOPERATIVE VISIBLE BACTERIA PROOF ABSORBENT PAD ADHERENT SUP-270000000 CDM 270 RC outpatient 5.32 5.21 All Payors / Plans All Payors / Plans 5.32 other 5.32 5.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING WOUND ABTHERA FOAM OPEN ABDOMEN PAD STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 1014.28 993.99 All Payors / Plans All Payors / Plans 1014.28 other 1014.28 1014.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING WOUND JUMPSTART L8 IN OD1.5 IN ANTIMICROBIAL SUP-270000000 CDM 270 RC outpatient 39.9 39.1 All Payors / Plans All Payors / Plans 39.9 other 39.9 39.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING WOUND MEPILEX BORDER FLEX 3 IN X 3 IN SUP-270000000 CDM 270 RC outpatient 3.8 3.72 All Payors / Plans All Payors / Plans 3.8 other 3.8 3.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING WOUND MEPILEX BORDER FLEX 4 X 4 IN SUP-270000000 CDM 270 RC outpatient 5.18 5.08 All Payors / Plans All Payors / Plans 5.18 other 5.18 5.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING WOUND MEPILEX BORDER POST OP 4 X 12IN SUP-270000000 CDM 270 RC outpatient 12.34 12.09 All Payors / Plans All Payors / Plans 12.34 other 12.34 12.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRESSING WOUND PRIMAPORE ACRYLIC POLYESTER L8 IN X W4 IN ADHESIVE NONWOVEN HIGH ABSORBENT PAD SOFT BREATHABLE COVER SUP-270000000 CDM 270 RC outpatient 1.27 1.24 All Payors / Plans All Payors / Plans 1.27 other 1.27 1.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL BONE 3.0 SUP-270000000 CDM 270 RC outpatient 474.6 465.11 All Payors / Plans All Payors / Plans 474.6 other 474.6 474.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS LARGE LONG OD 3.7MM AO QUICK CONNECTOR STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 680.4 666.79 All Payors / Plans All Payors / Plans 680.4 other 680.4 680.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS LARGE OD 3.7MM AO QUICK CONNECTOR TARGETER STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 880.95 863.33 All Payors / Plans All Payors / Plans 880.95 other 880.95 880.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS MINI OD 2MM AO QUICK CONNECT COUPLING DISPOSABLE SUP-270000000 CDM 270 RC outpatient 154.22 151.14 All Payors / Plans All Payors / Plans 154.22 other 154.22 154.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS OD 1.5MM AO QUICK CONNECT DISPOSABLE SUP-270000000 CDM 270 RC outpatient 154.22 151.14 All Payors / Plans All Payors / Plans 154.22 other 154.22 154.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS OD 2.4MM AO QUICK CONNECT DISPOSABLE SUP-270000000 CDM 270 RC outpatient 124.85 122.35 All Payors / Plans All Payors / Plans 124.85 other 124.85 124.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS SHORT OD 2MM AO QUICK CONNECT DISPOSABLE SUP-270000000 CDM 270 RC outpatient 154.22 151.14 All Payors / Plans All Payors / Plans 154.22 other 154.22 154.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS SMALL LONG OD 2.5MM AO QUICK CONNECT STERILE LATEX FREE REUSABLE SUP-270000000 CDM 270 RC outpatient 131.78 129.14 All Payors / Plans All Payors / Plans 131.78 other 131.78 131.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS SMALL SHORT OD 2MM AO QUICK CONNECT DISPOSABLE SUP-270000000 CDM 270 RC outpatient 162.79 159.53 All Payors / Plans All Payors / Plans 162.79 other 162.79 162.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS SMALL SHORT OD 3.5 MM AO QUICK CONNECT OVER STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 162.79 159.53 All Payors / Plans All Payors / Plans 162.79 other 162.79 162.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOS SMALL SHORT OD2.5MM AO QUICK CONNECT DISPOSABLE SUP-270000000 CDM 270 RC outpatient 79.07 77.49 All Payors / Plans All Payors / Plans 79.07 other 79.07 79.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL EVOSO SHORT OD1.8MM AO QUICK CONNECT DISPOSABLE SUP-270000000 CDM 270 RC outpatient 146.88 143.94 All Payors / Plans All Payors / Plans 146.88 other 146.88 146.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL JET-X MINI OD2 MM RADIUS DISTAL NONSTERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 647.89 634.93 All Payors / Plans All Payors / Plans 647.89 other 647.89 647.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL TRIGEN SHORT L 161MM OD 4MM TROCHANTER FEMUR AO PILOT STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 210 205.8 All Payors / Plans All Payors / Plans 210 other 210 210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility DRILL SURGICAL VLP MINI-MOD SHORT L 122 MM OD 1.8MM - LOG620156 SUP-270000000 CDM 270 RC outpatient 294.84 288.94 All Payors / Plans All Payors / Plans 294.84 other 294.84 294.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EAGLE EYE PTLATINUM ST IVUS CATHETER SUP-270000000 CDM 270 RC outpatient 1522.5 1492.05 All Payors / Plans All Payors / Plans 1522.5 other 1522.5 1522.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EBU 3.0 GUIDE SUP-270000000 CDM 270 RC outpatient 91.35 89.52 All Payors / Plans All Payors / Plans 91.35 other 91.35 91.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EBU 3.75 SUP-270000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE CUTTING 24FR SUP-270000000 CDM 270 RC outpatient 162.11 158.87 All Payors / Plans All Payors / Plans 162.11 other 162.11 162.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE CUTTING 26FR SUP-270000000 CDM 270 RC outpatient 165.42 162.11 All Payors / Plans All Payors / Plans 165.42 other 165.42 165.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE DEFIBRILLATOR MEDI-TRACE CADENCE ADULT MULTIFUNCTION RADIOLUCENT MEDTRONIC PAD SUP-270000000 CDM 270 RC outpatient 15.92 15.6 All Payors / Plans All Payors / Plans 15.92 other 15.92 15.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE DEFIBRILLATOR MEDITRACE CADENCE SILVER CHLORIDE ADULT OVAL L6.25IN X W4.5IN MULTIFUNCTION ADHESIVE RADIOTRANSPARENT CONNECTOR LATEX FREE ZOLL 8900-2100-01/8900-4005 SUP-270000000 CDM 270 RC outpatient 14.58 14.29 All Payors / Plans All Payors / Plans 14.58 other 14.58 14.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE ELECTROSURGICAL ARGON PLUS VALLEYLAB 10FT 1IN DISPOSABLE STERILE LF HANDSET RETRACTABLE BLADE HOLSTER SUP-270000000 CDM 270 RC outpatient 213.83 209.55 All Payors / Plans All Payors / Plans 213.83 other 213.83 213.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE ELECTROSURGICAL ARGONPLUS L11 IN FLEXIBLE LAPAROSCOPIC STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 179.66 176.07 All Payors / Plans All Payors / Plans 179.66 other 179.66 179.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE ELECTROSURGICAL SUREFIT L10 FT 2 DISPERSIVE ADHESIVE BORDER PULL TAB CABLE NONSTERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 2.33 2.28 All Payors / Plans All Payors / Plans 2.33 other 2.33 2.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE ELECTROSURGICAL ULTRACLEAN BLADE 1IN DISPOSABLE STERILE EXTEND INSULATE SUP-270000000 CDM 270 RC outpatient 3.55 3.48 All Payors / Plans All Payors / Plans 3.55 other 3.55 3.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE ELECTROSURGICAL ULTRACLEAN PTFE BLADE 90 D L1 IN L4 IN X W4 IN HEXAGONAL HUB STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 3.09 3.03 All Payors / Plans All Payors / Plans 3.09 other 3.09 3.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE ELECTROSURGICAL UTAHBALL STAINLESS STEEL BALL L11 CM OD5 MM ODSEC3/32 IN Y SHAFT STERILE DISPOSABLE RED LEEP SUP-270000000 CDM 270 RC outpatient 27.37 26.82 All Payors / Plans All Payors / Plans 27.37 other 27.37 27.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE ELECTROSURGICAL UTAHLOOP LETZ SAFE-T-GAUGE STAINLESS STEEL TUNGSTEN PLASTIC ROUND LOOP L12 MM X W20 MM L11 CM OD3/32 IN SHAFT WIRE STERILE DISPOSABLE WHITE SUP-270000000 CDM 270 RC outpatient 32.76 32.1 All Payors / Plans All Payors / Plans 32.76 other 32.76 32.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE ELECTROSURGICAL VAPR 90D 40MM DISPOSABLE STERILE LF SUCTION INTEGRATE HANDPIECE SUP-270000000 CDM 270 RC outpatient 567 555.66 All Payors / Plans All Payors / Plans 567 other 567 567 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE LOOP OD.3 MM ODSEC22 FR CUT DISPOSABLE SUP-270000000 CDM 270 RC outpatient 762.83 747.57 All Payors / Plans All Payors / Plans 762.83 other 762.83 762.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ELECTRODE PATIENT RETURN VALLEYLAB 9FT PVC DISPOSABLE NS LF ADULT CORD NONIRRITATE NONSENSITIZE ADHESIVE STRIP RECQM SUP-270000000 CDM 270 RC outpatient 5.49 5.38 All Payors / Plans All Payors / Plans 5.49 other 5.49 5.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENDOWRIST 12-8MM CANNULA REDUCER SUP-270000000 CDM 270 RC outpatient 44.77 43.87 All Payors / Plans All Payors / Plans 44.77 other 44.77 44.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ENVELOPE ABSORBABLE TYRX LG 3.3X2.9IN POLYARYLATE MINOCYCLINE RIFAMPIN STERILE ICD SUP-270000000 CDM 270 RC outpatient 912.9 894.64 All Payors / Plans All Payors / Plans 912.9 other 912.9 912.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ESYSUIT MEDENVISION SUP-270000000 CDM 270 RC outpatient 132.6 129.95 All Payors / Plans All Payors / Plans 132.6 other 132.6 132.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EV3 AMPLATZ GOOSE NECK SNARE KIT 25MM SUP-481000000 CDM 270 RC outpatient 1303.93 1277.85 All Payors / Plans All Payors / Plans 1303.93 other 1303.93 1303.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EVACUATOR UROLOGY UROVAC BLADDER ADAPTER IRRIGATION LATEX DISPOSABLE SUP-270000000 CDM 270 RC outpatient 51.11 50.09 All Payors / Plans All Payors / Plans 51.11 other 51.11 51.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EVOLUT FX DELIVERY SYSTEM 23-29MM SUP-270000000 CDM 270 RC outpatient 4431 4342.38 All Payors / Plans All Payors / Plans 4431 other 4431 4431 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EVOLUT FX DELIVERY SYSTEM 34MM SUP-270000000 CDM 270 RC outpatient 5275 5169.5 All Payors / Plans All Payors / Plans 5275 other 5275 5275 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EVOLUT FX LOADING SYSTEM 23-29MM SUP-270000000 CDM 270 RC outpatient 819 802.62 All Payors / Plans All Payors / Plans 819 other 819 819 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EVOLUT FX LOADING SYSTEM 34MM SUP-270000000 CDM 270 RC outpatient 975 955.5 All Payors / Plans All Payors / Plans 975 other 975 975 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EVOS LARGE 3.7MM/5.5MM STEP DRILL W AO QC SUP-270000000 CDM 270 RC outpatient 1002.3 982.25 All Payors / Plans All Payors / Plans 1002.3 other 1002.3 1002.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility EXPANDER TISSUE NATRELLE 14CM X 13CM 6CM 500ML SALINE-FILLED SMOOTH BREAST W/SUTURE TAB FOURTE FILL SYSTEM STYLE 133SMVT MRI-UNSAFE MODERATE HEIGHT VARIABLE PROJECTION SUP-270000000 CDM 270 RC outpatient 2835 2778.3 All Payors / Plans All Payors / Plans 2835 other 2835 2835 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FABRIC CARDIOVASCULAR HEMASHIELD 2 VELOUR COLLAGEN THK.76 MM L6 IN X W1 IN KNIT IMPREGNATE STERILE SUP-270000000 CDM 270 RC outpatient 252.08 247.04 All Payors / Plans All Payors / Plans 252.08 other 252.08 252.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FELT CARDIOVASCULAR THK1.65MM 4X4IN PTFE STERILE SUP-270000000 CDM 270 RC outpatient 367.71 360.36 All Payors / Plans All Payors / Plans 367.71 other 367.71 367.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FEMORAL STEM ACTIS COLLARD SIZE 3 SUP-270010025 CDM 270 RC outpatient 3876 3798.48 All Payors / Plans All Payors / Plans 3876 other 3876 3876 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FEMUR ACTIS COLLARD STEM STD SIZE 4 SUP-270010024 CDM 270 RC outpatient 7980 7820.4 All Payors / Plans All Payors / Plans 7980 other 7980 7980 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FIBER LASER FLEXIVA FLEXSHIELD 365 UM HIGH POWER POLISH OUTPUT TIP NONTAPER GUIDE CONNECTOR LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 684.56 670.87 All Payors / Plans All Payors / Plans 684.56 other 684.56 684.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FIBER LASER FLEXIVA TRAC TIP FLEXSHIELD HOLMIUM 200 UM FLEXIBLE CUSTOM GUIDE CONNECTOR LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 1016.15 995.83 All Payors / Plans All Payors / Plans 1016.15 other 1016.15 1016.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FIELDER XT STRAIGHT TIP GUIDEWIRE 190CM SUP-481000000 CDM 270 RC outpatient 273 267.54 All Payors / Plans All Payors / Plans 273 other 273 273 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FILIFORM CATH SUP-270000000 CDM 270 RC outpatient 121.72 119.29 All Payors / Plans All Payors / Plans 121.72 other 121.72 121.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FILLER BONE VOID .5CC DBX ALLOGRAFT PUTTY FREEZE DRIED SUP-270010031 CDM 270 RC outpatient 186.05 182.33 All Payors / Plans All Payors / Plans 186.05 other 186.05 186.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FILLER BONE VOID 1CC DBX ALLOGRAFT PUTTY FREEZE DRIED SUP-270010031 CDM 270 RC outpatient 406.73 398.6 All Payors / Plans All Payors / Plans 406.73 other 406.73 406.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FILTER EMBOLIZATION CELECT NAVALIGN 65CM 49MM 79CM 30MM 7FR PLATINUM HYDROPHILIC DISPOSABLE STERILE VENA CAVA RADIOPAQUE SUP-270000000 CDM 270 RC outpatient 1020 999.6 All Payors / Plans All Payors / Plans 1020 other 1020 1020 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FILTER INSUFFLATION HYDROPHOBIC BULB RECTUM HIGHLY VISIBLE LATEX FREE DISPOSABLE FLEX SIGMOIDOSCOPE SUP-270000000 CDM 270 RC outpatient 33.08 32.42 All Payors / Plans All Payors / Plans 33.08 other 33.08 33.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FILTER MILLEX-GS MIXED CELLULOSE ESTER .22 UM H26 MM OD33 MM 100 ML FEMALE LUER LOCK MALE LUER SLIP STERILE BLUE SUP-270000000 CDM 270 RC outpatient 11.3 11.07 All Payors / Plans All Payors / Plans 11.3 other 11.3 11.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLLOWER URETHRAL PHILLIPS 13.5IN 12FR PLASTIC REUSABLE STERILE LF DILATION CATHETER WOVEN SUP-270000000 CDM 270 RC outpatient 182.82 179.16 All Payors / Plans All Payors / Plans 182.82 other 182.82 182.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLLOWER URETHRAL PHILLIPS 13.5IN 14FR PLASTIC REUSABLE STERILE LF DILATION CATHETER WOVEN SUP-270000000 CDM 270 RC outpatient 100.18 98.18 All Payors / Plans All Payors / Plans 100.18 other 100.18 100.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLLOWER URETHRAL PHILLIPS 13.5IN 16FR PLASTIC REUSABLE STERILE LF DILATION CATHETER WOVEN SUP-270000000 CDM 270 RC outpatient 99.82 97.82 All Payors / Plans All Payors / Plans 99.82 other 99.82 99.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLLOWER URETHRAL PHILLIPS 13.5IN 18FR PLASTIC REUSABLE STERILE LF DILATION CATHETER WOVEN SUP-270000000 CDM 270 RC outpatient 104.07 101.99 All Payors / Plans All Payors / Plans 104.07 other 104.07 104.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLLOWER URETHRAL PHILLIPS 13.5IN 20FR PLASTIC REUSABLE STERILE LF DILATION CATHETER WOVEN SUP-270000000 CDM 270 RC outpatient 182.82 179.16 All Payors / Plans All Payors / Plans 182.82 other 182.82 182.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FOLLOWER URETHRAL PHILLIPS 13.5IN 8FR PLASTIC REUSABLE STERILE LF DILATION CATHETER WOVEN SUP-270000000 CDM 270 RC outpatient 105.59 103.48 All Payors / Plans All Payors / Plans 105.59 other 105.59 105.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS BIOPSY RADIAL JAW 4 2.8 MM LARGE CAPACITY L240 CM OD2.4 MM NEEDLE DISPOSABLE ORANGE SUP-270000000 CDM 270 RC outpatient 19.7 19.31 All Payors / Plans All Payors / Plans 19.7 other 19.7 19.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS BIOPSY RADIAL JAW 4 STAINLESS STEEL STANDARD CAPACITY L100 CM OD1.8 MM PULMONARY PRECISE BITE CONSISTENT SAMPLE RETENTION STREAMLINE CATHETER POSITION MARKER DISPOSABLE SUP-270000000 CDM 270 RC outpatient 57.38 56.23 All Payors / Plans All Payors / Plans 57.38 other 57.38 57.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS BIOPSY SPYBITE MAX L286 CM OD1.2 MM STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 1040.96 1020.14 All Payors / Plans All Payors / Plans 1040.96 other 1040.96 1040.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS BIOPSY SUPERTRAX L110 CM L2 MM OD1.7 MM SHAFT REINFORCED STACKED COIL DESIGN PROPRIETARY SHEATH SMOOTH BILATERAL CUP STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 188.02 184.26 All Payors / Plans All Payors / Plans 188.02 other 188.02 188.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS ENDOSCOPIC RADIAL JAW 4 JUMBO L240 CM OD2.8 MM NEEDLE STERILE DISPOSABLE ORANGE SUP-270000000 CDM 270 RC outpatient 89.3 87.51 All Payors / Plans All Payors / Plans 89.3 other 89.3 89.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS LENS GRIESHABER MAXGRIP OD25+ GA MICRO TEXTURE BROAD GRASP SURFACE BLUNT DISTAL END HEAVY MEMBRANE STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 176.29 172.76 All Payors / Plans All Payors / Plans 176.29 other 176.29 176.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS RADIAL JAW 4 HOT BIOPSY FORCEPS SUP-270000000 CDM 270 RC outpatient 85.12 83.42 All Payors / Plans All Payors / Plans 85.12 other 85.12 85.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS SURGICAL L25 CM END GRASPING TIP POSITIVE SUP-270000000 CDM 270 RC outpatient 325.4 318.89 All Payors / Plans All Payors / Plans 325.4 other 325.4 325.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility FORCEPS SURGICAL SHARKSKIN OD25+ GA ILLUMINATE STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 182.19 178.55 All Payors / Plans All Payors / Plans 182.19 other 182.19 182.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GEL ULTRASOUND AQUASONIC 100 .25 L PH 6.5-6.95 TRANSMISSION AQUEOUS DISPENSER CLEAR BLUE SLIGHT SUP-270000000 CDM 270 RC outpatient 4.2 4.12 All Payors / Plans All Payors / Plans 4.2 other 4.2 4.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GEL ULTRASOUND AQUASONIC 100 STERILE LF 20GM COMPLETE AQUEOUS TRANSMISSION FOIL POUCH SUP-270000000 CDM 270 RC outpatient 1.23 1.21 All Payors / Plans All Payors / Plans 1.23 other 1.23 1.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GENERATOR NEUROSTIMULATOR PROCLAIM ELITE THK1.34 CM 25.5-MA 2-1200HZ 30.4 CU CM L1.95 IN X H2.19 IN 1.7 OZ 5 IMPLANTABLE PULSE TONIC STIMULATION MODE BATTERY SUP-270000000 CDM 270 RC outpatient 27500 26950 All Payors / Plans All Payors / Plans 27500 other 27500 27500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLENOSPHERE 36/24 SUP-270010030 CDM 270 RC outpatient 1710.07 1675.87 All Payors / Plans All Payors / Plans 1710.07 other 1710.07 1710.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIDE LENS THK6 MIL L30 MM X W5 MM L10 MM X W2.6 MM OD2.5 MM OPHTHALMIC PHACO STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 3.3 3.23 All Payors / Plans All Payors / Plans 3.3 other 3.3 3.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIDESHEATH SLENDER 7FR 10 CM DOUBLEWALL SUP-481000000 CDM 270 RC outpatient 127.5 124.95 All Payors / Plans All Payors / Plans 127.5 other 127.5 127.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLIDEWIRE.038 X 150CM SUP-270000000 CDM 270 RC outpatient 29.58 28.99 All Payors / Plans All Payors / Plans 29.58 other 29.58 29.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL 7.5 285X96MM STRAW BIOGEL M NATURAL RUBBER STERILE LATEX POWDER FREE TEXTURE BEAD CUFF NONPYROGENIC SUP-270000000 CDM 270 RC outpatient 1.16 1.14 All Payors / Plans All Payors / Plans 1.16 other 1.16 1.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL 6 285X77MM STRAW NATURAL RUBBER STERILE LATEX POWDER FREE BEAD CUFF MICRO ROUGHENED NON PYROGENIC SUP-270000000 CDM 270 RC outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL 6.5 285X85MM STRAW NATURAL RUBBER STERILE LATEX POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL 7 STRAW NATURAL RUBBER STERILE LATEX POWDER FREE MICRO ROUGHENED BEAD CUFF NONPYROGENIC CURVE SUP-270000000 CDM 270 RC outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL 7.5 298X96MM STRAW NATURAL RUBBER STERILE LATEX POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL 8 299X103MM STRAW NATURAL RUBBER STERILE LATEX POWDER FREE BEAD CUFF MICRO ROUGHENED NON PYROGENIC SUP-270000000 CDM 270 RC outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL 8.5 301X109MM STRAW NATURAL RUBBER STERILE LATEX POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ECLIPSE NATURAL RUBBER 8 L299 MM X W103 MM POWDER FREE MICRO ROUGHEN SURFACE BEAD CUFF NONPYROGENIC STERILE LATEX STRAW CURVE FINGER SUP-270000000 CDM 270 RC outpatient 4.04 3.96 All Payors / Plans All Payors / Plans 4.04 other 4.04 4.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ORTHOPRO 7 298X91MM BROWN POLYISOPRENE STERILE LF POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC outpatient 137.44 134.69 All Payors / Plans All Payors / Plans 137.44 other 137.44 137.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ORTHOPRO POLYISOPRENE 7 1/2 SUP-270000000 CDM 270 RC outpatient 71.51 70.08 All Payors / Plans All Payors / Plans 71.51 other 71.51 71.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ORTHOPRO POLYISOPRENE 8 SUP-270000000 CDM 270 RC outpatient 196.65 192.72 All Payors / Plans All Payors / Plans 196.65 other 196.65 196.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ORTHOPRO POLYISOPRENE 8.5 SUP-270000000 CDM 270 RC outpatient 81.81 80.17 All Payors / Plans All Payors / Plans 81.81 other 81.81 81.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ULTRATOUCH 6 285X77MM STRAW POLYISOPRENE STERILE LF POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC outpatient 1.41 1.38 All Payors / Plans All Payors / Plans 1.41 other 1.41 1.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ULTRATOUCH 6.5 285X85MM STRAW POLYISOPRENE STERILE LF POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC outpatient 1.14 1.12 All Payors / Plans All Payors / Plans 1.14 other 1.14 1.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ULTRATOUCH 7 288X91MM STRAW POLYISOPRENE STERILE LF POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC outpatient 1.14 1.12 All Payors / Plans All Payors / Plans 1.14 other 1.14 1.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ULTRATOUCH 7.5 298X96MM STRAW POLYISOPRENE STERILE LF POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC outpatient 1.39 1.36 All Payors / Plans All Payors / Plans 1.39 other 1.39 1.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL BIOGEL ULTRATOUCH 8 299X103MM STRAW POLYISOPRENE STERILE LF POWDER FREE BEAD CUFF MICRO ROUGHENED NON SUP-270000000 CDM 270 RC outpatient 1.14 1.12 All Payors / Plans All Payors / Plans 1.14 other 1.14 1.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVE SURGICAL PI INDICATOR 8 299X103MM BLUE BIOGEL POLYISOPRENE STERILE LF POWDER FREE SMOOTH BEAD CUFF UNDERGLOVE SUP-270000000 CDM 270 RC outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GLOVER SURGICAL DERMA PRENE ULTRA NEOPRENE POLYURETHANE 8 L11.6 IN CHEMOTHERAPY POWDER FREE SMOOTH BEAD CUFF STERILE LATEX FREE DARK GREEN SUP-270000000 CDM 270 RC outpatient 1.36 1.33 All Payors / Plans All Payors / Plans 1.36 other 1.36 1.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GORE VIABAHN VBX BALLOON EXPANDABLE ENDOPROSTHESIS SUP-270000000 CDM 270 RC outpatient 9156 8972.88 All Payors / Plans All Payors / Plans 9156 other 9156 9156 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GORTEX SUTURE SUP-270000000 CDM 270 RC outpatient 129 126.42 All Payors / Plans All Payors / Plans 129 other 129 129 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GOWN SURGICAL 2XL XLONG 56IN BLUE PREVENTION PLUS DISPOSABLE STERILE LF AAMI LEVEL 4 IMPERVIOUS HOOK LOOP CLOSURE SUP-270000000 CDM 270 RC outpatient 5.08 4.98 All Payors / Plans All Payors / Plans 5.08 other 5.08 5.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GOWN SURGICAL SIRUS SMS POLYETHYLENE 2XL L49 IN AAMI LEVEL 4 IMPERVIOUS SLEEVE REINFORCE HOOK LOOP CLOSURE STERILE LATEX FREE DISPOSABLE BLUE SUP-270000000 CDM 270 RC outpatient 4.08 4 All Payors / Plans All Payors / Plans 4.08 other 4.08 4.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GOWN SURGICAL SIRUS SMS POLYETHYLENE LARGE L43 IN AAMI LEVEL 4 IMPERVIOUS SLEEVE REINFORCE HOOK LOOP CLOSURE STERILE LATEX FREE DISPOSABLE BLUE SUP-270000000 CDM 270 RC outpatient 3.04 2.98 All Payors / Plans All Payors / Plans 3.04 other 3.04 3.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GOWN SURGICAL SIRUS SMS POLYETHYLENE XL L47 IN AAMI LEVEL 4 IMPERVIOUS SLEEVE REINFORCE HOOK LOOP CLOSURE STERILE LATEX FREE DISPOSABLE BLUE SUP-270000000 CDM 270 RC outpatient 3.33 3.26 All Payors / Plans All Payors / Plans 3.33 other 3.33 3.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GOWN SURGICAL SIRUS SMS POLYETHYLENE XL XLONG L56 IN AAMI LEVEL 4 IMPERVIOUS REINFORCE HOOK LOOP CLOSURE STERILE LATEX FREE DISPOSABLE BLUE SUP-270000000 CDM 270 RC outpatient 7.88 7.72 All Payors / Plans All Payors / Plans 7.88 other 7.88 7.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT BONE 1-8MM 5CC CANCELLOUS ALLOGRAFT CHIP CRUSHED PRESERVON SUP-270010031 CDM 270 RC outpatient 266.99 261.65 All Payors / Plans All Payors / Plans 266.99 other 266.99 266.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT BONE CANCELLOUS H1-4 MM 15 ML FREEZE DRIED CHIPS SUP-270010031 CDM 270 RC outpatient 221.18 216.76 All Payors / Plans All Payors / Plans 221.18 other 221.18 221.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT BONE CANCELLOUS H1-4 MM 30 ML FREEZE DRIED CHIPS SUP-270010031 CDM 270 RC outpatient 381.84 374.2 All Payors / Plans All Payors / Plans 381.84 other 381.84 381.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT CARDIOVASCULAR HEMAGARD COLLAGEN POLYESTER STRAIGHT L40 CM X H.49 MM OD22 MM KNIT REVERSE LOCKNIT CROSS LINK EXCELLENT HEAL SUP-270000000 CDM 270 RC outpatient 783.41 767.74 All Payors / Plans All Payors / Plans 783.41 other 783.41 783.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT CARDIOVASCULAR HEMASHIELD PLATINUM 2 VELOUR COLLAGEN STRAIGHT L15 CM OD38 MM THORACIC 2 PASS SEWING WOVEN STERILE SUP-270000000 CDM 270 RC outpatient 905.45 887.34 All Payors / Plans All Payors / Plans 905.45 other 905.45 905.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT CARDIOVASCULAR INTERGARD POLYESTER VELOUR COLLAGEN 2 BRANCH L50 CM ID16 MM IDSEC8 MM THORAX ABDOMEN KNIT REVERSE LOCKNIT SUP-270000000 CDM 270 RC outpatient 1142.84 1119.98 All Payors / Plans All Payors / Plans 1142.84 other 1142.84 1142.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT CARDIOVASCULAR INTERGARD VELOUR COLLAGEN POLYESTER STRAIGHT L15 CM OD30 MM THORACIC AORTA WOVEN EXCLUSIVE WEAVE SUP-270000000 CDM 270 RC outpatient 808.4 792.23 All Payors / Plans All Payors / Plans 808.4 other 808.4 808.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT ENDOVASCULAR EXCLUDER GORE-TEX NITINOL FEP L12 CM OD27 MM SUP-270000000 CDM 270 RC outpatient 12942.8 12683.94 All Payors / Plans All Payors / Plans 12942.8 other 12942.8 12942.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT ENDOVASCULAR GORE EXCLUDER L14 CM OD14.5 MM ID12-13.5 MM CONTRALATERAL LEG AAA ACCEPTS 12 FR SHEATH SUP-270000000 CDM 270 RC outpatient 12942.8 12683.94 All Payors / Plans All Payors / Plans 12942.8 other 12942.8 12942.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT NET SUP-270000000 CDM 270 RC outpatient 654.5 641.41 All Payors / Plans All Payors / Plans 654.5 other 654.5 654.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT SOFT TISSUE ANGIOGRAFT SAPHENOUS VEIN L71-80 CM OD3 MM CRYOPRESERVE SUP-270000000 CDM 270 RC outpatient 15732.68 15418.03 All Payors / Plans All Payors / Plans 15732.68 other 15732.68 15732.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT SOFT TISSUE ARTHROFLEX THK2.5-3.5MM 70X40MM DECELLULARIZED DERMIS ALLOGRAFT SUP-270000000 CDM 270 RC outpatient 7991.32 7831.49 All Payors / Plans All Payors / Plans 7991.32 other 7991.32 7991.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT SOFT TISSUE DURAGEN BOVINE COLLAGEN MATRIX L3 IN X W1 IN CRANIAL DURA PATCH RESORBABLE SUTURABLE STERILE DURAPLASTY SUP-270010012 CDM 270 RC outpatient 1078.46 1056.89 All Payors / Plans All Payors / Plans 1078.46 other 1078.46 1078.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT SOFT TISSUE DURAGEN BOVINE COLLAGEN MATRIX L5 IN X W4 IN CRANIUM RESORBABLE SUTURABLE STERILE DURAPLASTY SUP-270010012 CDM 270 RC outpatient 3384.8 3317.1 All Payors / Plans All Payors / Plans 3384.8 other 3384.8 3384.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT SOFT TISSUE DURAMATRIX L5 IN X W4 IN SUTURABLE SUP-270000000 CDM 270 RC outpatient 2266.7 2221.37 All Payors / Plans All Payors / Plans 2266.7 other 2266.7 2266.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT SOFT TISSUE GEISTLICH BIO-GIDE PORCINE COLLAGEN MEMBRANE L50 MM X W40 MM 2 BLISTER 2 LAYER RESORBABLE STERILE SUP-270000000 CDM 270 RC outpatient 1096.2 1074.28 All Payors / Plans All Payors / Plans 1096.2 other 1096.2 1096.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT SOFT TISSUE STRAVIX PLACENTAL TISSUE L6 CM X W3 CM ALLOGRAFT SUP-270000000 CDM 270 RC outpatient 5613.3 5501.03 All Payors / Plans All Payors / Plans 5613.3 other 5613.3 5613.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT VASCULAR ARTEGRAFT 6MM 40CM WOVEN BOVINE COLLAGEN CAROTID ARTERY F/LOWER EXTREMITY BYPASS SUP-270000000 CDM 270 RC outpatient 4470.9 4381.48 All Payors / Plans All Payors / Plans 4470.9 other 4470.9 4470.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT VASCULAR GORE HEPARIN PROPATEN PTFE THIN WALL L80 CM L60 CM ID7 MM REMOVABLE RING STRETCH SUP-270000000 CDM 270 RC outpatient 4862 4764.76 All Payors / Plans All Payors / Plans 4862 other 4862 4862 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT VASCULAR GORE-TEX STANDARD WALL L40 CM ID6 MM PERIPHERAL STRETCH STERILE SUP-270000000 CDM 270 RC outpatient 1405 1376.9 All Payors / Plans All Payors / Plans 1405 other 1405 1405 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRAFT VASCULAR GORE-TEX STANDARD WALL TAPER L45 CM ID4-7 MM PERIPHERAL STRETCH STERILE SUP-270000000 CDM 270 RC outpatient 1381.8 1354.16 All Payors / Plans All Payors / Plans 1381.8 other 1381.8 1381.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GRIPPER MEDENVISION SUP-270000000 CDM 270 RC outpatient 280.5 274.89 All Payors / Plans All Payors / Plans 280.5 other 280.5 280.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUARDIAN HEMOSTASIS VALVE SUP-481000000 CDM 270 RC outpatient 37.74 36.99 All Payors / Plans All Payors / Plans 37.74 other 37.74 37.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDE CATHETER BOBBY L95 CM 8 F BALLOON GUIDE SUP-270000000 CDM 270 RC outpatient 5040 4939.2 All Payors / Plans All Payors / Plans 5040 other 5040 5040 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDE PIN ORTHOPEDIC BAYONET L 140MM OD 1.3MM STERILE DIPOSABLE 4MM 5MM CANNULATED SCREW SUP-270000000 CDM 270 RC outpatient 57.9 56.74 All Payors / Plans All Payors / Plans 57.9 other 57.9 57.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDE PIN ORTHOPEDIC L300 MM OD 3.2MM THREAD SUP-270000000 CDM 270 RC outpatient 322.37 315.92 All Payors / Plans All Payors / Plans 322.37 other 322.37 322.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDE PIN ORTHOPEDIC TRIGEN META-TAN L 343MM OD 3.2MM SUP-270000000 CDM 270 RC outpatient 210 205.8 All Payors / Plans All Payors / Plans 210 other 210 210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "GUIDE PIN, 3.0MM" SUP-270000000 CDM 270 RC outpatient 2574 2522.52 All Payors / Plans All Payors / Plans 2574 other 2574 2574 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDE ROD ORTHOPEDIC TRIGEN STAINLESS STEEL BALL L 1000MM OD 3MM BALL TIP STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 216.3 211.97 All Payors / Plans All Payors / Plans 216.3 other 216.3 216.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDE WIRE VASCULAR 1.5MM J TIP .035IN DIA 145CM LONG FIXED CORE SUP-270000000 CDM 270 RC outpatient 23.79 23.31 All Payors / Plans All Payors / Plans 23.79 other 23.79 23.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDELINER 5.5F CATHETER SUP-270000000 CDM 270 RC outpatient 835.8 819.08 All Payors / Plans All Payors / Plans 835.8 other 835.8 835.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE - GLIDEWIRE ADVANTAGE .035X260 ANGLED SUP-272C17691 CDM 270 RC outpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE CORONARY EXTRA FLOPPY 300CM SUP-481000000 CDM 270 RC outpatient 272 266.56 All Payors / Plans All Payors / Plans 272 other 272 272 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE CORONARY RUNTHROUGH EXTRA FLOPPY 180 CM SUP-481000000 CDM 270 RC outpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE ENDOSCOPIC ACROBAT 2 HYDROPHILIC L5.8 CM STRAIGHT L450 CM L4 CM OD.035 IN RADIOPAQUE CALIBRATED TIP SUP-270000000 CDM 270 RC outpatient 476.7 467.17 All Payors / Plans All Payors / Plans 476.7 other 476.7 476.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE ENDOSCOPIC HYDRA JAGWIRE PTFE HYDROPHILIC STRAIGHT L450 CM OD.035 IN BILIARY HIGH PERFORMANCE RAPID EXCHANGE RADIOPAQUE DISTAL STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 201.18 197.16 All Payors / Plans All Payors / Plans 201.18 other 201.18 201.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE ENDOSCOPIC JAGWIRE L180 CM OD.035 IN PULMONARY DISPOSABLE SUP-270000000 CDM 270 RC outpatient 286.92 281.18 All Payors / Plans All Payors / Plans 286.92 other 286.92 286.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE ORTHOPEDIC L100 MM OD.8 MM SUP-270000000 CDM 270 RC outpatient 140.4 137.59 All Payors / Plans All Payors / Plans 140.4 other 140.4 140.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE ORTHOPEDIC L150 MM OD1.1 MM SUP-270000000 CDM 270 RC outpatient 267.75 262.4 All Payors / Plans All Payors / Plans 267.75 other 267.75 267.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE ORTHOPEDIC OD.062 IN TROCAR TIP DISPOSABLE SUP-270000000 CDM 270 RC outpatient 31.5 30.87 All Payors / Plans All Payors / Plans 31.5 other 31.5 31.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE STRAIGHT AMPLATZ 180CM -- USE PMM 100541 SUP-270000000 CDM 270 RC outpatient 80.07 78.47 All Payors / Plans All Payors / Plans 80.07 other 80.07 80.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE UROLOGICAL SENSOR NITINOL STAINLESS STEEL HYDROPHILIC PTFE STRAIGHT L150 CM L3 CM OD.035 IN URETERAL FLEXIBLE TIP RADIOPAQUE LATEX FREE SUP-270000000 CDM 270 RC outpatient 89.41 87.62 All Payors / Plans All Payors / Plans 89.41 other 89.41 89.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR 1.5MM ROSEN CURVE J 260CM .035IN SS HEPARIN PTFE HEAVY DUTY MANDRIL FIX CORE EXCHANGE FLEXIBLE TIP SUP-270000000 CDM 270 RC outpatient 37.8 37.04 All Payors / Plans All Payors / Plans 37.8 other 37.8 37.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR AMPLATZ STAINLESS STEEL PTFE 3 MM RADIUS L3 CM CURVE TAPER L180 CM L7 CM OD.035 IN FLOPPY TIP EXTRA STIFF SUPPORT SUP-270000000 CDM 270 RC outpatient 87.95 86.19 All Payors / Plans All Payors / Plans 87.95 other 87.95 87.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR AMPLATZ SUPER STIFF STAINLESS STEEL PTFE 3 MM J L260 CM L7 CM OD.035 IN FLEXIBLE TIP SUP-270000000 CDM 270 RC outpatient 59.5 58.31 All Payors / Plans All Payors / Plans 59.5 other 59.5 59.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR AMPLATZ SUPER STIFF STAINLESS STEEL PTFE L3 MM SHORT FLAT TAPER L180 CM L7 CM OD.035 IN STRAIGHT TIP SUP-270000000 CDM 270 RC outpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR AMPLATZ SUPER STIFF STAINLESS STEEL PTFE SHORT TAPER L260 CM L1 CM OD.035 IN STRAIGHT TIP SUP-270000000 CDM 270 RC outpatient 52.5 51.45 All Payors / Plans All Payors / Plans 52.5 other 52.5 52.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR AMPLATZ SUPER STIFF STAINLESS STEEL PTFE STRAIGHT L260 CM L7 CM OD.035 IN FLEXIBLE TIP SUP-270000000 CDM 270 RC outpatient 73.5 72.03 All Payors / Plans All Payors / Plans 73.5 other 73.5 73.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR AMPLATZ SUPER STIFF STAINLESS STEEL PTFE TAPER L180 CM L7 CM OD.035 IN PERIPHERAL STRAIGHT TIP SUP-270000000 CDM 270 RC outpatient 73.5 72.03 All Payors / Plans All Payors / Plans 73.5 other 73.5 73.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ARISTOTLE L200CM L10 CM RADIOPAQUE OD 0.024 IN 24 GUIDEWIRE SUPPORT PROFILE WIRE HYCROPHILIC COATING L46CM SUP-270000000 CDM 270 RC outpatient 1554 1522.92 All Payors / Plans All Payors / Plans 1554 other 1554 1554 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ARISTOTLE NITINOL HYDROPHILIC L46 CM L35 CM L200 CM L10 CM OD.024 IN SOFT PROFILE RADIOPAQUE FLATTEN CORE TUBE SUP-270000000 CDM 270 RC outpatient 1554 1522.92 All Payors / Plans All Payors / Plans 1554 other 1554 1554 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR BENTSON STANDARD 145CM 6CM .035IN SS HEPARIN PTFE DISPOSABLE STERILE FIX CORE ATRAUMATIC TIP EXTRA SUP-270000000 CDM 270 RC outpatient 33.71 33.04 All Payors / Plans All Payors / Plans 33.71 other 33.71 33.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR BENTSON STANDARD 145CM 6CM .035IN SS PTFE DISPOSABLE STERILE FIX CORE ATRAUMATIC TIP EXTRA FLOPPY SUP-270000000 CDM 270 RC outpatient 28.03 27.47 All Payors / Plans All Payors / Plans 28.03 other 28.03 28.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR COONS STAINLESS STEEL PTFE 3.5 CM STRAIGHT TAPER FLOPPY L180 CM L15 CM OD.035 IN HEAVY DUTY FLEXIBLE TIP INTERVENTIONAL ATRAUMATIC SUP-270000000 CDM 270 RC outpatient 31.61 30.98 All Payors / Plans All Payors / Plans 31.61 other 31.61 31.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR COONS STAINLESS STEEL PTFE 3.5 CM STRAIGHT TAPER FLOPPY L260 CM L15 CM OD.035 IN HEAVY DUTY FLEXIBLE TIP INTERVENTIONAL ATRAUMATIC SUP-270000000 CDM 270 RC outpatient 75.58 74.07 All Payors / Plans All Payors / Plans 75.58 other 75.58 75.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR CORDIS EMERALD 3MM RADIUS J 150CM 7CM .025IN HEPARIN PTFE DISPOSABLE STERILE LF PERCUTANEOUS FLEXIBLE SUP-481000000 CDM 270 RC outpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR CORDIS EMERALD 3MM RADIUS J 260CM 7CM .025IN HEPARIN PTFE DISPOSABLE STERILE LF PERCUTANEOUS FLEXIBLE SUP-481000000 CDM 270 RC outpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR COUGAR XT HYDRO-TRACK J L190 CM OD.014 IN EXTRA SUPPORT SUP-481000000 CDM 270 RC outpatient 134.4 131.71 All Payors / Plans All Payors / Plans 134.4 other 134.4 134.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR COUGAR XT HYDRO-TRACK STRAIGHT L190 CM OD.014 IN EXTRA SUPPORT SUP-481000000 CDM 270 RC outpatient 65.28 63.97 All Payors / Plans All Payors / Plans 65.28 other 65.28 65.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ENROUTE PTFE HYDROPHILIC L5 CM L95 CM L15 CM OD .014 IN RADIOPAQUE SUP-270000000 CDM 270 RC outpatient 219.3 214.91 All Payors / Plans All Payors / Plans 219.3 other 219.3 219.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR FATHOM NITINOL STRAIGHT L200 CM L25 CM OD.016 IN STEERABLE SUP-27000000 CDM 270 RC outpatient 728.28 713.71 All Payors / Plans All Payors / Plans 728.28 other 728.28 728.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR GLIDEWIRE ADVANTAGE PTFE NITINOL HYDROPHILIC ANGLE L180 CM L25 CM OD.035 IN SUP-481000000 CDM 270 RC outpatient 272 266.56 All Payors / Plans All Payors / Plans 272 other 272 272 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR GLIDEWIRE ADVANTAGE PTFE NITINOL HYDROPHILIC ANGLED L260 CM L25 CM OD.035 IN SUP-481000000 CDM 270 RC outpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR GLIDEWIRE ANGLE STANDARD 150CM 3CM .035IN HYDROPHILIC JACKET CORE TO TIP ATRAUMATIC SUP-270000000 CDM 270 RC outpatient 29.58 28.99 All Payors / Plans All Payors / Plans 29.58 other 29.58 29.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR GLIDEWIRE HYDROPHILIC ANGLE L150 CM L3 CM OD.035 IN FLEXIBLE TIP STIFF SHAFT SUP-270000000 CDM 270 RC outpatient 46.05 45.13 All Payors / Plans All Payors / Plans 46.05 other 46.05 46.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR GLIDEWIRE NITINOL TUNGSTEN POLYURETHANE HYDROPHILIC STANDARD STRAIGHT L150 CM L3 CM OD.038 IN RADIOPAQUE FLEXIBLE SHAPEABLE KINK RESISTANCE SUP-270000000 CDM 270 RC outpatient 62.58 61.33 All Payors / Plans All Payors / Plans 62.58 other 62.58 62.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR GLIDEWIRE TUNGSTEN NITINOL POLYURETHANE HYDROPHILIC ANGLE STANDARD L180 CM L3 CM OD.035 IN PERIPHERAL JACKET CORE TO TIP ATRAUMATIC SUP-481000000 CDM 270 RC outpatient 40.49 39.68 All Payors / Plans All Payors / Plans 40.49 other 40.49 40.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR GLIDEWIRE TUNGSTEN NITINOL POLYURETHANE HYDROPHILIC ANGLE STANDARD L260 CM L3 CM OD.035 IN PERIPHERAL JACKET CORE TO TIP ATRAUMATIC SUP-481000000 CDM 270 RC outpatient 75.48 73.97 All Payors / Plans All Payors / Plans 75.48 other 75.48 75.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR HI-TORQUE BALANCE HEAVYWEIGHT J CURVE 190CM 4.5CM .014IN ELASTINITE HYDROPHILIC DISPOSABLE STERILE LF SUP-481000000 CDM 270 RC outpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR HI-TORQUE BALANCE MIDDLEWEIGHT J CURVE 190CM 3CM .014IN ELASTINITE HYDROPHILIC DISPOSABLE STERILE LF SUP-481000000 CDM 270 RC outpatient 168 164.64 All Payors / Plans All Payors / Plans 168 other 168 168 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR HI-TORQUE BALANCE MIDDLEWEIGHT STRAIGHT 190CM 3CM .014IN ELASTINITE HYDROPHILIC DISPOSABLE STERILE LF SUP-481000000 CDM 270 RC outpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR HI-TORQUE PILOT 150 J CURVE 190CM 3CM .014IN DURASTEEL POLYMER HYDROPHILIC DISPOSABLE STERILE LF CORE SUP-481000000 CDM 270 RC outpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR HI-TORQUE PILOT 50 J CURVE 190CM 3CM .014IN DURASTEEL POLYMER HYDROPHILIC DISPOSABLE STERILE LF CORE SUP-481000000 CDM 270 RC outpatient 136 133.28 All Payors / Plans All Payors / Plans 136 other 136 136 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR LUNDERQUIST STRAIGHT 260CM 15CM .035IN SS PTFE LF EXTRA STIFF FLEXIBLE TIP EXCHANGE SUP-270000000 CDM 270 RC outpatient 262.71 257.46 All Payors / Plans All Payors / Plans 262.71 other 262.71 262.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR MICROPUNCTURE NITINOL ANGLE L60 CM OD.018 IN SUP-270000000 CDM 270 RC outpatient 16.7 16.37 All Payors / Plans All Payors / Plans 16.7 other 16.7 16.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR MICROPUNCTURE NITINOL STRAIGHT L80 CM OD.018 IN SUP-270000000 CDM 270 RC outpatient 77.68 76.13 All Payors / Plans All Payors / Plans 77.68 other 77.68 77.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR NITINOL STAINLESS STEEL L215 CM L45 CM OD.014 IN SOFT ACCESS PRESHAPE SUP-270000000 CDM 270 RC outpatient 1264.8 1239.5 All Payors / Plans All Payors / Plans 1264.8 other 1264.8 1264.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR NITREX NITINOL 0 D STRAIGHT L60 CM L5 CM OD.018 IN PERIPHERAL CORONARY ATRAUMATIC RADIOPAQUE INTERMEDIATE TIP KINK RESISTANT SUP-270000000 CDM 270 RC outpatient 125.54 123.03 All Payors / Plans All Payors / Plans 125.54 other 125.54 125.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR OMNIWIRE NITINOL STRAIGHT L185 CM PRESSURE SUP-481000000 CDM 270 RC outpatient 1386 1358.28 All Payors / Plans All Payors / Plans 1386 other 1386 1386 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR PT2 POLYMER HYDROPHILIC L185 CM OD.014 IN MODERATE RAIL SUPPORT INTERMEDIATE J TIP SUP-481000000 CDM 270 RC outpatient 68.13 66.77 All Payors / Plans All Payors / Plans 68.13 other 68.13 68.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR PT2 STAINLESS STEEL NITINOL POLYMER HYDROPHILIC STRAIGHT L185 CM OD.014 IN MODERATE SUPPORT INTERMEDIATE TIP SUP-481000000 CDM 270 RC outpatient 140.27 137.46 All Payors / Plans All Payors / Plans 140.27 other 140.27 140.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR PUSH-PLUS MICROPUNCTURE 40CM 10CM .018IN 5FR SS 1 PART NEEDLE STIFFENED CANNULA COAXIAL CATHETER SUP-270000000 CDM 270 RC outpatient 44.56 43.67 All Payors / Plans All Payors / Plans 44.56 other 44.56 44.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ROADRUNNER HYDROPHILIC NITINOL PLATINUM TAPER L260 CM OD.035 IN RADIOPAQUE FLEXIBLE TIP SUP-270000000 CDM 270 RC outpatient 44.88 43.98 All Payors / Plans All Payors / Plans 44.88 other 44.88 44.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ROADRUNNER PC HYDROPHILIC NITINOL PLATINUM ANGLE TAPER STANDARD L260 CM OD.035 IN RADIOPAQUE STIFF SHAFT SUP-270000000 CDM 270 RC outpatient 67.52 66.17 All Payors / Plans All Payors / Plans 67.52 other 67.52 67.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ROADRUNNER PC NIMBLE NITINOL PLATINUM HYDROPHILIC L145 CM OD.035 IN ANGLE SHORT TAPER FLEXIBLE SHAFT SUP-270000000 CDM 270 RC outpatient 65.43 64.12 All Payors / Plans All Payors / Plans 65.43 other 65.43 65.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ROADRUNNER TAPER FLOPPY ANGLE SPRING COIL 300CM 8.5CM .014IN PLATINUM NITINOL PTFE DISPOSABLE STERILE SUP-270000000 CDM 270 RC outpatient 130.04 127.44 All Payors / Plans All Payors / Plans 130.04 other 130.04 130.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ROSEN J CURVE 180CM 1.5MM .035IN SS PTFE DISPOSABLE STERILE FIX CORE HEAVY DUTY EXCHANGE SUP-270000000 CDM 270 RC outpatient 16.25 15.93 All Payors / Plans All Payors / Plans 16.25 other 16.25 16.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR SAFE-T-J STANDARD CURVE TAPER 145CM 1.5CM .035IN SS PTFE DISPOSABLE STERILE FIX CORE FLEXIBLE TIP SUP-270000000 CDM 270 RC outpatient 27.28 26.73 All Payors / Plans All Payors / Plans 27.28 other 27.28 27.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR SYNCHRO SELECT NITINOL STAINLESS STEEL STANDARD L300 CM L35 CM OD.014 IN EXCHANGE SUP-270000000 CDM 270 RC outpatient 1816.5 1780.17 All Payors / Plans All Payors / Plans 1816.5 other 1816.5 1816.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR SYNCHRO SELECT NITINOL STAINLESS STEEL STRAIGHT L215 CM L35 CM OD.014 IN SOFT ACCESS LENGTH SUP-270000000 CDM 270 RC outpatient 1264.8 1239.5 All Payors / Plans All Payors / Plans 1264.8 other 1264.8 1264.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR SYNCHRO SELECT NITINOL STAINLESS STEEL STRAIGHT L300 CM L35 CM OD.014 IN SOFT EXCHANGE LENGTH SUP-270000000 CDM 270 RC outpatient 1470.5 1441.09 All Payors / Plans All Payors / Plans 1470.5 other 1470.5 1470.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR V-18 CONTROLWIRE SCITANIUM ICE STRAIGHT L110 CM L8 CM OD.018 IN RADIOPAQUE SUP-270000000 CDM 270 RC outpatient 238 233.24 All Payors / Plans All Payors / Plans 238 other 238 238 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR V-18 CONTROLWIRE SCITANIUM ICE TAPER L300 CM L8 CM OD.018 IN PERIPHERAL RADIOPAQUE STRAIGHT TIP SUP-270000000 CDM 270 RC outpatient 294 288.12 All Payors / Plans All Payors / Plans 294 other 294 294 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR VICTORY STAINLESS STEEL PTFE HYDROPHILIC STRAIGHT L300 CM OD.014 IN ODSEC12 GA BROAD MATRIX PUSHABILITY EXCELLENT CROSS ENHANCE TORQUE RADIOPAQUE SUP-270000000 CDM 270 RC outpatient 251.77 246.73 All Payors / Plans All Payors / Plans 251.77 other 251.77 251.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ZIPWIRE HYDROPHILIC L150 CM L3 CM OD.035 IN STANDARD SHAFT TAPER ANGLE TIP SUP-270000000 CDM 270 RC outpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDEWIRE VASCULAR ZIPWIRE NITINOL POLYMER HYDROPHILIC STANDARD STRAIGHT L150 CM L3 CM OD.035 IN SUPER ELASTIC CORE PRECISE TORQUE CONTROL SUPERIOR VISIBILITY SUP-270000000 CDM 270 RC outpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "GUIDEWIRE, PTFE 035 X 180CM FC 3MM J" SUP-481000000 CDM 270 RC outpatient 9.49 9.3 All Payors / Plans All Payors / Plans 9.49 other 9.49 9.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDING LAUNCHER 7F EBU 3.5 SUP-270000000 CDM 270 RC outpatient 72.25 70.81 All Payors / Plans All Payors / Plans 72.25 other 72.25 72.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GUIDING LAUNCHER 7F EBU 4.0 SUP-270000000 CDM 270 RC outpatient 72.25 70.81 All Payors / Plans All Payors / Plans 72.25 other 72.25 72.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility GW VSI TRU-TORQUE WIRE 260CM SUP-481000000 CDM 270 RC outpatient 132.6 129.95 All Payors / Plans All Payors / Plans 132.6 other 132.6 132.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC .9% NACL 500 ML SUP-270002114 CDM 270 RC outpatient 6.4 6.27 All Payors / Plans All Payors / Plans 6.4 other 6.4 6.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC APHERESIS SUPPLIES SUP-27000000 CDM 270 RC outpatient 811.78 795.54 All Payors / Plans All Payors / Plans 811.78 other 811.78 811.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC CARDIAC CATH LAB SUPPLIES SUP-481000000 CDM 270 RC outpatient 35700 34986 All Payors / Plans All Payors / Plans 35700 other 35700 35700 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COVERSITE 4X4 PLUS SUP-270041318 CDM 270 RC outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC COVERSITE PLUS 6X6 SUP-270041323 CDM 270 RC outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DAVINCI PACK SUP-270010034 CDM 270 RC outpatient 280.8 275.18 All Payors / Plans All Payors / Plans 280.8 other 280.8 280.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DENTAL CROWN CHARGE SUP-270009241 CDM 270 RC outpatient 41.24 40.42 All Payors / Plans All Payors / Plans 41.24 other 41.24 41.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC DIALYSIS SUPPLIES SUP-270001000 CDM 270 RC outpatient 102 99.96 All Payors / Plans All Payors / Plans 102 other 102 102 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC ENDOFORM 2X2 FENESTRATED COLLAGEN SUP-270041333 CDM 270 RC outpatient 12.97 12.71 All Payors / Plans All Payors / Plans 12.97 other 12.97 12.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HIP SUPPLIES SUP-270010024 CDM 270 RC outpatient 550 539 All Payors / Plans All Payors / Plans 550 other 550 550 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC HYDROFERA BLUE BACTERIO DRESS 4X4 SUP-270041330 CDM 270 RC outpatient 7.62 7.47 All Payors / Plans All Payors / Plans 7.62 other 7.62 7.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC INSTRUMENT TRAY SUP-270009300 CDM 270 RC outpatient 58 56.84 All Payors / Plans All Payors / Plans 58 other 58 58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC IODOFLEX 5 GRAM SUP-270041319 CDM 270 RC outpatient 5.72 5.61 All Payors / Plans All Payors / Plans 5.72 other 5.72 5.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC KNEE SUPPLIES SUP-270010025 CDM 270 RC outpatient 3264 3198.72 All Payors / Plans All Payors / Plans 3264 other 3264 3264 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC LYOFOAM 3X3.4 SUP-270041374 CDM 270 RC outpatient 2.64 2.59 All Payors / Plans All Payors / Plans 2.64 other 2.64 2.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MED SURG SUPPLIES SUP-270000000 CDM 270 RC outpatient 54.6 53.51 All Payors / Plans All Payors / Plans 54.6 other 54.6 54.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEDIHONEY CALC ALG 4X5 SUP-270041327 CDM 270 RC outpatient 10.19 9.99 All Payors / Plans All Payors / Plans 10.19 other 10.19 10.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEDIHONEY HCS 4.3X4.3 SUP-270041386 CDM 270 RC outpatient 10.62 10.41 All Payors / Plans All Payors / Plans 10.62 other 10.62 10.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEDIHONEY HCS NON-AD 4.3X4.3 SUP-270041328 CDM 270 RC outpatient 10.52 10.31 All Payors / Plans All Payors / Plans 10.52 other 10.52 10.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX 3X3 BORDERED FOAM SUP-270041377 CDM 270 RC outpatient 2.58 2.53 All Payors / Plans All Payors / Plans 2.58 other 2.58 2.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX BORDERED SACRUM SUP-270041379 CDM 270 RC outpatient 7.6 7.45 All Payors / Plans All Payors / Plans 7.6 other 7.6 7.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX TRANSFER 6X8 SUP-270041315 CDM 270 RC outpatient 8.74 8.57 All Payors / Plans All Payors / Plans 8.74 other 8.74 8.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC MEPILEX TRANSFER 8X20 SUP-270041316 CDM 270 RC outpatient 23.8 23.32 All Payors / Plans All Payors / Plans 23.8 other 23.8 23.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC OPTILOCK NON-ADHESIVE 8X12 SUP-270041405 CDM 270 RC outpatient 6.58 6.45 All Payors / Plans All Payors / Plans 6.58 other 6.58 6.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PACEMAKER SUP-275000000 CDM 270 RC outpatient 402.9 394.84 All Payors / Plans All Payors / Plans 402.9 other 402.9 402.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PEDIATRIC DENTAL CHARGE SUP-270009240 CDM 270 RC outpatient 84.8 83.1 All Payors / Plans All Payors / Plans 84.8 other 84.8 84.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PERITONEAL DIALYSIS SUPPLY SUP-270001050 CDM 270 RC outpatient 120 117.6 All Payors / Plans All Payors / Plans 120 other 120 120 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POLYMEM 4X12.5 SUP-270041404 CDM 270 RC outpatient 22.1 21.66 All Payors / Plans All Payors / Plans 22.1 other 22.1 22.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC POLYMEM 4X4 SUP-270041403 CDM 270 RC outpatient 7 6.86 All Payors / Plans All Payors / Plans 7 other 7 7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROFORE BANDAGE COMPRESSION PAD SUP-270041406 CDM 270 RC outpatient 8.8 8.62 All Payors / Plans All Payors / Plans 8.8 other 8.8 8.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROFORE WRAPS SUP-270041320 CDM 270 RC outpatient 13.52 13.25 All Payors / Plans All Payors / Plans 13.52 other 13.52 13.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC PROMOGRAN/PRISMA 4.34 SQ IN SUP-270041384 CDM 270 RC outpatient 9.8 9.6 All Payors / Plans All Payors / Plans 9.8 other 9.8 9.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC SPINAL FUSION FIXATION SUPPLY SUP-270010020 CDM 270 RC outpatient 503.57 493.5 All Payors / Plans All Payors / Plans 503.57 other 503.57 503.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST 3 IN W/1 BOOT REGULAR SUP-270041335 CDM 270 RC outpatient 136.2 133.48 All Payors / Plans All Payors / Plans 136.2 other 136.2 136.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC TCC EZ CAST 3 INCH NO BOOT SUP-270041334 CDM 270 RC outpatient 122.96 120.5 All Payors / Plans All Payors / Plans 122.96 other 122.96 122.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VAGAL NERVE PACKAGE SUP-270010003 CDM 270 RC outpatient 1393.08 1365.22 All Payors / Plans All Payors / Plans 1393.08 other 1393.08 1393.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HC VISCOPASTE SUP-270041322 CDM 270 RC outpatient 6.77 6.63 All Payors / Plans All Payors / Plans 6.77 other 6.77 6.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD43 MM ID26 MM HIP SUP-270010023 CDM 270 RC outpatient 6195.02 6071.12 All Payors / Plans All Payors / Plans 6195.02 other 6195.02 6195.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP SUP-270010024 CDM 270 RC outpatient 950 931 All Payors / Plans All Payors / Plans 950 other 950 950 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP SUP-270010023 CDM 270 RC outpatient 6195.02 6071.12 All Payors / Plans All Payors / Plans 6195.02 other 6195.02 6195.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP SUP-270010023 CDM 270 RC outpatient 6195.02 6071.12 All Payors / Plans All Payors / Plans 6195.02 other 6195.02 6195.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP SUP-270010023 CDM 270 RC outpatient 6195.02 6071.12 All Payors / Plans All Payors / Plans 6195.02 other 6195.02 6195.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP SUP-270010023 CDM 270 RC outpatient 6195.02 6071.12 All Payors / Plans All Payors / Plans 6195.02 other 6195.02 6195.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP SUP-270010023 CDM 270 RC outpatient 1365 1337.7 All Payors / Plans All Payors / Plans 1365 other 1365 1365 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL -4MM OFFSET TAPER 28MM HIP BIOLOX DELTA V40 SUP-270010024 CDM 270 RC outpatient 500 490 All Payors / Plans All Payors / Plans 500 other 500 500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL ARTICUL/EZE +1.5MM 12/14 TAPER 36MM BIOLOX DELTA TITANIUM STERILE LF HIP CEMENTLESS SUP-270010024 CDM 270 RC outpatient 4029 3948.42 All Payors / Plans All Payors / Plans 4029 other 4029 4029 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL ARTICUL/EZE +5MM 12/14 TAPER 32MM BIOLOX DELTA STERILE LF HIP SUP-270010024 CDM 270 RC outpatient 3876 3798.48 All Payors / Plans All Payors / Plans 3876 other 3876 3876 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL ARTICUL/EZE +5MM 12/14 TAPER 36MM BIOLOX DELTA TITANIUM STERILE LF HIP CEMENTLESS SUP-270010024 CDM 270 RC outpatient 3876 3798.48 All Payors / Plans All Payors / Plans 3876 other 3876 3876 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL ARTICUL/EZE +8.5MM 12/14 TAPER 36MM BIOLOX DELTA TITANIUM STERILE LF HIP CEMENTLESS SUP-270010024 CDM 270 RC outpatient 7980 7820.4 All Payors / Plans All Payors / Plans 7980 other 7980 7980 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL BIOLOX DELTA +7.5 MM OD36 MM HIP C TAPER SUP-270010024 CDM 270 RC outpatient 500 490 All Payors / Plans All Payors / Plans 500 other 500 500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL BIOLOX DELTA -3.5 MM 12/14 SMALL OD36 MM HIP ACETABULAR STERILE SUP-270010025 CDM 270 RC outpatient 3876 3798.48 All Payors / Plans All Payors / Plans 3876 other 3876 3876 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL V40 BIOLOX DELTA +2.5 MM OFFSET TAPER OD36 MM HIP SUP-270010024 CDM 270 RC outpatient 7665.06 7511.76 All Payors / Plans All Payors / Plans 7665.06 other 7665.06 7665.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL V40 BIOLOX DELTA 0 MM OFFSET TAPER OD36 MM HIP SUP-270010024 CDM 270 RC outpatient 7665.02 7511.72 All Payors / Plans All Payors / Plans 7665.02 other 7665.02 7665.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD FEMORAL V40 LFIT COCR -4 MM OFFSET TAPER OD28 MM HIP PRIMARY SUP-270010024 CDM 270 RC outpatient 500 490 All Payors / Plans All Payors / Plans 500 other 500 500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD HUMERAL UNIVERS II H18 MM OD46 MM SHOULDER ANATOMIC RESTORATION VARIABLE ADJUSTMENT STERILE SUP-270010030 CDM 270 RC outpatient 5670 5556.6 All Payors / Plans All Payors / Plans 5670 other 5670 5670 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD MARINER POLYAXIAL SUP-270000000 CDM 270 RC outpatient 1836 1799.28 All Payors / Plans All Payors / Plans 1836 other 1836 1836 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEAD MATCH 3.0MM PRECISION NEURO SUP-270000000 CDM 270 RC outpatient 145.96 143.04 All Payors / Plans All Payors / Plans 145.96 other 145.96 145.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEMOSPRAY 7 SUP-270000000 CDM 270 RC outpatient 5250 5145 All Payors / Plans All Payors / Plans 5250 other 5250 5250 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEMOSTAT ABSORBABLE FIBRILLAR SURGICEL L4 IN X W2 IN LIGHTWEIGHT LAYER STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 100.96 98.94 All Payors / Plans All Payors / Plans 100.96 other 100.96 100.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEMOSTAT ABSORBABLE L14 IN X W2 IN SUP-270009023 CDM 270 RC outpatient 21 20.58 All Payors / Plans All Payors / Plans 21 other 21 21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEMOSTAT ABSORBABLE SURGICEL 3X2IN STERILE FLEXIBLE SUP-270009023 CDM 270 RC outpatient 21 20.58 All Payors / Plans All Payors / Plans 21 other 21 21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEMOSTAT ABSORBABLE SURGICEL FIBRILLAR 2X1IN STERILE LIGHTWEIGHT LAYER TUFT SUP-270000000 CDM 270 RC outpatient 92.34 90.49 All Payors / Plans All Payors / Plans 92.34 other 92.34 92.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HEMOSTAT ABSORBABLE SURGICEL L8 IN X W4 IN SHEER WEAVE STERILE DISPOSABLE SUP-270009023 CDM 270 RC outpatient 21 20.58 All Payors / Plans All Payors / Plans 21 other 21 21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HOLDER LIMB QUICK RELEASE 60 INCH STRAP SUP-270009040 CDM 270 RC outpatient 3.42 3.35 All Payors / Plans All Payors / Plans 3.42 other 3.42 3.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HOOD FLYTE SURGICOOL SUP-270000000 CDM 270 RC outpatient 40.4 39.59 All Payors / Plans All Payors / Plans 40.4 other 40.4 40.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HOOD SURGEON FLYTE STERI-SHIELD PEELAWAY FACE SHIELD LATEX FREE PERSONAL PROTECTION SYSTEM SUP-270000000 CDM 270 RC outpatient 84.2 82.52 All Payors / Plans All Payors / Plans 84.2 other 84.2 84.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HOOK RETRACTION 5 MM BLUNT ELASTIC STAY DISPOSABLE SUP-270000000 CDM 270 RC outpatient 28.3 27.73 All Payors / Plans All Payors / Plans 28.3 other 28.3 28.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HOOK RETRACTION LONE STAR 12 MM BLUNT ELASTIC STAY STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 131.87 129.23 All Payors / Plans All Payors / Plans 131.87 other 131.87 131.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HOOK RETRACTION LONE STAR STAINLESS STEEL 5 MM SHARP ELASTIC STAY STERILE LATEX FREE DISPOSABLE INDIVIDUALLY WRAPPED SUP-270000000 CDM 270 RC outpatient 91.43 89.6 All Payors / Plans All Payors / Plans 91.43 other 91.43 91.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HOOK RETRACTOR LONE STAR STAINLESS STEEL 5 MM SHARP ELASTIC STAY STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 990.7 970.89 All Payors / Plans All Payors / Plans 990.7 other 990.7 990.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility HYDROGEN PEROXIDE 4OZ SUP-270000000 CDM 270 RC outpatient 1.24 1.22 All Payors / Plans All Payors / Plans 1.24 other 1.24 1.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ICD COBALT XT MRI DR SURESCAN DEVICE SUP-275000000 CDM 270 RC outpatient 11772 11536.56 All Payors / Plans All Payors / Plans 11772 other 11772 11772 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ICD QUADRA ASSURA MP CRT-D DR4 CONNECTOR SUP-275000000 CDM 270 RC outpatient 18090 17728.2 All Payors / Plans All Payors / Plans 18090 other 18090 18090 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMOBILIZER ORTHOPEDIC ALUMINUM FOAM 26 IN OD 20.5 IN ODSEC 22 IN L KNEE 3 PANEL LOOP LOCK CLOSURE POSTERIOR STAY ADJUSTABLE LATEX FREE SUP-270009016 CDM 270 RC outpatient 32.05 31.41 All Payors / Plans All Payors / Plans 32.05 other 32.05 32.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMOBILIZER ORTHOPEDIC ALUMINUM FOAM NYLON CONTOUR L22 IN OD29 IN KNEE ELASTIC PATELLA STRAP PERFORATE BREATHABLE SUP-270009016 CDM 270 RC outpatient 18.25 17.89 All Payors / Plans All Payors / Plans 18.25 other 18.25 18.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMMOBILIZER ORTHOPEDIC ALUMINUM TRICOT UNIVERSAL L12 IN KNEE POSTERIOR STAY HOOK LOOP CLOSURE 3 PANEL LATEX FREE SUP-270009016 CDM 270 RC outpatient 28.5 27.93 All Payors / Plans All Payors / Plans 28.5 other 28.5 28.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMPELLA CP WITH SMARTASSIST SUP-481000000 CDM 270 RC outpatient 38500 37730 All Payors / Plans All Payors / Plans 38500 other 38500 38500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMPLANT CORNERSTONE L-SR 7X14X11 SUP-270010020 CDM 270 RC outpatient 1995 1955.1 All Payors / Plans All Payors / Plans 1995 other 1995 1995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMPLANT HIP INSIGNIA 5 STEM 105 MM NK 38.5 MM HIGH STEM HIGH OFFSET STERILE SUP-270010024 CDM 270 RC outpatient 1800 1764 All Payors / Plans All Payors / Plans 1800 other 1800 1800 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMPLANT PUTTY OSTEOSTRUX 10CC SUP-270010031 CDM 270 RC outpatient 1424.08 1395.6 All Payors / Plans All Payors / Plans 1424.08 other 1424.08 1424.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IMPLANT STRIP POCKET DBM 20CC SUP-270010031 CDM 270 RC outpatient 3168.61 3105.24 All Payors / Plans All Payors / Plans 3168.61 other 3168.61 3168.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INBONE STEINMANN PIN 2.4MM SUP-270000000 CDM 270 RC outpatient 655.2 642.1 All Payors / Plans All Payors / Plans 655.2 other 655.2 655.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSERT ACETABULAR ADM MOBILE BEARING HIP RESTORATION X3 POLYETHYLENE H9.9 MM OD48 MM ODSEC54 MM ID28 MM HIP SUP-270010024 CDM 270 RC outpatient 775 759.5 All Payors / Plans All Payors / Plans 775 other 775 775 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSERT CLAMP EVERCLIP FOGARTY HYDRAGRIP L33 MM ATRAUMATIC OCCLUSION SOFT COMPLIANT TRACTION GENTLE SURROUND VESSEL SET STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 46.33 45.4 All Payors / Plans All Payors / Plans 46.33 other 46.33 46.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSERT CLAMP EVERCLIP FOGARTY HYDRAGRIP L61 MM ATRAUMATIC OCCLUSION SOFT COMPLIANT TRACTION GENTLE SURROUND VESSEL RUBBER PYRAMID SET STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 39.33 38.54 All Payors / Plans All Payors / Plans 39.33 other 39.33 39.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSERT CLAMP FOGARTY HYDRAGRIP L86 MM SOFTJAW SET ATRAUMATIC OCCLUSION HIGH FLOW STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 3.88 3.8 All Payors / Plans All Payors / Plans 3.88 other 3.88 3.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSERT NEEDLE HOLDER SUTURE RETENTION SLOT DISPOSABLE OCTOBASE RETRACTOR SUP-270000000 CDM 270 RC outpatient 98.6 96.63 All Payors / Plans All Payors / Plans 98.6 other 98.6 98.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSERT TIBIAL ATTUNE 5 H5 MM KNEE RIGHT CRUCIATE RETAIN MEDIAL STABILIZE SUP-270010025 CDM 270 RC outpatient 6720 6585.6 All Payors / Plans All Payors / Plans 6720 other 6720 6720 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSERT TIBIAL GMK 5 H11 MM RIGHT FIXED SPHERE FLEX SUP-270010024 CDM 270 RC outpatient 3366 3298.68 All Payors / Plans All Payors / Plans 3366 other 3366 3366 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSTRUMENT BIOPSY BARD MAX-CORE ANGLE 22MM 20CM 13.8CM 18GA PINK DISPOSABLE STERILE LF PROSTATIC 2 TRIGGER ULTRA SHARP SUP-270000000 CDM 270 RC outpatient 51.46 50.43 All Payors / Plans All Payors / Plans 51.46 other 51.46 51.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSTRUMENT BIOPSY BARD MAX-CORE L16 CM OD14 GA 2 TRIGGER ULTRA SHARP TIP BEVEL TROCAR ANGLE NOTCH STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 570.47 559.06 All Payors / Plans All Payors / Plans 570.47 other 570.47 570.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSTRUMENT ELECTROSURGICAL LIGASURE FORCETRIAD TISSUEFECT 28D 3.4V 14.7MM CURVE 18.8CM 16.5X1-4MM DISPOSABLE STERILE LF SUP-270000000 CDM 270 RC outpatient 1927.54 1888.99 All Payors / Plans All Payors / Plans 1927.54 other 1927.54 1927.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INSTRUMENT ENDOSCOPIC SIGMOID 30CM 6FT 18FR DISPOSABLE STERILE PREATTACH TUBE ON OFF CONTROL SIGMOIDOSCOPY COLONOSCOPY SUP-270000000 CDM 270 RC outpatient 7.46 7.31 All Payors / Plans All Payors / Plans 7.46 other 7.46 7.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTERTAN 10MM X 18CM 130DEG SUP-270000000 CDM 270 RC outpatient 1687.5 1653.75 All Payors / Plans All Payors / Plans 1687.5 other 1687.5 1687.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTERTAN 11.5MM X 18CM 125DEG SUP-270000000 CDM 270 RC outpatient 2835 2778.3 All Payors / Plans All Payors / Plans 2835 other 2835 2835 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTERTAN LAG/COMP KIT 100/95 SUP-270000000 CDM 270 RC outpatient 769.25 753.87 All Payors / Plans All Payors / Plans 769.25 other 769.25 769.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTERTAN LAG/COMP KIT 85/80 SUP-270000000 CDM 270 RC outpatient 1600.04 1568.04 All Payors / Plans All Payors / Plans 1600.04 other 1600.04 1600.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTERTAN LAG/COMP KIT 90/85 SUP-270000000 CDM 270 RC outpatient 1292.34 1266.49 All Payors / Plans All Payors / Plans 1292.34 other 1292.34 1292.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER HEMOSTASIS FAST CATH LUER LOCK GUIDEWIRE AND REPOSITIONING SLEEVE 7 FR 12CM 0.038 IN SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER HEMOSTATSIS FAST CATH LUER LOCK GUIDEWIRE AND REPOSITIONING SLEEVE 8.5 FR 12 CM 0.038 IN SUP-481000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER MICRO STIFFEN 5FR SUP-270000000 CDM 270 RC outpatient 38.18 37.42 All Payors / Plans All Payors / Plans 38.18 other 38.18 38.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH AGILIS NXT DUAL REACH .032 IN LARGE CURL CURVE L50 MM L71 CM OD8.5 FR STEERABLE ERGONOMIC HANDLE ATRAUMATIC TIP INTEGRATE HEMOSTASIS VALVE RADIOPAQUE TIP MARKER SUP-270000000 CDM 270 RC outpatient 1785 1749.3 All Payors / Plans All Payors / Plans 1785 other 1785 1785 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH CHECK-FLO FLEXOR .035 IN L70 CM OD7 FR ID.1 IN ANL0 CURVE STRAIGHT TIP ANSEL MODIFICATION HIGH FLEX DILATOR GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 162.83 159.57 All Payors / Plans All Payors / Plans 162.83 other 162.83 162.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH CHECK-FLO FLEXOR 6 FR 1 CURVE MULTIPURPOSE TIP ANSEL MODIFICATION HIGH FLEX DILATOR GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 110.16 107.96 All Payors / Plans All Payors / Plans 110.16 other 110.16 110.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH CORDIS BRITE TIP 35CM 35MM 6FR GREEN SILICONE DISPOSABLE STERILE LF ENDOVASCULAR KINK RESISTANT SUP-270000000 CDM 270 RC outpatient 21.42 20.99 All Payors / Plans All Payors / Plans 21.42 other 21.42 21.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH CORDIS BRITE TIP 35CM 35MM 7FR ORANGE SILICONE DISPOSABLE STERILE LF ENDOVASCULAR KINK RESISTANT SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH FAST-CATH STRAIGHT J L12 CM OD12 FR INTRACARDIAC LARGE LUMEN HEMOSTASIS VALVE SIDEPORT DILATOR ACCEPTS .038 IN GUIDEWIRE SUP-481000000 CDM 270 RC outpatient 45.9 44.98 All Payors / Plans All Payors / Plans 45.9 other 45.9 45.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH FAST-CATH SWARTZ SR .038 IN J SR0 CURVE L63 CM L145 CM OD8 FR TRANSSEPTAL GUIDE HEMOSTASIS VALVE SIDEPORT DILATOR RADIOPAQUE TIP MARKER SUP-270000000 CDM 270 RC outpatient 181.56 177.93 All Payors / Plans All Payors / Plans 181.56 other 181.56 181.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC L10 CM L2.5 CM OD4 FR PERIPHERAL KINK RESISTANT DESIGN CROSS CUT VALVE SMOOTH TRANSITION DILATOR SUP-270000000 CDM 270 RC outpatient 14.88 14.58 All Payors / Plans All Payors / Plans 14.88 other 14.88 14.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE .035 IN L10 CM L2.5 CM ID8 FR PERIPHERAL DILATOR KINK RESISTANT SUP-270000000 CDM 270 RC outpatient 14.88 14.58 All Payors / Plans All Payors / Plans 14.88 other 14.88 14.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE .035 IN L10 CM L2.5 CM OD6 FR MINI GUIDEWIRE DILATOR SUP-270000000 CDM 270 RC outpatient 18.38 18.01 All Payors / Plans All Payors / Plans 18.38 other 18.38 18.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE .038 IN L10 CM L2.5 CM ID10 FR PERIPHERAL GUIDEWIRE DILATOR KINK RESISTANT SUP-481000000 CDM 270 RC outpatient 8.67 8.5 All Payors / Plans All Payors / Plans 8.67 other 8.67 8.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE .038 IN L10 CM L2.5 CM ID6 FR CORONARY GUIDEWIRE DILATOR KINK RESISTANT SUP-270009215 CDM 270 RC outpatient 8.67 8.5 All Payors / Plans All Payors / Plans 8.67 other 8.67 8.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE .038 IN L10 CM L2.5 CM ID7 FR CORONARY GUIDEWIRE DILATOR KINK RESISTANT SUP-481000000 CDM 270 RC outpatient 8.67 8.5 All Payors / Plans All Payors / Plans 8.67 other 8.67 8.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE .038 IN L10 CM L2.5 CM ID8 FR CORONARY GUIDEWIRE DILATOR KINK RESISTANT SUP-270009215 CDM 270 RC outpatient 8.67 8.5 All Payors / Plans All Payors / Plans 8.67 other 8.67 8.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE .038 IN L10 CM L2.5 CM ID9 FR CORONARY GUIDEWIRE DILATOR KINK RESISTANT SUP-481000000 CDM 270 RC outpatient 8.67 8.5 All Payors / Plans All Payors / Plans 8.67 other 8.67 8.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE L25 CM L2.5 CM ID10 FR PERIPHERAL DILATOR KINK RESISTANT SUP-270000000 CDM 270 RC outpatient 29.16 28.58 All Payors / Plans All Payors / Plans 29.16 other 29.16 29.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE L25 CM L2.5 CM ID6 FR CORONARY DILATOR KINK RESISTANT SUP-270000000 CDM 270 RC outpatient 17.49 17.14 All Payors / Plans All Payors / Plans 17.49 other 17.49 17.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE L25 CM L2.5 CM ID8 FR CORONARY DILATOR KINK RESISTANT SMOOTH TRANSITION SNAP ON SUP-270009215 CDM 270 RC outpatient 36.02 35.3 All Payors / Plans All Payors / Plans 36.02 other 36.02 36.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE HYDROPHILIC PTFE L25 CM L2.5 CM ID9 FR CORONARY DILATOR KINK RESISTANT SUP-270000000 CDM 270 RC outpatient 29.16 28.58 All Payors / Plans All Payors / Plans 29.16 other 29.16 29.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE R/O II L6 CM L2.5 CM ID6 FR DILATOR RADIOPAQUE MARKER SUP-270000000 CDM 270 RC outpatient 39.38 38.59 All Payors / Plans All Payors / Plans 39.38 other 39.38 39.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PINNACLE STAINLESS STEEL HYDROPHILIC PTFE L10 CM L2.5 CM ID5 FR CORONARY DILATOR KINK RESISTANT SMOOTH TRANSITION SNAP ON ACCEPTS .038 IN GUIDEWIRE SUP-481000000 CDM 270 RC outpatient 14.45 14.16 All Payors / Plans All Payors / Plans 14.45 other 14.45 14.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility INTRODUCER SHEATH PRELUDE SNAP L13 CM OD8 FR ROBUST VALVE SPLITTABLE SIDEPORT HUB BLUE SUP-275000000 CDM 270 RC outpatient 178.5 174.93 All Payors / Plans All Payors / Plans 178.5 other 178.5 178.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRRIGATOR ENDOSCOPIC PATHFINDER PLUS BULB L10 IN UROLOGICAL TUBE LUER LOCK STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 83.27 81.6 All Payors / Plans All Payors / Plans 83.27 other 83.27 83.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility IRRIGATOR SUCTION SUP-270000000 CDM 270 RC outpatient 584.5 572.81 All Payors / Plans All Payors / Plans 584.5 other 584.5 584.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility JELLY LUBRICANT E-Z 2 OZ WATER SOLUBLE FLIP TOP TUBE GREASELESS STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 3.52 3.45 All Payors / Plans All Payors / Plans 3.52 other 3.52 3.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT 13.5FR X 16CM MAHURKAR SUP-270000000 CDM 270 RC outpatient 1229.68 1205.09 All Payors / Plans All Payors / Plans 1229.68 other 1229.68 1229.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT 13.5FR X 24CM MAHURKAR SUP-270000000 CDM 270 RC outpatient 155.93 152.81 All Payors / Plans All Payors / Plans 155.93 other 155.93 155.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT ARTERIAL LINE QUICKFLASH POLYURETHANE L1 1/2 IN OD20 GA ODSEC.018 IN RADIAL ARTERY CATHETER RADIOPAQUE SPRING GUIDEWIRE NEEDLE LATEX FREE SUP-270000000 CDM 270 RC outpatient 25.37 24.86 All Payors / Plans All Payors / Plans 25.37 other 25.37 25.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT ARTERIAL PTFE .028 IN 40 CM MINI L6 IN L2.25 IN OD18 GA ODSEC19 GA RADIOPAQUE FEMALE LUER HUB GUIDEWIRE NEEDLE SUP-270009171 CDM 270 RC outpatient 29.86 29.26 All Payors / Plans All Payors / Plans 29.86 other 29.86 29.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT ARTHROSCOPIC FIXATION INTERNALBRACE SWIVELOCK BIOCOMPOSITE STANDARD OD4.75 MM ODSEC3.5 MM RADIOPAQUE SUP-270000000 CDM 270 RC outpatient 3139.5 3076.71 All Payors / Plans All Payors / Plans 3139.5 other 3139.5 3139.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT BONE CEMENT AUTOPLEX VERTAPLEX WITHOUT NEEDLE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 2185.93 2142.21 All Payors / Plans All Payors / Plans 2185.93 other 2185.93 2185.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT BONE CEMENT FEMUR 2 RESTRICTOR PRESSURIZER SPONGE BRUSH 2 CURETTES INSERTER STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 816.9 800.56 All Payors / Plans All Payors / Plans 816.9 other 816.9 816.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT BONE GRAFT OSTEOSET 25ML CALCIUM SULFATE RESORBABLE BEAD SUP-270000000 CDM 270 RC outpatient 2618.75 2566.38 All Payors / Plans All Payors / Plans 2618.75 other 2618.75 2618.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT CATHETER L4.5 IN OD9 FR CENTRAL VENOUS 2 LUMEN SUP-270000000 CDM 270 RC outpatient 182.96 179.3 All Payors / Plans All Payors / Plans 182.96 other 182.96 182.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT CATHETER MAHURKAR ELITE L20 CM OD13.5 FR STRAIGHT EXTENSION SUP-270000000 CDM 270 RC outpatient 55.66 54.55 All Payors / Plans All Payors / Plans 55.66 other 55.66 55.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT CATHETER MAHURKAR POLYURETHANE .038 IN STRAIGHT J L19.5 CM L70 CM OD13.5 FR 1.7 ML 2 LUMEN HIGH FLOW CURVE EXTENSION GUIDEWIRE STERILE HEMODIALYSIS SUP-270000000 CDM 270 RC outpatient 161.42 158.19 All Payors / Plans All Payors / Plans 161.42 other 161.42 161.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT CATHETER PALINDROME L19 CM OD 14.5 FR TWO LUMEN LATEX FREE SUP-270000000 CDM 270 RC outpatient 454.41 445.32 All Payors / Plans All Payors / Plans 454.41 other 454.41 454.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT CATHETER THROMBECTOMY RED 62 REPERFUSION 0.076IN 0.062IN LUMEN 138CM LOW-PROFILE W/PENUMBRA ASPIRATION TUBING SUP-270000000 CDM 270 RC outpatient 5953.5 5834.43 All Payors / Plans All Payors / Plans 5953.5 other 5953.5 5953.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT CATHETER UROMAX ULTRA QUADRA-FOLD ENCORE HYDROPLUS POLYMER L75 CM L4 CM OD5.8 FR ODSEC15 FR URINARY TRACT HIGH PRESSURE KINK RESISTANT SHAFT RADIOPAQUE TAPER DISTAL END LATEX FREE ACCEPTS .038 IN GUIDEWIRE RADIAL DILATATION SUP-270009094 CDM 270 RC outpatient 199.49 195.5 All Payors / Plans All Payors / Plans 199.49 other 199.49 199.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT CATHETER UROMAX ULTRA QUADRA-FOLD ENCORE HYDROPLUS POLYMER L75 CM L4 CM OD5.8 FR ODSEC18 FR URINARY TRACT HIGH PRESSURE KINK RESISTANT SHAFT RADIOPAQUE TAPER DISTAL END LATEX FREE ACCEPTS .038 IN GUIDEWIRE RADIAL DILATATION SUP-270000000 CDM 270 RC outpatient 562.91 551.65 All Payors / Plans All Payors / Plans 562.91 other 562.91 562.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRAINAGE JACKSON-PRATT PVC 1/8 IN ROUND OD10 FR 400 ML 3 SPRING RESERVOIR TROCAR Y CONNECTOR STERILE LATEX FREE DISPOSABLE SUP-270009033 CDM 270 RC outpatient 18.83 18.45 All Payors / Plans All Payors / Plans 18.83 other 18.83 18.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRAINAGE PLEURAGUIDE THORACIC ALL IN ONE CHEST TUBE STERILE LATEX FREE DISPOSABLE SUP-270009127 CDM 270 RC outpatient 206.33 202.2 All Payors / Plans All Payors / Plans 206.33 other 206.33 206.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRAINAGE PLEURX 1000 ML STARTER CATHETER SUP-270000000 CDM 270 RC outpatient 661.5 648.27 All Payors / Plans All Payors / Plans 661.5 other 661.5 661.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRAINAGE PLEURX ALCOHOL PLASTIC GAUZE FOAM L4 IN X W4 IN 1000 ML THORACIC CATHETER VACUUM BOTTLE SELF ADHESIVE DRESSING VALVE CAP STERILE LATEX FREE DISPOSABLE BLUE PLEURAL EFFUSION SUP-270000000 CDM 270 RC outpatient 202.27 198.22 All Payors / Plans All Payors / Plans 202.27 other 202.27 202.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRAINAGE PLEURX POLYESTER OD15.5 FR PLEURAL CATHETER ACTIVE VACCUM TECHNOLOGY PROPRIETARY SAFETY VALVE CUFF STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 1419.6 1391.21 All Payors / Plans All Payors / Plans 1419.6 other 1419.6 1419.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRAINAGE PVC ROUND L12 IN OD1/4 IN 400 ML 3 SPRING EVACUATOR TROCAR Y CONNECTOR TUBE HOLE PATTERN STERILE LATEX FREE DISPOSABLE SUP-270009033 CDM 270 RC outpatient 18.83 18.45 All Payors / Plans All Payors / Plans 18.83 other 18.83 18.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRAPE SPY-PHI DRUG SUP-270000000 CDM 270 RC outpatient 639.32 626.53 All Payors / Plans All Payors / Plans 639.32 other 639.32 639.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRESSING GRANUFOAM SENSAT.R.A.C. V.A.C. POLYURETHANE FOAM THK3.3 CM SMALL STANDARD L10 CM X W7.5 CM 1 ADHESIVE DRAPE PAD HYDROPHOBIC FLEXIBLE DISPOSABLE SUP-270009205 CDM 270 RC outpatient 27.53 26.98 All Payors / Plans All Payors / Plans 27.53 other 27.53 27.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRESSING GRANUFOAM SENSATRAC VAC POLYURETHANE FOAM THK3.3 CM MEDIUM STANDARD L18 CM X W12.5 CM 2 ADHESIVE DRAPE PAD HARD TO REACH FLEXIBLE HYDROPHOBIC SUP-270009207 CDM 270 RC outpatient 34.72 34.03 All Payors / Plans All Payors / Plans 34.72 other 34.72 34.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRESSING GRANUFOAM VAC POLYURETHANE FOAM HYDROPHOBIC THK3.3 CM LARGE STANDARD L26 CM X W15 CM 2 ADHESIVE DRAPE SENSATRAC PAD HARD TO REACH FLEXIBLE BLACK SUP-270009208 CDM 270 RC outpatient 95.78 93.86 All Payors / Plans All Payors / Plans 95.78 other 95.78 95.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRESSING NEGATIVE PRESSURE VACUUM PEEL AND PLACE PREVENA 20CM SUP-270000000 CDM 270 RC outpatient 1070.69 1049.28 All Payors / Plans All Payors / Plans 1070.69 other 1070.69 1070.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT DRESSING WITH VACUUM PEEL AND PLACE PREVENA 13CM SUP-270000000 CDM 270 RC outpatient 866.75 849.42 All Payors / Plans All Payors / Plans 866.75 other 866.75 866.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT ELECTRODE SURFACE ENSITE X SUP-270000000 CDM 270 RC outpatient 1428 1399.44 All Payors / Plans All Payors / Plans 1428 other 1428 1428 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT EXTERNAL DRAINAGE ACCUDRAIN SPECIAL LATEX FREE INS8400 SUP-270009150 CDM 270 RC outpatient 251.78 246.74 All Payors / Plans All Payors / Plans 251.78 other 251.78 251.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT EYE MEROCEL WIPE EYE DRAIN CORNEAL LIGHT SHIELD STERILE SUP-270000000 CDM 270 RC outpatient 8.32 8.15 All Payors / Plans All Payors / Plans 8.32 other 8.32 8.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT FIRST FRACTURE STABILIT SUP-270000000 CDM 270 RC outpatient 5617.5 5505.15 All Payors / Plans All Payors / Plans 5617.5 other 5617.5 5617.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INJECTION RS PENINSULA REGIONAL MEDICAL SUP-270000000 CDM 270 RC outpatient 30.15 29.55 All Payors / Plans All Payors / Plans 30.15 other 30.15 30.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INSERTION FOR IABP SUP-270000000 CDM 270 RC outpatient 331.67 325.04 All Payors / Plans All Payors / Plans 331.67 other 331.67 331.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INTERVENTIONAL ENROUTE TRANSCAROTID NEUROPROTECTION SUP-270000000 CDM 270 RC outpatient 3825 3748.5 All Payors / Plans All Payors / Plans 3825 other 3825 3825 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INTRODUCER AVEIR HYDROPHILIC COATED L 50 CM OD 8.9 MM 25 FR INTRODUCER STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 1260 1234.8 All Payors / Plans All Payors / Plans 1260 other 1260 1260 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INTRODUCER GLIDESHEATH SLENDER .021IN 35MM 10CM 45CM 5FR 21GA SS HYDROPHILIC DISPOSABLE STERILE NEEDLE DILATOR SUP-270000000 CDM 270 RC outpatient 105 102.9 All Payors / Plans All Payors / Plans 105 other 105 105 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INTRODUCER GLIDESHEATH SLENDER .021IN 35MM 10CM 45CM 6FR 21GA SS HYDROPHILIC DISPOSABLE STERILE NEEDLE DILATOR SUP-270000000 CDM 270 RC outpatient 62.5 61.25 All Payors / Plans All Payors / Plans 62.5 other 62.5 62.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INTRODUCER SAFESHEATH II L13CM OD 9 FR PEEL AWAY SUP-481000000 CDM 270 RC outpatient 165.75 162.44 All Payors / Plans All Payors / Plans 165.75 other 165.75 165.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INTRODUCER SAFESHEATH II LONG L23CM L 28.5CM OD 9 FR VASCULAR SIDEPORT TEAR AWAY DILATOR HEMOSTATIC VALVE ORANGE SUP-275000000 CDM 270 RC outpatient 383.25 375.59 All Payors / Plans All Payors / Plans 383.25 other 383.25 383.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT INTRODUCER SILK ROAD .018 IN L50 CM L15 CM OD 4 FR MICROWIRE EXTENSION TUBE NEEDLE STIFF DILATOR SUP-270000000 CDM 270 RC outpatient 204 199.92 All Payors / Plans All Payors / Plans 204 other 204 204 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT IV CHLORAPREP TEGADERM L2 IN X W2 IN .67 ML IV START STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 1.16 1.14 All Payors / Plans All Payors / Plans 1.16 other 1.16 1.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT LEFT HEART SUP-481000000 CDM 270 RC outpatient 43.3 42.43 All Payors / Plans All Payors / Plans 43.3 other 43.3 43.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT LIVER ACCESS BIOPSY SUP-270000000 CDM 270 RC outpatient 1568.7 1537.33 All Payors / Plans All Payors / Plans 1568.7 other 1568.7 1568.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT MICROINTRODUCER STAINLESS STEEL SILICONE NITINOL .018 IN REGULAR TAPER L40 CM L7 CM OD5 FR ODSEC21 GA DILATOR SMOOTH NEEDLE SOFT TIP WIRE MANDREL SUP-481000000 CDM 270 RC outpatient 36.66 35.93 All Payors / Plans All Payors / Plans 36.66 other 36.66 36.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT NEEDLE GUIDE CIV FLEX SONOSITE OD21 GA COVER BAND GEL STERILE TEAL L25 SUP-270000000 CDM 270 RC outpatient 48.3 47.33 All Payors / Plans All Payors / Plans 48.3 other 48.3 48.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PEG ENDOVIVE SAFETYGLIDE CHLORAPREP XYLOCAINE SILICONE 11 L1 1/2 IN OD20 FR ODSEC22 GA PUSH METHOD AMPULE 2 EXTERNAL BOLSTER SPRING LOAD BLADE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 227.49 222.94 All Payors / Plans All Payors / Plans 227.49 other 227.49 227.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PEG ENDOVIVE SILICONE STANDARD UNIVERSAL OD20 FR 5 ML PULL FENESTRATE DRAPE CLAMP STERILE DISPOSABLE ENTERAL ACCESS DEVICE SUP-270000000 CDM 270 RC outpatient 146.6 143.67 All Payors / Plans All Payors / Plans 146.6 other 146.6 146.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PERICARDIOCENTESIS PIGTAIL CURVE L40 CM OD8 FR CATHETER SUP-481000000 CDM 270 RC outpatient 197.2 193.26 All Payors / Plans All Payors / Plans 197.2 other 197.2 197.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PILLCAM SENSOR BELT 2 DISPOSABLE SUP-270000000 CDM 270 RC outpatient 31.62 30.99 All Payors / Plans All Payors / Plans 31.62 other 31.62 31.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT POSITIONING COBAN S SHOULDER STABILIZATION ARM DRAPE HOOK SUSPENSION STERILE LATEX FREE DISPOSABLE ARTHROSCOPY SUP-270000000 CDM 270 RC outpatient 195.97 192.05 All Payors / Plans All Payors / Plans 195.97 other 195.97 195.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT POSITIONING JACKSON L7 IN PILLOW COVER ARM CRADLE 4 HIP THIGH PAD COVER JACKSON TABLE SUP-270000000 CDM 270 RC outpatient 27.17 26.63 All Payors / Plans All Payors / Plans 27.17 other 27.17 27.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT POSITIONING PROAXIS PRONEVIEW SUP-270000000 CDM 270 RC outpatient 72.38 70.93 All Payors / Plans All Payors / Plans 72.38 other 72.38 72.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT POSITIONING TRIMANO BEACH CHAIR ARM HOLDER DRAPE LIGHTWEIGHT DISPOSABLE SUP-270000000 CDM 270 RC outpatient 76.5 74.97 All Payors / Plans All Payors / Plans 76.5 other 76.5 76.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT POSITIONING WILSON L7 IN PATIENT CARE FRAME SUP-270000000 CDM 270 RC outpatient 22.92 22.46 All Payors / Plans All Payors / Plans 22.92 other 22.92 22.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PREP QUIK USE FEMORAL BONE CEMENT SUP-270000000 CDM 270 RC outpatient 151.01 147.99 All Payors / Plans All Payors / Plans 151.01 other 151.01 151.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PRESSURE MONITOR TRUWAVE L60 IN L12 IN 3 WAY STOPCOCK TRANSDUCER FLUSH DEVICE MACRODRIP TUBE STERILE DISPOSABLE MODEL PX600F SUP-270009140 CDM 270 RC outpatient 13.5 13.23 All Payors / Plans All Payors / Plans 13.5 other 13.5 13.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PROCEDURE EDGE 180 D LOCATABLE GUIDE FIRM TIP EXTEND WORK CHANNEL CATHETER SUP-270000000 CDM 270 RC outpatient 3271.8 3206.36 All Payors / Plans All Payors / Plans 3271.8 other 3271.8 3271.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PROCEDURE EDGE 90D LOCATABLE GUIDE FIRM TIP EXTEND WORK CHANNEL CATHETER SUP-270000000 CDM 270 RC outpatient 3271.8 3206.36 All Payors / Plans All Payors / Plans 3271.8 other 3271.8 3271.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT PULSED LAVAGE PULSAVAC PLUS FAN SPRAY TIP RETAIN MECHANISM ROCKER SWITCH TEXTURE PISTOL GRIP HANDLE SUP-270000000 CDM 270 RC outpatient 30.91 30.29 All Payors / Plans All Payors / Plans 30.91 other 30.91 30.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT RIGHT HEART SUP-481000000 CDM 270 RC outpatient 40.57 39.76 All Payors / Plans All Payors / Plans 40.57 other 40.57 40.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT SCREW INTERTAN L 95MM L 90MM OD 11.5 ODSEC 7MM TROCHANTERIC LAG COMPRESSION INTEGRATE INTERLOCK SUP-270000000 CDM 270 RC outpatient 1292.34 1266.49 All Payors / Plans All Payors / Plans 1292.34 other 1292.34 1292.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT SUCTION AXS UNIVERSAL LINER NONSTERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 58.1 56.94 All Payors / Plans All Payors / Plans 58.1 other 58.1 58.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT SUTURE COR-KNOT MINI STERILE COMBO SUP-270000000 CDM 270 RC outpatient 1606.5 1574.37 All Payors / Plans All Payors / Plans 1606.5 other 1606.5 1606.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT SUTURE HEART IN-HOUSE CUSTOM SUP-270000000 CDM 270 RC outpatient 131.05 128.43 All Payors / Plans All Payors / Plans 131.05 other 131.05 131.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT SUTURE VALVE IN-HOUSE CUSTOM SUP-270000000 CDM 270 RC outpatient 194.27 190.38 All Payors / Plans All Payors / Plans 194.27 other 194.27 194.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT SYRINGE ORISE INTERJECT OD23 GA 10 ML 1 PACK GEL PREFILL PREDYE CLEAR SUP-270000000 CDM 270 RC outpatient 216.24 211.92 All Payors / Plans All Payors / Plans 216.24 other 216.24 216.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT THORACENTESIS ARROW-CLARKE PLEURA-SEAL SHARPSAWAY II CHLORAPREP HI-LITE ORANGE POLYURETHANE L7 1/2 IN L1 1/2 IN OD8 FR ODSEC18 GA 5 ML 3 WAY STOPCOCK NEEDLE CATHETER SELF SEAL VALVE LUER LOCK SYRINGE STERILE LATEX SUP-270009223 CDM 270 RC outpatient 129.2 126.62 All Payors / Plans All Payors / Plans 129.2 other 129.2 129.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT THROMBECTOMY POWER PULSE ANGIOJET ULTRA CONSOLE SUP-270000000 CDM 270 RC outpatient 75.14 73.64 All Payors / Plans All Payors / Plans 75.14 other 75.14 75.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT TRANSSEPTAL NRG RADIOFREQUENCY PTW-25-230 SUP-481000000 CDM 270 RC outpatient 1827 1790.46 All Payors / Plans All Payors / Plans 1827 other 1827 1827 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT VESSEL HARVESTING VASOVIEW HEMOPRO 2 ENDOSCOPIC SUP-270000000 CDM 270 RC outpatient 1071 1049.58 All Payors / Plans All Payors / Plans 1071 other 1071 1071 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KIT VITRECTOMY PERFLUORON PERFLUORO-N-OCTANE 7 ML PROCEDURAL LIQUID PURIFY LATEX FREE SUP-270000000 CDM 270 RC outpatient 1183.67 1160 All Payors / Plans All Payors / Plans 1183.67 other 1183.67 1183.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KNIFE CRESCENT SUP-270000000 CDM 270 RC outpatient 23.1 22.64 All Payors / Plans All Payors / Plans 23.1 other 23.1 23.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KNIFE OPHTHALMIC ALCON A-OK 15 D STANDARD W1.52 MM BLADE FULL HANDLE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 14.22 13.94 All Payors / Plans All Payors / Plans 14.22 other 14.22 14.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KNIFE OPHTHALMIC A-OK 30 D W1.85 MM FULL HANDLE ANGLE BLADE STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 14.22 13.94 All Payors / Plans All Payors / Plans 14.22 other 14.22 14.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KNIFE OPHTHALMIC BD EDGEAHEAD STRAIGHT W1.1 MM OD20 GA MVR SIDEPORT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 66.42 65.09 All Payors / Plans All Payors / Plans 66.42 other 66.42 66.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KNIFE OPHTHALMIC CLEARCUT ANGLE FULL W1 MM 2 BEVEL SIDEPORT SATIN FINISH STERILE LATEX DISPOSABLE FLUORESCENT PINK SUP-270000000 CDM 270 RC outpatient 34.15 33.47 All Payors / Plans All Payors / Plans 34.15 other 34.15 34.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility KNIFE OPHTHALMIC CLEARCUT SATINSLIT ANGLE W3.2 MM SLIT STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 71.06 69.64 All Payors / Plans All Payors / Plans 71.06 other 71.06 71.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility K-WIRE1.4MMX228MM SUP-270000000 CDM 270 RC outpatient 62.4 61.15 All Payors / Plans All Payors / Plans 62.4 other 62.4 62.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LANGSTON 6F 145 PIGTAIL DIAGNOSTIC CATHETER SUP-481000000 CDM 270 RC outpatient 267.92 262.56 All Payors / Plans All Payors / Plans 267.92 other 267.92 267.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LAUNCHER 7 F GUIDING CATHETER 3.75 SUP-270000000 CDM 270 RC outpatient 72.25 70.81 All Payors / Plans All Payors / Plans 72.25 other 72.25 72.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD 0672 ICD RELIANCE 4-FRONT SINGLE COIL SUP-275000000 CDM 270 RC outpatient 6537.3 6406.55 All Payors / Plans All Payors / Plans 6537.3 other 6537.3 6537.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD ATTAIN SUP-275000000 CDM 270 RC outpatient 2060.4 2019.19 All Payors / Plans All Payors / Plans 2060.4 other 2060.4 2060.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD INGEVITY PLUS PACING 52CM SUP-275000000 CDM 270 RC outpatient 680 666.4 All Payors / Plans All Payors / Plans 680 other 680 680 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD NEUROSTIMULATOR VNS THERAPY PERENNIAFLEX 2MM STERILE LF MODEL 304 SUP-270010003 CDM 270 RC outpatient 22212.71 21768.46 All Payors / Plans All Payors / Plans 22212.71 other 22212.71 22212.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING ATTAIN STARFIX LEFT VENTRICLE SUP-275000000 CDM 270 RC outpatient 1734 1699.32 All Payors / Plans All Payors / Plans 1734 other 1734 1734 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING CAPSUREFIX NOVUS STEROID ELUTING PLATINUM SILICONE 10 MM SPACE SMALL STRAIGHT L45 CM L20-110 CM OD6.2 FR ODSEC2 MM ATRIUM VENTRICLE BIPOLAR SCREW IN IMPLANTABLE ACTIVE FIXATION SUP-275000000 CDM 270 RC outpatient 402.9 394.84 All Payors / Plans All Payors / Plans 402.9 other 402.9 402.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING CAPSUREFIX NOVUS STEROID ELUTING PLATINUM SILICONE 10 MM SPACE SMALL STRAIGHT L52 CM L20-110 CM OD6.2 FR ODSEC2 MM ATRIUM VENTRICLE BIPOLAR SCREW IN IMPLANTABLE ACTIVE FIXATION SUP-275000000 CDM 270 RC outpatient 402.9 394.84 All Payors / Plans All Payors / Plans 402.9 other 402.9 402.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING CAPSUREFIX NOVUS STEROID ELUTING PLATINUM SILICONE 10 MM SPACE SMALL STRAIGHT L58 CM L20-110 CM OD6.2 FR ODSEC2 MM ATRIUM VENTRICLE BIPOLAR SCREW IN IMPLANTABLE ACTIVE FIXATION SUP-275000000 CDM 270 RC outpatient 829.5 812.91 All Payors / Plans All Payors / Plans 829.5 other 829.5 829.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING DURATA SJ4 STEROID ELUTING SILICONE 11 MM SPACING L58 CM OD6.8 FR ENDOCARDIUM 1 COIL SUP-275000000 CDM 270 RC outpatient 4495 4405.1 All Payors / Plans All Payors / Plans 4495 other 4495 4495 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING QUARTET OPTIM LOW PROFILE S CURVE NARROW L86 CM X H16 MM OD5 FR LEFT HEART 4 ELECTRODE IS-4 CONNECTOR SUP-275000000 CDM 270 RC outpatient 1860 1822.8 All Payors / Plans All Payors / Plans 1860 other 1860 1860 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING SELECTSECURE L69 CM ATRIUM VENTRICLE BIPOLAR FIXED SCREW IN CATHETER DELIVER SUP-275000000 CDM 270 RC outpatient 829.5 812.91 All Payors / Plans All Payors / Plans 829.5 other 829.5 829.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING SILICONE L53 CM OD6.6 FR MYOCARDIUM UNIPOLAR FIXED SCREW IS-1 SUP-275000000 CDM 270 RC outpatient 840 823.2 All Payors / Plans All Payors / Plans 840 other 840 840 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING SPRINT QUATTRO SECURE DEXAMETHASONE SODIUM PHOSPHATE STEROID ELUTING L62 CM SUP-275000000 CDM 270 RC outpatient 3169.14 3105.76 All Payors / Plans All Payors / Plans 3169.14 other 3169.14 3169.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING STREAMLINE L3 MM OD.48 MM ATRIUM UNIPOLAR TEMPORARY PURPLE SUP-270000000 CDM 270 RC outpatient 67.16 65.82 All Payors / Plans All Payors / Plans 67.16 other 67.16 67.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING TENDRIL MRI L58 CM SUP-275000000 CDM 270 RC outpatient 630 617.4 All Payors / Plans All Payors / Plans 630 other 630 630 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING TENDRIL STS STEROID ELUTING SILICONE HELIX L46 CM OD6 FR ENDOCARDIUM IS-1 CONNECTOR SUP-275000000 CDM 270 RC outpatient 480.5 470.89 All Payors / Plans All Payors / Plans 480.5 other 480.5 480.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD PACING TENDRIL STS STEROID ELUTING SILICONE HELIX L52 CM OD6 FR ENDOCARDIUM IS-1 CONNECTOR SUP-275000000 CDM 270 RC outpatient 510 499.8 All Payors / Plans All Payors / Plans 510 other 510 510 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEAD TENDRIL MRI 52CM SUP-275000000 CDM 270 RC outpatient 630 617.4 All Payors / Plans All Payors / Plans 630 other 630 630 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LEGGINGS SURGICAL PROXIMA SMS L48 IN X W31 IN L6 IN CUFF STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 3.71 3.64 All Payors / Plans All Payors / Plans 3.71 other 3.71 3.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LENS INTRAOCULAR AKRESO AO 17.5 DIOIPTER POSTERIOR CHAMBER SUP-270000000 CDM 270 RC outpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LENS INTRAOCULAR AKRESO AO 18.5 DIOIPTER POSTERIOR CHAMBER SUP-270000000 CDM 270 RC outpatient 273 267.54 All Payors / Plans All Payors / Plans 273 other 273 273 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIGATOR 18IN ENDOLOOP MONOFILAMENT TIES LOOP SUTURE ENDOSCOPIC PDS II 12 LF VIOLET SUP-270000000 CDM 270 RC outpatient 87.12 85.38 All Payors / Plans All Payors / Plans 87.12 other 87.12 87.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIGATOR ENDOSCOPIC ENDOLOOP 12 18IN VIOLET PDS II LF MONOFILAMENT TIE LOOP SUTURE SUP-270009006 CDM 270 RC outpatient 12.49 12.24 All Payors / Plans All Payors / Plans 12.49 other 12.49 12.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIGATOR ENDOSCOPIC SPEEDBAND SUPERVIEW SUPER 7 2.8 MM L2.8 MM OD8.6-11.5 MM ESOPHAGEAL 1 STRING MULTIPLE BAND ERGONOMIC HANDLE AUDIBLE CLICK STERILE LATEX FREE DISPOSABLE HEMOSTASIS SUP-270000000 CDM 270 RC outpatient 272.07 266.63 All Payors / Plans All Payors / Plans 272.07 other 272.07 272.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LIGHT RETRACTOR WAVEGUIDE WIDE FLAT FIBER OPTIC STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 419.02 410.64 All Payors / Plans All Payors / Plans 419.02 other 419.02 419.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINER ACETABULAR MDM COCR G OD48 MM HIP 28 MM FEMORAL HEAD SUP-270010024 CDM 270 RC outpatient 775 759.5 All Payors / Plans All Payors / Plans 775 other 775 775 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINER ACETABULAR PINNACLE NEUTRAL 52MM 36MM ALTRX STERILE LF HIP SUP-270010024 CDM 270 RC outpatient 6715 6580.7 All Payors / Plans All Payors / Plans 6715 other 6715 6715 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINER GLOVE BIOGEL INDICATOR NATURAL RUBBER 6 1/2 L285 MM X W85 MM POWDER FREE BEAD CUFF SMOOTH SURFACE NONPYROGENIC STERILE LATEX GREEN CURVE FINGER SUP-270000000 CDM 270 RC outpatient 1.49 1.46 All Payors / Plans All Payors / Plans 1.49 other 1.49 1.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINER GLOVE BIOGEL INDICATOR NATURAL RUBBER 7 L288 MM X W91 MM POWDER FREE BEAD CUFF SMOOTH SURFACE NONPYROGENIC STERILE LATEX GREEN CURVE FINGER SUP-270000000 CDM 270 RC outpatient 1.36 1.33 All Payors / Plans All Payors / Plans 1.36 other 1.36 1.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINER GLOVE BIOGEL INDICATOR NATURAL RUBBER 8 1/2 L301 MM X W109 MM POWDER FREE SMOOTH BEAD CUFF NONPYROGENIC STERILE LATEX DISPOSABLE GREEN CURVE SUP-270000000 CDM 270 RC outpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LINER GLOVE BIOGEL INDICATOR NATURAL RUBBER 8 L299 MM X W103 MM POWDER FREE BEAD CUFF SMOOTH SURFACE NONPYROGENIC STERILE LATEX GREEN CURVE FINGER SUP-270000000 CDM 270 RC outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility LOOP VESSEL RETRACT-O-TAPE STAINLESS STEEL SILICONE MAXI ROUND L12 IN OD18 GA VASCULAR AIR CUSHION CURVE BLUNT TIP THIN WALL NEEDLE LATEX FREE WHITE SUP-270000000 CDM 270 RC outpatient 18.9 18.52 All Payors / Plans All Payors / Plans 18.9 other 18.9 18.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAHURKAR 20CM SUP-270000000 CDM 270 RC outpatient 185.63 181.92 All Payors / Plans All Payors / Plans 185.63 other 185.63 185.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANIFOLD SUCTION NEPTUNE 2 4 PORT SPECIMEN COLLECTION SUP-270000000 CDM 270 RC outpatient 45.31 44.4 All Payors / Plans All Payors / Plans 45.31 other 45.31 45.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANIFOLD SUCTION NEPTUNE 2 STANDARD 1 PORT WASTE MANAGEMENT SYSTEM SUP-270000000 CDM 270 RC outpatient 14.18 13.9 All Payors / Plans All Payors / Plans 14.18 other 14.18 14.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANIPULATOR ENDOSCOPIC HUMI UTERINE ADJUSTABLE SUP-270000000 CDM 270 RC outpatient 49.44 48.45 All Payors / Plans All Payors / Plans 49.44 other 49.44 49.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANIPULATOR ENDOSCOPIC VCARE DX CURVE UTERINE GRADUATED SHAFT LUER CHANNEL LOCK SCREW LAPAROSCOPIC HYSTERECTOMY SUP-270000000 CDM 270 RC outpatient 129.15 126.57 All Payors / Plans All Payors / Plans 129.15 other 129.15 129.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MANIPULATOR ENDOSCOPIC VCARE SM 32MM DISPOSABLE STERILE LF CERVIX UTERUS 2 CUP LOCK SCREW HOLE INFLATE BALLOON SUP-270000000 CDM 270 RC outpatient 149.52 146.53 All Payors / Plans All Payors / Plans 149.52 other 149.52 149.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAPPING CATHETER WITH TRUEREF TECHNOLOGY D-F SUP-270000000 CDM 270 RC outpatient 5355 5247.9 All Payors / Plans All Payors / Plans 5355 other 5355 5355 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MARKER ENDOSCOPIC SPOT STERILE 5 ML GI TRACT SYRINGE PREFILL SUP-270000000 CDM 270 RC outpatient 79.8 78.2 All Payors / Plans All Payors / Plans 79.8 other 79.8 79.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MARKER SURGICAL DEVON GENTIAN VIOLET DISPOSABLE STERILE LF SKIN 2 TIP RULER CAP LABEL NONTOXIC SUP-270000000 CDM 270 RC outpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MASK O2/CO2 CAPNOMASK ADULT TRANSPARENT GAS SAMPLING LINE DEHP PVC FREE LATEX FREE SUP-270000000 CDM 270 RC outpatient 5.5 5.39 All Payors / Plans All Payors / Plans 5.5 other 5.5 5.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MASK OXYGEN POM ADULT MALE TO MALE MEDIUM CONCENTRATION CO2 MONITOR NONSTERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 8.33 8.16 All Payors / Plans All Payors / Plans 8.33 other 8.33 8.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MASK OXYGEN POM ELITE MSA ADULT HIGH CONCENTRATION CO2 MONITOR LATEX FREE MICROSTREAM SUP-270000000 CDM 270 RC outpatient 13.8 13.52 All Payors / Plans All Payors / Plans 13.8 other 13.8 13.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MAT OPERATING ROOM SURGISAFE L40 IN X W28 IN HIGH ABSORBENT FLUID BARRIER BACKING NONSTERILE LATEX FREE GREEN SUP-270000000 CDM 270 RC outpatient 9.26 9.07 All Payors / Plans All Payors / Plans 9.26 other 9.26 9.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MATRIX TISSUE ALLODERM SELECT THK.4-1.6 MM MEDIUM CONTOUR L19.3 CM X W9.6 CM ALLOGRAFT REGENERATIVE PERFORATE SUP-270000000 CDM 270 RC outpatient 5051.04 4950.02 All Payors / Plans All Payors / Plans 5051.04 other 5051.04 5051.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MATTRESS TRANSFER HOVERMATT W34 IN BREATHABLE NONSTERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 143.85 140.97 All Payors / Plans All Payors / Plans 143.85 other 143.85 143.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH BARD PERFIX BARD POLYPROPYLENE EXTRA LARGE L1.6 IN X W 2 IN PLUG MONOFILAMENT STERILE PREPERITONEAL REPAIR 3D KNITTED TRIMMABLE SUP-270000000 CDM 270 RC outpatient 349.86 342.86 All Payors / Plans All Payors / Plans 349.86 other 349.86 349.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH BARD PERFIX BARD POLYPROPYLENE LARGE L1.6 IN X W 1.9 IN PLUG MONOFILAMENT STERILE PREPERITONEAL REPAIR SUP-270000000 CDM 270 RC outpatient 141.88 139.04 All Payors / Plans All Payors / Plans 141.88 other 141.88 141.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH BARD PERFIX BARD POLYPROPYLENE MEDIUM L1.55 IN X W 1.3 IN PLUG MONOFILAMENT STERILE PREPERITONEAL REPAIR SUP-270000000 CDM 270 RC outpatient 287.91 282.15 All Payors / Plans All Payors / Plans 287.91 other 287.91 287.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH BARD PERFIX BARD POLYPROPYLENE SMALL L1 IN X W 1.35 IN PLUG MONOFILAMENT STERILE PREPERITONEAL REPAIR SUP-270000000 CDM 270 RC outpatient 282.24 276.6 All Payors / Plans All Payors / Plans 282.24 other 282.24 282.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH CRANIAL LORENZ L85 MM X W53 MM X H.6 MM NEURO PANEL 1.5 MM SCREW SUP-270000000 CDM 270 RC outpatient 2547.3 2496.35 All Payors / Plans All Payors / Plans 2547.3 other 2547.3 2547.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH GYNECARE Y SUP-270000000 CDM 270 RC outpatient 1868.52 1831.15 All Payors / Plans All Payors / Plans 1868.52 other 1868.52 1868.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH HERNIA OVITEX POLYGLYCOLIC ACID THK 1.1MM 6MM L 10CM X W 6CM RESORBABLE GRID 1 SMOOTH SIDE VISCERA CONTACT SUP-270000000 CDM 270 RC outpatient 2041.2 2000.38 All Payors / Plans All Payors / Plans 2041.2 other 2041.2 2041.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL 3DMAX POLYPROPYLENE XL 3D CURVE L7 IN X W5 IN GROIN LEFT CONTOUR SEAL EDGE STERILE LAPAROSCOPIC INGUINAL HERNIA REPAIR SUP-270000000 CDM 270 RC outpatient 432.18 423.54 All Payors / Plans All Payors / Plans 432.18 other 432.18 432.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL 3DMAX POLYPROPYLENE XL 3D CURVE L7 IN X W5 IN GROIN RIGHT CONTOUR SEAL EDGE STERILE LAPAROSCOPIC INGUINAL HERNIA REPAIR SUP-270000000 CDM 270 RC outpatient 432.18 423.54 All Payors / Plans All Payors / Plans 432.18 other 432.18 432.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL ABSORBABLE PATCH 1.7 IN DIAMETER SUP-270000000 CDM 270 RC outpatient 829.92 813.32 All Payors / Plans All Payors / Plans 829.92 other 829.92 829.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL ABSORBABLE PATCH 2.5 IN DIAMETER SUP-270000000 CDM 270 RC outpatient 1004.64 984.55 All Payors / Plans All Payors / Plans 1004.64 other 1004.64 1004.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL BARD 3DMAX LG 3D CURVE CONTOUR 6X4IN POLYPROPYLENE STERILE GROIN LEFT SEAL EDGE LAPAROSCOPIC INGUINAL SUP-270000000 CDM 270 RC outpatient 360.15 352.95 All Payors / Plans All Payors / Plans 360.15 other 360.15 360.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL BARD 3DMAX LG 3D CURVE CONTOUR 6X4IN POLYPROPYLENE STERILE GROIN RIGHT SEAL EDGE LAPAROSCOPIC INGUINAL SUP-270000000 CDM 270 RC outpatient 360.15 352.95 All Payors / Plans All Payors / Plans 360.15 other 360.15 360.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL BARD 3DMAX MED 3D CURVE CONTOUR 5X3IN POLYPROPYLENE STERILE GROIN LEFT SEAL EDGE LAPAROSCOPIC INGUINAL SUP-270000000 CDM 270 RC outpatient 329.28 322.69 All Payors / Plans All Payors / Plans 329.28 other 329.28 329.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL BARD 3DMAX MED 3D CURVE CONTOUR 5X3IN POLYPROPYLENE STERILE GROIN RIGHT SEAL EDGE LAPAROSCOPIC INGUINAL SUP-270000000 CDM 270 RC outpatient 329.28 322.69 All Payors / Plans All Payors / Plans 329.28 other 329.28 329.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL BARD POLYPROPYLENE L14IN X W10 IN GROIN MONOFILAMENT VENTRAL INGUINAL HERNIA REPAIR SUP-270000000 CDM 270 RC outpatient 388.5 380.73 All Payors / Plans All Payors / Plans 388.5 other 388.5 388.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL BARD POLYPROPYLENE L6IN X W3 IN GROIN MONOFILAMENT VENTRAL INGUINAL HERNIA REPAIR SUP-270000000 CDM 270 RC outpatient 64.43 63.14 All Payors / Plans All Payors / Plans 64.43 other 64.43 64.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL BARD POLYPROPYLENE L6IN X W6 IN GROIN MONOFILAMENT VENTRAL INGUINAL HERNIA REPAIR SUP-270000000 CDM 270 RC outpatient 187 183.26 All Payors / Plans All Payors / Plans 187 other 187 187 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL GORE BIO-A SYNTHETIC L10 CM X W7 CM TISSUE REINFORCEMENT HIATAL HERNIA REPAIR SUP-270000000 CDM 270 RC outpatient 1071 1049.58 All Payors / Plans All Payors / Plans 1071 other 1071 1071 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL GORE SYNECOR RECTANGLE L30 CM X W20 CM PREPERITONEAL KNIT WEB SUP-270000000 CDM 270 RC outpatient 9420.6 9232.19 All Payors / Plans All Payors / Plans 9420.6 other 9420.6 9420.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL PHASIX POLY-4-HYDROXYBUTYRATE RECTANGLE L4 IN X W3 IN MONOFILAMENT SCAFFOLD RESORBABLE HERNIA REPAIR INTRAABDOMINAL PLACEMENT SUP-270000000 CDM 270 RC outpatient 1707.89 1673.73 All Payors / Plans All Payors / Plans 1707.89 other 1707.89 1707.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE ELLIPSE L10IN X W 8IN MONOFILAMENT LOW PROFILE MEDIUM WEIGHT UNCOATED STERILE LATEX FREE LAPROSCOPIC VENTRAL HERNIA REPAIR SUP-270000000 CDM 270 RC outpatient 2245.36 2200.45 All Payors / Plans All Payors / Plans 2245.36 other 2245.36 2245.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE ELLIPSE L6IN X W 4IN MONOFILAMENT LOW PROFILE MEDIUM WEIGHT UNCOATED STERILE LATEX FREE LAPROSCOPIC VENTRAL HERNIA REPAIR SUP-270000000 CDM 270 RC outpatient 408.58 400.41 All Payors / Plans All Payors / Plans 408.58 other 408.58 408.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE ELLIPSE L8IN X W 6IN MONOFILAMENT LOW PROFILE MEDIUM WEIGHT UNCOATED STERILE LATEX FREE LAPROSCOPIC VENTRAL HERNIA REPAIR SUP-270000000 CDM 270 RC outpatient 2188.42 2144.65 All Payors / Plans All Payors / Plans 2188.42 other 2188.42 2188.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICROCATHETER CEREBROVASCULAR MAMBA FLEX L 135CM STERILE LATEX FREE DISPOSABLE SUP-481000000 CDM 270 RC outpatient 926.5 907.97 All Payors / Plans All Payors / Plans 926.5 other 926.5 926.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICROCATHETER VASCULAR EXCELSIOR SL-10 2.4/1.7FR P/D 0.0165IN ID 150CM 45DEG PRESHAPED 6CM NON-BRAIDED LOW-PROFILE 2-TIP MARKER HYDROLENE 0.014/0.038IN GW SUP-270000000 CDM 270 RC outpatient 1997.5 1957.55 All Payors / Plans All Payors / Plans 1997.5 other 1997.5 1997.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICROCATHETER XT27 X 150 SUP-270000000 CDM 270 RC outpatient 2193 2149.14 All Payors / Plans All Payors / Plans 2193 other 2193 2193 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICRODOSE INJECTION KIT SUP-270000000 CDM 270 RC outpatient 52.5 51.45 All Payors / Plans All Payors / Plans 52.5 other 52.5 52.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MICROSAGITTAL BLADE SUP-270000000 CDM 270 RC outpatient 27.38 26.83 All Payors / Plans All Payors / Plans 27.38 other 27.38 27.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MIDAS REX MR8 SUP-270000000 CDM 270 RC outpatient 186.35 182.62 All Payors / Plans All Payors / Plans 186.35 other 186.35 186.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "MIS ARTHRODESUS CARTILAGE BURR, SHAPE: CYL SS 4MM, L:16MM" SUP-270000000 CDM 270 RC outpatient 2210 2165.8 All Payors / Plans All Payors / Plans 2210 other 2210 2210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility MODULAR POST 25MM SUP-270010030 CDM 270 RC outpatient 10403.4 10195.33 All Payors / Plans All Payors / Plans 10403.4 other 10403.4 10403.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL FEMORAL RETRO 10 X 36 SUP-270000000 CDM 270 RC outpatient 2710.68 2656.47 All Payors / Plans All Payors / Plans 2710.68 other 2710.68 2710.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY INTERTAN 125 D L 40 CM OD 10MM LEFT TROCHANTER SUP-270000000 CDM 270 RC outpatient 3832.5 3755.85 All Payors / Plans All Payors / Plans 3832.5 other 3832.5 3832.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY INTERTAN 130 D L 38 CM OD 10 MM LEFT TROCHANTER SUP-270000000 CDM 270 RC outpatient 3832.5 3755.85 All Payors / Plans All Payors / Plans 3832.5 other 3832.5 3832.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY INTERTAN 130 D L 40 CM OD 10 MM RIGHT TROCHANTER SUP-270000000 CDM 270 RC outpatient 3832.5 3755.85 All Payors / Plans All Payors / Plans 3832.5 other 3832.5 3832.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY TITANIUM 12-14 YR L440 MM OD4 MM DIAPHYSIS METAPHYSIS EPIPHYSIS ELASTIC SYMMETRICAL BRACING ACTION NONSTERILE PURPLE SUP-270010022 CDM 270 RC outpatient 1966.9 1927.56 All Payors / Plans All Payors / Plans 1966.9 other 1966.9 1966.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY TITANIUM 6-8 YR L440 MM OD3 MM DIAPHYSIS METAPHYSIS EPIPHYSIS ELASTIC SYMMETRICAL BRACING ACTION NONSTERILE GOLD SUP-270010022 CDM 270 RC outpatient 2795.31 2739.4 All Payors / Plans All Payors / Plans 2795.31 other 2795.31 2795.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY TITANIUM 9-11 YR L440 MM OD3.5 MM DIAPHYSIS METAPHYSIS EPIPHYSIS ELASTIC SYMMETRICAL BRACING ACTION NONSTERILE BLUE SUP-270010022 CDM 270 RC outpatient 1836.51 1799.78 All Payors / Plans All Payors / Plans 1836.51 other 1836.51 1836.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY TITANIUM PEDIATRIC L440 MM OD2 MM DIAPHYSIS METAPHYSIS EPIPHYSIS ELASTIC SYMMETRICAL BRACING ACTION NONSTERILE GREEN SUP-270010022 CDM 270 RC outpatient 1991.21 1951.39 All Payors / Plans All Payors / Plans 1991.21 other 1991.21 1991.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY TRIGEN META-NAIL TITANIUM L 32 CM OD 10 MM FEMORAL RETROGRADE GOLD SUP-270000000 CDM 270 RC outpatient 2710.68 2656.47 All Payors / Plans All Payors / Plans 2710.68 other 2710.68 2710.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAIL INTRAMEDULLARY TRIGEN META-NAIL TITANIUM L 38 CM OD 13 MM FEMORAL RETROGRADE GOLD SUP-270000000 CDM 270 RC outpatient 3227 3162.46 All Payors / Plans All Payors / Plans 3227 other 3227 3227 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NARROW SAW BLADE SS SUP-270000000 CDM 270 RC outpatient 369.2 361.82 All Payors / Plans All Payors / Plans 369.2 other 369.2 369.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAVILYST .035 J-TIP GUIDEWIRE 260CM SUP-481000000 CDM 270 RC outpatient 16.54 16.21 All Payors / Plans All Payors / Plans 16.54 other 16.54 16.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NAVILYST .035 STRAIGHT TIP GUIDEWIRE 260CM SUP-481000000 CDM 270 RC outpatient 11.81 11.57 All Payors / Plans All Payors / Plans 11.81 other 11.81 11.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE ASPIRATION 22GA 0-8CML F/ENDOSCOPIC ULTRASOUND ACQUIRE LATEX-FREE NON-RADIOLUCENT SUP-270000000 CDM 270 RC outpatient 437.46 428.71 All Payors / Plans All Payors / Plans 437.46 other 437.46 437.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE ASPIRATION ARCPOINT METAL L137 MM OD21 GA ODSEC1.9 MM PULMONARY BRAID TAPER SHEATH SHORT RIGID LENGTH 2 MM CHANNEL SUP-270000000 CDM 270 RC outpatient 388.96 381.18 All Payors / Plans All Payors / Plans 388.96 other 388.96 388.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE ASPIRATION EXPECT SLIMLINE 8- CM 137.5-141.5CM 22GA 1.83MM 20CC COCR ECHOGENIC PATTERN ULTRASOUND STYLET CAP 2.4 SUP-270000000 CDM 270 RC outpatient 519.54 509.15 All Payors / Plans All Payors / Plans 519.54 other 519.54 519.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE ASPIRATION L40 MM L700 MM OD22 GA ODSEC1.8 MM ECHOGENIC DIMPLE FLEXIBLE PRESTERILIZE SAFE RELIABLE STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 93.2 91.34 All Payors / Plans All Payors / Plans 93.2 other 93.2 93.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE ASPIRATION VIZISHOT L70 CM L40 MM OD21 GA ID1.9 MM ECHOGENIC DIMPLED TIP DESIGN MAXIMUM EXTRUDING STROKE STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 190.79 186.97 All Payors / Plans All Payors / Plans 190.79 other 190.79 190.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE BIOPSY CHIBA L 15CM OD 22GA ASPIRATION STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 24.13 23.65 All Payors / Plans All Payors / Plans 24.13 other 24.13 24.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE BIOPSY JAMSHIDI 4IN 11GA DISPOSABLE STERILE LF BONE MARROW TAPER DISTAL ADAPTER SHARP BEVEL TIP SUP-270000000 CDM 270 RC outpatient 15.31 15 All Payors / Plans All Payors / Plans 15.31 other 15.31 15.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE BIOPSY SUPERDIMENSION SHORT L130 MM L2 MM OD21 GA ODSEC1.8 MM PREMARK ASPIRATE CATHETER SUP-270000000 CDM 270 RC outpatient 322.56 316.11 All Payors / Plans All Payors / Plans 322.56 other 322.56 322.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE BIOPSY TRU-CUT THIN WALL L4 1/2 IN OD14 GA DEPTH MARK REMOVABLE STYLET SCALPEL SHARP EDGE STANDARD HANDLE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 145.75 142.84 All Payors / Plans All Payors / Plans 145.75 other 145.75 145.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE BONE CEMENT AVAFLEX CURVE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 1040.89 1020.07 All Payors / Plans All Payors / Plans 1040.89 other 1040.89 1040.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE DISPOSABLE BIOPSY BRAINLAB 1.8MM SUP-270000000 CDM 270 RC outpatient 987 967.26 All Payors / Plans All Payors / Plans 987 other 987 987 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE EPIDURAL PERIFIX TUOHY BISPHENOL A L3 1/2 IN OD18 GA WING HUB PVC FREE DEHP FREE LATEX FREE CLEAR SUP-270000000 CDM 270 RC outpatient 6.12 6 All Payors / Plans All Payors / Plans 6.12 other 6.12 6.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE EPIDURAL PERIFIX TUOHY BISPHENOL A L3 1/2 IN OD20 GA WING HUB PVC FREE DEHP FREE LATEX FREE CLEAR SUP-270000000 CDM 270 RC outpatient 6.12 6 All Payors / Plans All Payors / Plans 6.12 other 6.12 6.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE HYPODERMIC BD REGULAR WALL .5IN 30GA TAN POLYPROPYLENE DISPOSABLE STERILE LF REGULAR BEVEL LUER HUB DEHP FREE SUP-270000000 CDM 270 RC outpatient 20.91 20.49 All Payors / Plans All Payors / Plans 20.91 other 20.91 20.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE HYPODERMIC BD REGULAR WALL 5/8IN 25GA BLUE POLYPROPYLENE DISPOSABLE STERILE LF REGULAR BEVEL LUER HUB DEHP FREE SUP-270000000 CDM 270 RC outpatient 14.34 14.05 All Payors / Plans All Payors / Plans 14.34 other 14.34 14.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE INSUFFLATION 120MM 14GA ENDOPATH ULTRA VERESS STOPCOCK LUER LOCK BLUNT STYLET SUP-270000000 CDM 270 RC outpatient 12.39 12.14 All Payors / Plans All Payors / Plans 12.39 other 12.39 12.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE INSUFFLATION ENDOPATH ULTRA VERESS STAINLESS STEEL PLASTIC L120 MM OD14 GA STOPCOCK LUER LOCK BLUNT STYLET HANDLE STERILE DISPOSABLE PNEUMOPERITONEUM SUP-270009197 CDM 270 RC outpatient 43.52 42.65 All Payors / Plans All Payors / Plans 43.52 other 43.52 43.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SCLEROTHERAPY INTERJECT L4 MM L240 CM OD23 GA ODSEC2.3 MM ID.32 MM INNER CATHETER SHEATH STERILE DISPOSABLE CLEAR SUP-270000000 CDM 270 RC outpatient 38.24 37.48 All Payors / Plans All Payors / Plans 38.24 other 38.24 38.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SCLEROTHERAPY STAR CATHETER INTERJECT L4 MM L240 CM OD25 GA ODSEC2.3 MM BEVEL STRONG PUSHABLE CONTRAST SHEATH SPACER CLIP DISPOSABLE RED SUP-270000000 CDM 270 RC outpatient 78.73 77.16 All Payors / Plans All Payors / Plans 78.73 other 78.73 78.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SPINAL BD QUINCKE REGULAR WALL 3.5IN 18GA PINK POLYPROPYLENE DISPOSABLE STERILE LF REGULAR BEVEL LUER HUB DEHP SUP-270000000 CDM 270 RC outpatient 2.84 2.78 All Payors / Plans All Payors / Plans 2.84 other 2.84 2.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SPINAL BD QUINCKE REGULAR WALL 3.5IN 20GA YELLOW POLYPROPYLENE DISPOSABLE STERILE LF REGULAR BEVEL LUER HUB DEHP SUP-270000000 CDM 270 RC outpatient 6.26 6.13 All Payors / Plans All Payors / Plans 6.26 other 6.26 6.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SPINAL BD QUINCKE REGULAR WALL 3.5IN 22GA BLACK POLYPROPYLENE DISPOSABLE STERILE LF REGULAR BEVEL LUER HUB DEHP SUP-270000000 CDM 270 RC outpatient 2.82 2.76 All Payors / Plans All Payors / Plans 2.82 other 2.82 2.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SPINAL BD QUINCKE REGULAR WALL 3.5IN 25GA BLUE POLYPROPYLENE DISPOSABLE STERILE LF REGULAR BEVEL LUER HUB DEHP SUP-270000000 CDM 270 RC outpatient 5.73 5.62 All Payors / Plans All Payors / Plans 5.73 other 5.73 5.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SPINAL BD QUINCKE STANDARD LENGTH L2 1/2 IN OD20 GA SPINE BEVEL FIT STYLET UNIQUE TRANSLUCENT WINDOW CANNULA STERILE LATEX FREE DISPOSABLE YELLOW ANESTHESIA SUP-270000000 CDM 270 RC outpatient 6.55 6.42 All Payors / Plans All Payors / Plans 6.55 other 6.55 6.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SUTURE MAYO CATGUT 3 1/2 CIRCLE TAPER STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 10.12 9.92 All Payors / Plans All Payors / Plans 10.12 other 10.12 10.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SUTURE MULTIFIRE SCORPION SUP-270000000 CDM 270 RC outpatient 357 349.86 All Payors / Plans All Payors / Plans 357 other 357 357 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SUTURE RICHARD-ALLAN 3 1/2 CIRCLE L1.654 IN OD.043 IN FISTULA HEAVY REVERSE CUT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 12.5 12.25 All Payors / Plans All Payors / Plans 12.5 other 12.5 12.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SUTURE RICHARD-ALLAN MAYO STAINLESS STEEL CATGUT 5 1/2 CIRCLE REGULAR TAPER L1.26 IN OD.043 IN TEMPER STRENGTH DEPENDABLE LIGHT STERILE LATEX FREE DISPOSABLE TISSUE CLOSURE SUP-270000000 CDM 270 RC outpatient 10.12 9.92 All Payors / Plans All Payors / Plans 10.12 other 10.12 10.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEEDLE SUTURE RICHARD-ALLAN STAINLESS STEEL 3 1/2 CIRCLE REGULAR L.984 IN OD.024 IN INTESTINAL TAPER POINT FREE EYE STERILE LATEX FREE TISSUE CLOSURE SUP-270000000 CDM 270 RC outpatient 12.5 12.25 All Payors / Plans All Payors / Plans 12.5 other 12.5 12.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility NEPTUNE FLUID TRAP SUP-270000000 CDM 270 RC outpatient 7.65 7.5 All Payors / Plans All Payors / Plans 7.65 other 7.65 7.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OBSOLETE PER VENDOR - OBTURATOR 8MM BLADELESS SUP-270000000 CDM 270 RC outpatient 52.5 51.45 All Payors / Plans All Payors / Plans 52.5 other 52.5 52.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OBTURATOR 8MM BLADELESS OPTICAL SUP-270000000 CDM 270 RC outpatient 32.13 31.49 All Payors / Plans All Payors / Plans 32.13 other 32.13 32.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OBTURATOR 8MM BLADELESS OPTICAL LONG SUP-270000000 CDM 270 RC outpatient 53.55 52.48 All Payors / Plans All Payors / Plans 53.55 other 53.55 53.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OBTURATOR LAPAROSCOPIC DA VINCI S/SI ENDOWRIST SHORT OD8 MM STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 55.13 54.03 All Payors / Plans All Payors / Plans 55.13 other 55.13 55.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCCLUDER CARDIOVASCULAR GORE EPTFE OD 25MM SEPTAL SOFT WIRE FRAME FLUOROSCOPIC IMAGE SUP-275000000 CDM 270 RC outpatient 14412 14123.76 All Payors / Plans All Payors / Plans 14412 other 14412 14412 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OCCLUDER SHUNT AXIUS L16.25 MM OD1.5 MM CORONARY TEMPORARY SUP-270000000 CDM 270 RC outpatient 215.76 211.44 All Payors / Plans All Payors / Plans 215.76 other 215.76 215.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OLIVE WIRE SMOOTH 1.4MM SUP-270000000 CDM 270 RC outpatient 221 216.58 All Payors / Plans All Payors / Plans 221 other 221 221 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.0 X 12MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.0 X 18MM SUP-481000000 CDM 270 RC outpatient 765 749.7 All Payors / Plans All Payors / Plans 765 other 765 765 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.0 X 22MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.0 X 8MM SUP-481000000 CDM 270 RC outpatient 765 749.7 All Payors / Plans All Payors / Plans 765 other 765 765 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.25 X 12MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.25 X 15MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.25 X 8MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.5 X 12MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.5 X 15MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.5 X 18MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.5 X 22MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.5 X 8MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.75 X 15MM SUP-481000000 CDM 270 RC outpatient 459 449.82 All Payors / Plans All Payors / Plans 459 other 459 459 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 2.75 X 18MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.0 X 12MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.0 X 15MM SUP-481000000 CDM 270 RC outpatient 765 749.7 All Payors / Plans All Payors / Plans 765 other 765 765 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.0 X 18MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.0 X 22MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.0 X 26MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.0 X 30MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.5 X 15MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.5 X 18MM SUP-481000000 CDM 270 RC outpatient 1170 1146.6 All Payors / Plans All Payors / Plans 1170 other 1170 1170 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.5 X 22MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.5 X 26MM SUP-481000000 CDM 270 RC outpatient 1170 1146.6 All Payors / Plans All Payors / Plans 1170 other 1170 1170 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 3.5 X 8MM SUP-481000000 CDM 270 RC outpatient 945 926.1 All Payors / Plans All Payors / Plans 945 other 945 945 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 4.0 X 15MM SUP-481000000 CDM 270 RC outpatient 765 749.7 All Payors / Plans All Payors / Plans 765 other 765 765 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ONYX FRONTIER RX CORONARY STENT 4.0 X 26MM SUP-481000000 CDM 270 RC outpatient 765 749.7 All Payors / Plans All Payors / Plans 765 other 765 765 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OPSITE DRESSING LG SUP-270009208 CDM 270 RC outpatient 47.89 46.93 All Payors / Plans All Payors / Plans 47.89 other 47.89 47.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OR STERILE TOWELS 4/PK SUP-270000000 CDM 270 RC outpatient 9.98 9.78 All Payors / Plans All Payors / Plans 9.98 other 9.98 9.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility OSTEOBALLAST 45X17.5MM SUP-270000000 CDM 270 RC outpatient 3318 3251.64 All Payors / Plans All Payors / Plans 3318 other 3318 3318 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACEMAKER - LEAD - SELECTSECURE 3830-69 SUP-275C18981 CDM 270 RC outpatient 829.5 812.91 All Payors / Plans All Payors / Plans 829.5 other 829.5 829.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACEMAKER ACCOLADE DR EL MRI DUAL CHAMBER SUP-275000000 CDM 270 RC outpatient 7246.6 7101.67 All Payors / Plans All Payors / Plans 7246.6 other 7246.6 7246.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACEMAKER ACCOLADE DR EL MRI SYSTEM _44046_ SUP-275000000 CDM 270 RC outpatient 7950 7791 All Payors / Plans All Payors / Plans 7950 other 7950 7950 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACEMAKER ASSURITY MR SR-RF SUP-275000000 CDM 270 RC outpatient 4940 4841.2 All Payors / Plans All Payors / Plans 4940 other 4940 4940 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACEMAKER AZURE S XT SR W1SR01 MRI DEVICE SUP-275000000 CDM 270 RC outpatient 2225.57 2181.06 All Payors / Plans All Payors / Plans 2225.57 other 2225.57 2225.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACEMAKER CARDIAC MICRA AV2 LEADLESS BUNDLE SUP-275000000 CDM 270 RC outpatient 31772 31136.56 All Payors / Plans All Payors / Plans 31772 other 31772 31772 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK ANKLE SUP-270000000 CDM 270 RC outpatient 73.35 71.88 All Payors / Plans All Payors / Plans 73.35 other 73.35 73.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK ARTERIOGRAM CUSTOM SUP-270000000 CDM 270 RC outpatient 42.92 42.06 All Payors / Plans All Payors / Plans 42.92 other 42.92 42.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK BASIC NEURO SUP-270009164 CDM 270 RC outpatient 108.11 105.95 All Payors / Plans All Payors / Plans 108.11 other 108.11 108.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK BATTERY LITHIUM PRECHARGED STERILE DISPOSABLE POWERED DRIVER SUP-270000000 CDM 270 RC outpatient 565 553.7 All Payors / Plans All Payors / Plans 565 other 565 565 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK BIOPSY BASIN CUSTOM SUP-270000000 CDM 270 RC outpatient 11.78 11.54 All Payors / Plans All Payors / Plans 11.78 other 11.78 11.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK CARDIAC CATHETER SUP-481000000 CDM 270 RC outpatient 32.37 31.72 All Payors / Plans All Payors / Plans 32.37 other 32.37 32.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK CATHETER 36CM 19FR PALINDROME TAL VENATRAC VASCULAR 2 STYLET 2 TISSUE DILATOR SUP-270000000 CDM 270 RC outpatient 609 596.82 All Payors / Plans All Payors / Plans 609 other 609 609 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK CERVICAL ACCESSORY SUP-270000000 CDM 270 RC outpatient 35.16 34.46 All Payors / Plans All Payors / Plans 35.16 other 35.16 35.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK CUSTOM SHAKUR SUP-270000000 CDM 270 RC outpatient 160.35 157.14 All Payors / Plans All Payors / Plans 160.35 other 160.35 160.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK DAVINCI DR IM SUP-270000000 CDM 270 RC outpatient 235.83 231.11 All Payors / Plans All Payors / Plans 235.83 other 235.83 235.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK DAVINCI UROLOGY SUP-270000000 CDM 270 RC outpatient 474.75 465.26 All Payors / Plans All Payors / Plans 474.75 other 474.75 474.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK FEMPOP BYPASS SUP-270009163 CDM 270 RC outpatient 312.79 306.53 All Payors / Plans All Payors / Plans 312.79 other 312.79 312.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK HEART SUP-270009194 CDM 270 RC outpatient 183.61 179.94 All Payors / Plans All Payors / Plans 183.61 other 183.61 183.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK HEART CABG ACCESSORY SUP-270000000 CDM 270 RC outpatient 137.7 134.95 All Payors / Plans All Payors / Plans 137.7 other 137.7 137.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK LAPAROSCOPIC SUP-270000000 CDM 270 RC outpatient 82.68 81.03 All Payors / Plans All Payors / Plans 82.68 other 82.68 82.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK MAJOR ABDOMINAL SUP-270009161 CDM 270 RC outpatient 36.89 36.15 All Payors / Plans All Payors / Plans 36.89 other 36.89 36.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK MINOR SUP-270000000 CDM 270 RC outpatient 25.82 25.3 All Payors / Plans All Payors / Plans 25.82 other 25.82 25.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK PLIF ACCESSORY SUP-270000000 CDM 270 RC outpatient 55.99 54.87 All Payors / Plans All Payors / Plans 55.99 other 55.99 55.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK REVEAL LINQ SUP-481000000 CDM 270 RC outpatient 12.67 12.42 All Payors / Plans All Payors / Plans 12.67 other 12.67 12.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SHOULDER ARTHROSCOPY SUP-270009121 CDM 270 RC outpatient 168.68 165.31 All Payors / Plans All Payors / Plans 168.68 other 168.68 168.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SINUS KENNEDY SUP-270000000 CDM 270 RC outpatient 38.85 38.07 All Payors / Plans All Payors / Plans 38.85 other 38.85 38.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL 175 MM 200 MM 1 WIDE FIELD LENS 1 CORRECTION LENS BIOM THUMBSCREW CAP STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 303.59 297.52 All Payors / Plans All Payors / Plans 303.59 other 303.59 303.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL ARTHROSCOPY SUP-270009167 CDM 270 RC outpatient 141.13 138.31 All Payors / Plans All Payors / Plans 141.13 other 141.13 141.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL BASIN CUSTOM CV DRAPE SUP-270000000 CDM 270 RC outpatient 106.29 104.16 All Payors / Plans All Payors / Plans 106.29 other 106.29 106.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CARTICEL TRANSPLANT ACCESS PENINSULA REGIONAL MEDICAL CENTER SUP-270000000 CDM 270 RC outpatient 184.75 181.06 All Payors / Plans All Payors / Plans 184.75 other 184.75 184.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM AAA SUP-270009162 CDM 270 RC outpatient 407.55 399.4 All Payors / Plans All Payors / Plans 407.55 other 407.55 407.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM AV FISTULA SUP-270000000 CDM 270 RC outpatient 88.08 86.32 All Payors / Plans All Payors / Plans 88.08 other 88.08 88.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM C SECTION SUP-270009192 CDM 270 RC outpatient 157.7 154.55 All Payors / Plans All Payors / Plans 157.7 other 157.7 157.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM C SECTION LATEX FREE SUP-270009192 CDM 270 RC outpatient 120.72 118.31 All Payors / Plans All Payors / Plans 120.72 other 120.72 120.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM CAROTID SUP-270009166 CDM 270 RC outpatient 201.06 197.04 All Payors / Plans All Payors / Plans 201.06 other 201.06 201.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM CHEST SUP-270000000 CDM 270 RC outpatient 197.26 193.31 All Payors / Plans All Payors / Plans 197.26 other 197.26 197.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM CRANI ACCESSORY SUP-270009165 CDM 270 RC outpatient 205.38 201.27 All Payors / Plans All Payors / Plans 205.38 other 205.38 205.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM DENTAL SUP-270000000 CDM 270 RC outpatient 51.13 50.11 All Payors / Plans All Payors / Plans 51.13 other 51.13 51.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM GYN LAPAROSCOPY SUP-270009174 CDM 270 RC outpatient 112.07 109.83 All Payors / Plans All Payors / Plans 112.07 other 112.07 112.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM MAJOR ORTHO HAND SUP-270000000 CDM 270 RC outpatient 78.19 76.63 All Payors / Plans All Payors / Plans 78.19 other 78.19 78.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM PACEMAKER SUP-270000000 CDM 270 RC outpatient 42.98 42.12 All Payors / Plans All Payors / Plans 42.98 other 42.98 42.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM PACEMAKER DYNJ59287 SUP-270000000 CDM 270 RC outpatient 28.29 27.72 All Payors / Plans All Payors / Plans 28.29 other 28.29 28.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM TAVR SUP-270009161 CDM 270 RC outpatient 143.12 140.26 All Payors / Plans All Payors / Plans 143.12 other 143.12 143.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM TOTAL HIP ACCESSORY SUP-270009120 CDM 270 RC outpatient 40.26 39.45 All Payors / Plans All Payors / Plans 40.26 other 40.26 40.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL CUSTOM TOTAL SHOULDER ACCESSORY SUP-270000000 CDM 270 RC outpatient 77.37 75.82 All Payors / Plans All Payors / Plans 77.37 other 77.37 77.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL ECLIPSE LITHOTOMY IV GYN T SHEET NO GOWN STERILE LATEX FREE SUP-270009174 CDM 270 RC outpatient 11.32 11.09 All Payors / Plans All Payors / Plans 11.32 other 11.32 11.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL ECLIPSE T L76 IN X W44 IN L23 IN X W16 IN CYSTOSCOPY VI DRAPE ABSORBENT REINFORCEMENT MESH SCREEN STERILE LATEX FREE SUP-270009170 CDM 270 RC outpatient 12.31 12.06 All Payors / Plans All Payors / Plans 12.31 other 12.31 12.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL EP SUP-270000000 CDM 270 RC outpatient 39.34 38.55 All Payors / Plans All Payors / Plans 39.34 other 39.34 39.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL HYSTEROSCOPY D C SUP-270000000 CDM 270 RC outpatient 20.97 20.55 All Payors / Plans All Payors / Plans 20.97 other 20.97 20.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL TOTAL JOINT SUP-270000000 CDM 270 RC outpatient 247.2 242.26 All Payors / Plans All Payors / Plans 247.2 other 247.2 247.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SURGICAL TOTAL KNEE ACCESSORY SUP-270009119 CDM 270 RC outpatient 26.07 25.55 All Payors / Plans All Payors / Plans 26.07 other 26.07 26.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK SUTURE STERILE PERCUTANEOUS ACHILLES REPAIR SYSTEM SUP-270000000 CDM 270 RC outpatient 3139.5 3076.71 All Payors / Plans All Payors / Plans 3139.5 other 3139.5 3139.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK THROAT INTRA OP OROPAK MEROCEL WITH STRING SUP-270000000 CDM 270 RC outpatient 45.15 44.25 All Payors / Plans All Payors / Plans 45.15 other 45.15 45.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK TRENGUARD PROCEDURE 450 PAC 450LBS SUP-270000000 CDM 270 RC outpatient 67.05 65.71 All Payors / Plans All Payors / Plans 67.05 other 67.05 67.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK TROCH NAIL SUP-270000000 CDM 270 RC outpatient 79.82 78.22 All Payors / Plans All Payors / Plans 79.82 other 79.82 79.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK VITRECTOMY CONSTELLATION ENGAUGE RUBBER OD25 GA OD20 GA ODSEC23 GA 10 CC VISCUOUS FLUID CONTROL SYRINGE NEEDLE CANNULA STERILE LATEX FREE DISPOSABLE VFC SUP-270000000 CDM 270 RC outpatient 71.73 70.3 All Payors / Plans All Payors / Plans 71.73 other 71.73 71.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK VITRECTOMY CONSTELLATION ENGAUGE V-LOCITY C3F8 SF6 GAS FILL SYRINGE RFID AUTOMATIC PURGE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 71.73 70.3 All Payors / Plans All Payors / Plans 71.73 other 71.73 71.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK VITRECTOMY CONSTELLATION OD20 GA PROBE FRAGMENTATION HANDPIECE LIGHTWEIGHT LATEX FREE SUP-270000000 CDM 270 RC outpatient 182.91 179.25 All Payors / Plans All Payors / Plans 182.91 other 182.91 182.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK VITRECTOMY CONSTELLATION TOTAL PLUS 5000 CPM OD23 GA 20 CC 3 WAY STOPCOCK PROBE STRAIGHT ENDOILLUMINATOR AUTO INFUSION VALVE LATEX FREE SUP-270000000 CDM 270 RC outpatient 592.39 580.54 All Payors / Plans All Payors / Plans 592.39 other 592.39 592.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK VITRECTOMY II SUP-270000000 CDM 270 RC outpatient 53.32 52.25 All Payors / Plans All Payors / Plans 53.32 other 53.32 53.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACK VITRECTOMY TOTAL PLUS HYPERVIT 20000 CPM OD25 GA BEVEL SUP-270000000 CDM 270 RC outpatient 649.76 636.76 All Payors / Plans All Payors / Plans 649.76 other 649.76 649.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACKING NASAL MEROCEL POPE EPISTAXIS SUP-270000000 CDM 270 RC outpatient 85.26 83.55 All Payors / Plans All Payors / Plans 85.26 other 85.26 85.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACKING WOUND CURITY COTTON GAUZE L5 YD X W2 IN STRIP SELVAGE EDGE PLAIN MESH STERILE LATEX FREE DISPOSABLE SUP-270009022 CDM 270 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACKING WOUND CURITY IODOFORM COTTON MESH GAUZE L5 YD X W1/2 IN STRIP SUP-270009022 CDM 270 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PACKING WOUND GAUZE L72 IN X W2 IN VAGINAL 4 PLY RADIOPAQUE STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 10.05 9.85 All Payors / Plans All Payors / Plans 10.05 other 10.05 10.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAD ELECTROSURGICAL GROUNDING NESSY ADULT L168 CM L10 FT CABLE MONITORING SPLIT DISPOSABLE SUP-270000000 CDM 270 RC outpatient 4.28 4.19 All Payors / Plans All Payors / Plans 4.28 other 4.28 4.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PAD WOUND DRAIN SENSATRAC VAC TUBE CLAMP CONNECTOR STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 35.57 34.86 All Payors / Plans All Payors / Plans 35.57 other 35.57 35.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PADS CLOSURE D-STAT 4000 SUP-270000000 CDM 270 RC outpatient 241.4 236.57 All Payors / Plans All Payors / Plans 241.4 other 241.4 241.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PANNUS RETENTION SYSTEM 4 PAD 2 STRAP STERILE SUP-270000000 CDM 270 RC outpatient 123.25 120.79 All Payors / Plans All Payors / Plans 123.25 other 123.25 123.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PASSER SUTURE GABBAY-FRATER GUIDE ORGANIZER STERILE LATEX FREE VALVE IMPLANTATION SUP-270000000 CDM 270 RC outpatient 29.18 28.6 All Payors / Plans All Payors / Plans 29.18 other 29.18 29.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATCH CARDIOVASCULAR VASCU-GUARD BOVINE PERICARDIAL TAPER L8 CM X W.8 CM PERIPHERAL APEX PROCESS SUP-270000000 CDM 270 RC outpatient 491.48 481.65 All Payors / Plans All Payors / Plans 491.48 other 491.48 491.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATCH DURAL DURAMATRIX-ONLAY PLUS COLLAGEN L3 IN X W1 IN REGENERATION MEMBRANE STERILE SUP-270000000 CDM 270 RC outpatient 437.15 428.41 All Payors / Plans All Payors / Plans 437.15 other 437.15 437.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATCH DURAL DURAMATRIX-ONLAY PLUS COLLAGEN L5 IN X W4 IN REGENERATION MEMBRANE STERILE SUP-270000000 CDM 270 RC outpatient 1348.85 1321.87 All Payors / Plans All Payors / Plans 1348.85 other 1348.85 1348.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATCH REFERENCE CARTO 3 EXTERNAL SUP-270000000 CDM 270 RC outpatient 494.7 484.81 All Payors / Plans All Payors / Plans 494.7 other 494.7 494.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "PATCH, PHOTOFIX CAROTID 0.8X8" SUP-270000000 CDM 270 RC outpatient 306 299.88 All Payors / Plans All Payors / Plans 306 other 306 306 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATELLA DOME 38MM SUP-270010025 CDM 270 RC outpatient 6720 6585.6 All Payors / Plans All Payors / Plans 6720 other 6720 6720 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATELLA DOME 41MM SUP-270010025 CDM 270 RC outpatient 5440 5331.2 All Payors / Plans All Payors / Plans 5440 other 5440 5440 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATELLA REAMER BLADE WITH PILOT HOLE SIZE 38 - LOG619747 SUP-270010025 CDM 270 RC outpatient 210 205.8 All Payors / Plans All Payors / Plans 210 other 210 210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATELLA REAMER BLADE WITH PILOT HOLE SIZE 51 SUP-270010025 CDM 270 RC outpatient 102 99.96 All Payors / Plans All Payors / Plans 102 other 102 102 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PATELLA REAMING BLADE 46MM SUP-270010025 CDM 270 RC outpatient 210 205.8 All Payors / Plans All Payors / Plans 210 other 210 210 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PEAK PLASMABLADE 4.0 DISPOSABLE SUP-270000000 CDM 270 RC outpatient 304.34 298.25 All Payors / Plans All Payors / Plans 304.34 other 304.34 304.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PERFUSION OPEN HEART SUPPLIES SUP-270010026 CDM 270 RC outpatient 1500 1470 All Payors / Plans All Payors / Plans 1500 other 1500 1500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PERI-LOC KWIRE 1.6MM X 150MM LENGTH TROCAR POINT SUP-270000000 CDM 270 RC outpatient 397.8 389.84 All Payors / Plans All Payors / Plans 397.8 other 397.8 397.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIG 6FR C PIG PERFORMA SUP-481000000 CDM 270 RC outpatient 19 18.62 All Payors / Plans All Payors / Plans 19 other 19 19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIGTAIL CATH SUP-270000000 CDM 270 RC outpatient 38.4 37.63 All Payors / Plans All Payors / Plans 38.4 other 38.4 38.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PILLOW ABDUCTION FOAM LARGE SHOULDER ENVELOPE SLING THUMB LOOP PAD D RING CLOSURE NONSTERILE LATEX FREE SUP-270009116 CDM 270 RC outpatient 3.89 3.81 All Payors / Plans All Payors / Plans 3.89 other 3.89 3.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PILLOW POSITIONING INSITE GENTLETOUCH FOAM CONTOUR L7 FT PRONE HEADREST RIGHT INTUBATION SLOT LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 13.88 13.6 All Payors / Plans All Payors / Plans 13.88 other 13.88 13.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIN DISTRACTION TITANIUM L14 MM SHARP STERILE DISPOSABLE YELLOW ANTERIOR CERVICAL FUSION SUP-270000000 CDM 270 RC outpatient 76.5 74.97 All Payors / Plans All Payors / Plans 76.5 other 76.5 76.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIN DRILL VELYS L175 MM OD4 MM ARRAY SUP-270010025 CDM 270 RC outpatient 50.4 49.39 All Payors / Plans All Payors / Plans 50.4 other 50.4 50.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIN FIXATION L.42 IN OD.062 IN PROTECTOR GREEN YELLOW SUP-270000000 CDM 270 RC outpatient 5.79 5.67 All Payors / Plans All Payors / Plans 5.79 other 5.79 5.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIN HALF L15 MM OD3 MM RADIUS DISTAL SUP-270000000 CDM 270 RC outpatient 725.76 711.24 All Payors / Plans All Payors / Plans 725.76 other 725.76 725.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIN HALF L20 MM OD3 MM RADIUS DISTAL SUP-270000000 CDM 270 RC outpatient 725.76 711.24 All Payors / Plans All Payors / Plans 725.76 other 725.76 725.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PIN SKULL MAYFIELD PLASTIC ADULT CRANIUM WING GROOVE STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 19.46 19.07 All Payors / Plans All Payors / Plans 19.46 other 19.46 19.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BIOMET MAXON ONE LEVEL 11MM SUP-270010020 CDM 270 RC outpatient 2860 2802.8 All Payors / Plans All Payors / Plans 2860 other 2860 2860 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BIOMET 2 LEVEL MAXON SUP-270010020 CDM 270 RC outpatient 3380 3312.4 All Payors / Plans All Payors / Plans 3380 other 3380 3380 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE ATLANTIS TITANIUM L40 MM SPINE CERVICAL ANTERIOR LOCK TRANSLATIONAL SUP-270010020 CDM 270 RC outpatient 2730 2675.4 All Payors / Plans All Payors / Plans 2730 other 2730 2730 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS 10 HOLE STERILE LATEX FREE 2.7 MM SCREW SUP-270000000 CDM 270 RC outpatient 1482.6 1452.95 All Payors / Plans All Payors / Plans 1482.6 other 1482.6 1482.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS 20 HOLE FLEX 2.4 MM SCREW SUP-270000000 CDM 270 RC outpatient 1145.97 1123.05 All Payors / Plans All Payors / Plans 1145.97 other 1145.97 1145.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS 20 HOLE FLEX STERILE LATEX FREE 2.7MM SCREW SUP-270000000 CDM 270 RC outpatient 1482.6 1452.95 All Payors / Plans All Payors / Plans 1482.6 other 1482.6 1482.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS 6 HOLE STRENGTH 2 MM SCREW SUP-270000000 CDM 270 RC outpatient 1075.2 1053.7 All Payors / Plans All Payors / Plans 1075.2 other 1075.2 1075.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS L 297 MM FEMUR LEFT DISTAL 14 HOLE STERILE LATEX FREE 3.5/4.5 MM SCREW PERIPROSTHETIC SUP-270000000 CDM 270 RC outpatient 11702.25 11468.21 All Payors / Plans All Payors / Plans 11702.25 other 11702.25 11702.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS MINI STAINLESS STEEL 6 MM SPACE L 37 MM X W 6 MM X H 1.9MM 6 HOLE VARIABLE ANGLE LOCK LOW PROFILE STRENGTH STERILE 2.4 MM SCREW FRAGMENT SUP-270000000 CDM 270 RC outpatient 1145.97 1123.05 All Payors / Plans All Payors / Plans 1145.97 other 1145.97 1145.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS MINI STAINLESS STEEL 6 MM SPACE L 61 MM X W 6MM X H 1.9MM 10 HOLE CARIABLE ANGLE LOCK LOW PROFILE STRENGTH STERILE 2.4MM SCREW SMALL FRAGMENT SUP-270000000 CDM 270 RC outpatient 1145.97 1123.05 All Payors / Plans All Payors / Plans 1145.97 other 1145.97 1145.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 11MM SPACE I L 78 MM X W 10.9MM X H 2MM W 21.8 MM X H 1.8MM TIBIAL RIGHT PROXIMAL POSTEROMEDIAL 5 HOLE VARIABLE ANGLE LOCK LOW PROFILE PARTIAL ARTICULAR STERILE 3.5 MM SCREW SUP-270000000 CDM 270 RC outpatient 2196.6 2152.67 All Payors / Plans All Payors / Plans 2196.6 other 2196.6 2196.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 11MM SPACE L 103 MM X W 10 MM X H 2 MM W 16.3 MM X H 1.7MM FIBULA RIGHT DISTAL LATERAL 7 HOLE VARIABLE ANGLE LOCK LOW PROFILE STERILE 2.7/3.5 MM SCREW SUP-270000000 CDM 270 RC outpatient 1288.77 1262.99 All Payors / Plans All Payors / Plans 1288.77 other 1288.77 1288.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 11MM SPACE L 93 MM X W 10 MM X H 2 MM W 8 MM X H 1.8 MM FIBULA LEFT DISTAL POSTEROLATERAL 5 HOLE VARIABLE ANGLE LOCK LOW PROFILE STERILE 2.7/3.5 MM SCREW SUP-270000000 CDM 270 RC outpatient 1595.62 1563.71 All Payors / Plans All Payors / Plans 1595.62 other 1595.62 1595.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 11MM SPACE STRAIGHT L 114 MM X W 12MMX H 3 MM HUMERUS PROXIMAL 5 HOLE VARIABLE ANGLE LOCK LOW PROFILE STERILE 3.5 MM SCREW SUP-270000000 CDM 270 RC outpatient 1898.73 1860.76 All Payors / Plans All Payors / Plans 1898.73 other 1898.73 1898.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 12 MM SPACE 1/3 TUBULAR L 82 MM X W 9.5MM X H 1.5MM 7 HOLE LOCK STERILE 3.5 MM SCREW SUP-270000000 CDM 270 RC outpatient 429.83 421.23 All Payors / Plans All Payors / Plans 429.83 other 429.83 429.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 12 MM SPACE 1/3 TUBULAR L 94 MM X W 9.5 MM X H 1.5 MM 8 HOLE LOCK STERILE 3.5 MM SCREW SUP-270000000 CDM 270 RC outpatient 429.83 421.23 All Payors / Plans All Payors / Plans 429.83 other 429.83 429.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 12 MM SPACE 1/3 TUBULAR L70MM X W 9 MM H 1.1 MM 6 HOLE STERILE 3.5 MM SCREW SUP-270000000 CDM 270 RC outpatient 181.44 177.81 All Payors / Plans All Payors / Plans 181.44 other 181.44 181.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 12.5 MM SPACE L 77 MM X W 10.7MM X H 3.4MM 6 HOLE COMPRESSION STERILE 3.5MM SCREW SUP-270000000 CDM 270 RC outpatient 275.4 269.89 All Payors / Plans All Payors / Plans 275.4 other 275.4 275.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 12MM SPACE 1/3 TUBULAR L 118MM X W 9.5MM X H 1.5MM 10 HOLE LOCK STERILE 3.5MM SCREW SUP-270000000 CDM 270 RC outpatient 429.83 421.23 All Payors / Plans All Payors / Plans 429.83 other 429.83 429.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL 12MM SPACE 1/3 TUBULAR L 70MM X W 9.5MM X H 1.5MM 6 HOLE LOCK STERILE 3.5MM SCREW SUP-270000000 CDM 270 RC outpatient 429.83 421.23 All Payors / Plans All Payors / Plans 429.83 other 429.83 429.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL L 151MM HUMERUS LEFT DISTAL POSTEROLATERAL 12 HOLE LOW PROFILE VARIABLE ANGLE LOCK EXTRA ARTICULAR 2.7/3.5 MM SCREW SUP-270000000 CDM 270 RC outpatient 3723.2 3648.74 All Payors / Plans All Payors / Plans 3723.2 other 3723.2 3723.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STAINLESS STEEL L 83 MM OLECRANON LEFT 5 HOLE LOW PROFILE VARIABLE ANGLE LOCK STERILE 2.7/3.5 MM SCREW SUP-270000000 CDM 270 RC outpatient 2099.16 2057.18 All Payors / Plans All Payors / Plans 2099.16 other 2099.16 2099.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS STANDARD L 48 MM RADIAL LEFT DISTAL VOLAR 3 HOLE STERILE SUP-270000000 CDM 270 RC outpatient 1442.28 1413.43 All Payors / Plans All Payors / Plans 1442.28 other 1442.28 1442.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS T 2 HOLE HEAD 8 HOLE SHAFT 2.4MM SCREW SUP-270000000 CDM 270 RC outpatient 927.69 909.14 All Payors / Plans All Payors / Plans 927.69 other 927.69 927.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS TRIANGLE 6 HOLE 2.4 MM SCREW SUP-270000000 CDM 270 RC outpatient 1418.82 1390.44 All Payors / Plans All Payors / Plans 1418.82 other 1418.82 1418.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS WIDE L 48 MM RADIAL LEFT DISTAL VOLAR 3 HOLE STERILE SUP-270000000 CDM 270 RC outpatient 1167.56 1144.21 All Payors / Plans All Payors / Plans 1167.56 other 1167.56 1167.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS WIDE L 56 MM RADIAL LEFT DISTAL VOLAR 4 HOLE STERILE SUP-270000000 CDM 270 RC outpatient 1442.28 1413.43 All Payors / Plans All Payors / Plans 1442.28 other 1442.28 1442.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE EVOS Y 7 HOLE SHAFT TINE STERILE LATEX FREE 2.7MM SCREW SUP-270000000 CDM 270 RC outpatient 1856.4 1819.27 All Payors / Plans All Payors / Plans 1856.4 other 1856.4 1856.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE INTERCONTINENTAL 6 D W20 MM X H11 MM SPINE NONSTERILE SUP-270010020 CDM 270 RC outpatient 2754 2698.92 All Payors / Plans All Payors / Plans 2754 other 2754 2754 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE LCP COMBI STAINLESS STEEL PELVIC 2 HOLE SPRING NONSTERILE 3.5 MM SCREW SUP-270010022 CDM 270 RC outpatient 681.39 667.76 All Payors / Plans All Payors / Plans 681.39 other 681.39 681.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE MATRIXNEURO TITANIUM STRAIGHT L12 MM X H.4 MM CRANIAL 2 HOLE CENTER SPACE RIGID NONSTERILE BLUE SUP-270010013 CDM 270 RC outpatient 170 166.6 All Payors / Plans All Payors / Plans 170 other 170 170 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE STAINLESS STEEL 108 MM RADIUS CURVE L104 MM X W10.2 MM X H2.7 MM PELVIC 8 HOLE LOW PROFILE NONSTERILE 3.5 MM SCREW SUP-270010022 CDM 270 RC outpatient 3689.6 3615.81 All Payors / Plans All Payors / Plans 3689.6 other 3689.6 3689.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE STAINLESS STEEL 108 MM RADIUS L208 MM PELVIC 16 HOLE LOW PROFILE CURVED RECONSTRUCTION NONSTERILE 3.5 MM SCREW SUP-270010022 CDM 270 RC outpatient 1963.67 1924.4 All Payors / Plans All Payors / Plans 1963.67 other 1963.67 1963.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE VLP MINI-MOD TITANIUM 12 X 3 HOLE MESH 2.4MM SCREW MINI FRAGMENT SUP-270000000 CDM 270 RC outpatient 2916.9 2858.56 All Payors / Plans All Payors / Plans 2916.9 other 2916.9 2916.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BONE ZEVO TITANIUM L21 MM SPINE CERVICAL ANTERIOR LEVEL 1 SUP-270010020 CDM 270 RC outpatient 1870 1832.6 All Payors / Plans All Payors / Plans 1870 other 1870 1870 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE BURR HOLE 18.5MM SUP-270000000 CDM 270 RC outpatient 222.36 217.91 All Payors / Plans All Payors / Plans 222.36 other 222.36 222.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE SQUARE 4 HOLE 12MM SUP-270000000 CDM 270 RC outpatient 446.76 437.82 All Payors / Plans All Payors / Plans 446.76 other 446.76 446.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLATE TIBIAL NEXGEN TIVANIUM UHMWPE 6 L74 MM X W50 MM X H6 MM KNEE CEMENTED MODULAR STEM PRECOAT STERILE SUP-270010025 CDM 270 RC outpatient 3780 3704.4 All Payors / Plans All Payors / Plans 3780 other 3780 3780 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLEDGET CARDIOVASCULAR TEFLON THK1/16 IN LARGE L3/8 IN X W3/16 IN SOFT SUTURE STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 9.82 9.62 All Payors / Plans All Payors / Plans 9.82 other 9.82 9.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLUG CATHETER CURITY CAP STERILE SUP-270000000 CDM 270 RC outpatient 1.05 1.03 All Payors / Plans All Payors / Plans 1.05 other 1.05 1.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLUG STEM NEXGEN TIVANIUM TAPER KNEE FLEX STERILE SUP-270010025 CDM 270 RC outpatient 6300 6174 All Payors / Plans All Payors / Plans 6300 other 6300 6300 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLUG SURGICAL PERFIX LG TAPER 1.6IN 1.9IN POLYPROPYLENE STERILE GROIN MONOFILAMENT NONABSORBABLE HERNIA REPAIR SUP-270000000 CDM 270 RC outpatient 241.06 236.24 All Payors / Plans All Payors / Plans 241.06 other 241.06 241.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLUG SURGICAL PERFIX MED TAPER 1.3IN 1.55IN POLYPROPYLENE STERILE GROIN MONOFILAMENT NONABSORBABLE HERNIA REPAIR SUP-270000000 CDM 270 RC outpatient 292.11 286.27 All Payors / Plans All Payors / Plans 292.11 other 292.11 292.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PLUMEPEN ULTRA SURGICAL SMOKE EVAC PENCIL SUP-270000000 CDM 270 RC outpatient 24.55 24.06 All Payors / Plans All Payors / Plans 24.55 other 24.55 24.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POM WITH MICROSTREAM PHILIPS SUP-270000000 CDM 270 RC outpatient 16.17 15.85 All Payors / Plans All Payors / Plans 16.17 other 16.17 16.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PORT ACCESS AIRSEAL L100 MM OD12 MM OBTURATOR BLADELESS OPTICAL TIP STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 95.33 93.42 All Payors / Plans All Payors / Plans 95.33 other 95.33 95.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PORT ACCESS AIRSEAL L120 MM OD12 MM 2 WALL CANNULA PALM GRIP OBTURATOR BLADELESS OPTICAL TIP VALVELESS TROCAR SUP-270000000 CDM 270 RC outpatient 202.41 198.36 All Payors / Plans All Payors / Plans 202.41 other 202.41 202.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PORT AIRSEAL 5MM ACCESS PORT AND OBTURATOR SUP-270000000 CDM 270 RC outpatient 238.81 234.03 All Payors / Plans All Payors / Plans 238.81 other 238.81 238.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PORT HAND ACCESS ALEXIS GELPORT L120 MM ABDOMEN WOUND RETRACTOR LAPAROSCOPIC MARK PEN INCISION TEMPLATE GELSEAL TECHNOLOGY LATEX FREE SUP-270000000 CDM 270 RC outpatient 1501.5 1471.47 All Payors / Plans All Payors / Plans 1501.5 other 1501.5 1501.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PORT IMPLANTABLE INFUSION SMART PORT CARBOTHANE TITANIUM POLYURETHANE L55 CM OD6.6 FR ID7 FR IDSEC1.4 MM .4 ML .016 ML DETACH CATHETER INTRODUCER LOW PROFILE CT SUP-270000000 CDM 270 RC outpatient 179.93 176.33 All Payors / Plans All Payors / Plans 179.93 other 179.93 179.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PORT IMPLANTABLE INFUSION VACCESS CT 6FR TITANIUM POLYURETHANE POWER INJECTABLE LOW PROFILE SILICONE FILL SUTURE PLUG SUP-270000000 CDM 270 RC outpatient 231.25 226.63 All Payors / Plans All Payors / Plans 231.25 other 231.25 231.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POSITIONER IMPLANT SPINE PIN PLATE HOLD SUP-270010020 CDM 270 RC outpatient 105 102.9 All Payors / Plans All Payors / Plans 105 other 105 105 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POSITIONER OR FOAM H2 IN OD9 IN ID4 IN HEAD HIGH RESILIENT RING CUSHION LATEX FREE RASPBERRY SUP-270000000 CDM 270 RC outpatient 1.29 1.26 All Payors / Plans All Payors / Plans 1.29 other 1.29 1.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POUCH DRAINAGE PREMIER FLEXTEND LOCK N ROLL COMFORTWEAR POROUS FLAT L12 IN OD2 1/2 IN 1 PIECE CUT TO FIT TAPE LATEX FREE ULTRA CLEAR SUP-270009218 CDM 270 RC outpatient 2.2 2.16 All Payors / Plans All Payors / Plans 2.2 other 2.2 2.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility POUCH SPECIMEN RETRIEVAL ENDO CATCH II 34.5CM 29.5CM 15MM METAL POLYURETHANE DISPOSABLE LF FLEXIBLE ERGONOMIC HANDLE SUP-270009147 CDM 270 RC outpatient 80.4 78.79 All Payors / Plans All Payors / Plans 80.4 other 80.4 80.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PPM PM2272 ASSURITY MRI DR-RF DEVICE _45055_ SUP-275000000 CDM 270 RC outpatient 3900 3822 All Payors / Plans All Payors / Plans 3900 other 3900 3900 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRELUDE SNAP SUP-481000000 CDM 270 RC outpatient 33.15 32.49 All Payors / Plans All Payors / Plans 33.15 other 33.15 33.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRELUDE SNAP 9 FR SUP-481000000 CDM 270 RC outpatient 68.25 66.89 All Payors / Plans All Payors / Plans 68.25 other 68.25 68.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRELUDESYNC-EZ SUP-481000000 CDM 270 RC outpatient 67.5 66.15 All Payors / Plans All Payors / Plans 67.5 other 67.5 67.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PRESSURE PRODUCTS SUP-481000000 CDM 270 RC outpatient 68.25 66.89 All Payors / Plans All Payors / Plans 68.25 other 68.25 68.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE CRYOSURGERY CRYOPROBE L1.15 MR OD2.4 MM FLEXIBLE DISPOSABLE ERBECRYO 2 SUP-270000000 CDM 270 RC outpatient 516.8 506.46 All Payors / Plans All Payors / Plans 516.8 other 516.8 516.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE ELECTROSURGICAL ARTHREX APOLLORF 90 D 1 PIECE HAND CONTROL MULTIPLE PORT PLASMA BASE BIPOLAR RF TECHNOLOGY SUP-270000000 CDM 270 RC outpatient 319.2 312.82 All Payors / Plans All Payors / Plans 319.2 other 319.2 319.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE ELECTROSURGICAL FIAPC L220 CM OD2.3 MM FLEXIBLE STRAIGHT FIRE STERILE DISPOSABLE ARGON PLASMA COAGULATION SUP-270000000 CDM 270 RC outpatient 400.35 392.34 All Payors / Plans All Payors / Plans 400.35 other 400.35 400.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE LAPAROSCOPIC SONASTAR PLASTIC SILICONE RUBBER 23KHZ STANDARD L30 CM ID1.9 MM RIGID SHEATH STRAIGHT ASPIRATION TIP REPOSABLE SUP-270000000 CDM 270 RC outpatient 359.1 351.92 All Payors / Plans All Payors / Plans 359.1 other 359.1 359.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE LASER ENGAUGE VEKTOR OD25 GA ARTICULATE ILLUMINATE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 243.15 238.29 All Payors / Plans All Payors / Plans 243.15 other 243.15 243.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE LASER PUREPOINT 40 D L6 MM OD25 GA RETINA RFID FLEXIBLE NITINOL TIP EASY INSERTION ANGLED STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 324.19 317.71 All Payors / Plans All Payors / Plans 324.19 other 324.19 324.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE NASOPHARYNGEAL 9FR SUP-270000000 CDM 270 RC outpatient 3.31 3.24 All Payors / Plans All Payors / Plans 3.31 other 3.31 3.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE NERVE STIMULATOR NIM-RESPONSE STANDARD OD.33 MM PRASS MONOPOLAR FLUSH TIP SLIMLINE HANDLE STERILE SUP-270000000 CDM 270 RC outpatient 357.84 350.68 All Payors / Plans All Payors / Plans 357.84 other 357.84 357.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE VASCULAR POLYMER STANDARD L45 CM OD1-1.5 MM BULB FLEXIBLE SHAFT EXTRA SUPPLE STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 229.06 224.48 All Payors / Plans All Payors / Plans 229.06 other 229.06 229.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE VITRECTOMY EDGEPLUS 4 MM OD23 GA 1 COUNT VALVED ENTRY SYSTEM STAND ALONE SUP-270000000 CDM 270 RC outpatient 110.36 108.15 All Payors / Plans All Payors / Plans 110.36 other 110.36 110.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE VITRECTOMY EDGEPLUS 4 MM OD25 GA 1 COUNT VALVED ENTRY SYSTEM STAND ALONE LOCKING MECHANISM CANNULA SUP-270000000 CDM 270 RC outpatient 105.13 103.03 All Payors / Plans All Payors / Plans 105.13 other 105.13 105.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE VITRECTOMY GRIESHABER 30 D OD25 GA DSP POINTED TIP DIATHERMY ERGONOMIC HANDLE ACCURUS CONSTELLATION SUP-270000000 CDM 270 RC outpatient 51.06 50.04 All Payors / Plans All Payors / Plans 51.06 other 51.06 51.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE VITRECTOMY TOTAL PLUS CONSTELLATION 5000 CPM OD23 GA EDGEPLUS VALVED CANNULA STRAIGHT ENDOILLUMINATOR SUP-270000000 CDM 270 RC outpatient 1200.47 1176.46 All Payors / Plans All Payors / Plans 1200.47 other 1200.47 1200.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROBE VITRECTOMY ULTRAVIT 27+ 20000 CPM OD27 MM CONSTELLATION VISION SYSTEM SUP-270000000 CDM 270 RC outpatient 433.5 424.83 All Payors / Plans All Payors / Plans 433.5 other 433.5 433.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROGEL AIR SEALANT SUP-270000000 CDM 270 RC outpatient 4942.14 4843.3 All Payors / Plans All Payors / Plans 4942.14 other 4942.14 4942.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROTECTOR EXTREMITY KODEL UNIVERSAL HEEL ELBOW DELUXE FULL FOOT DESIGN VENTILATION HOLE STRAP HOOK LOOP CLOSURE NONSTERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 2.19 2.15 All Payors / Plans All Payors / Plans 2.19 other 2.19 2.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility PROTECTOR TISSUE ALEXIS LARGE FLEXIBLE RETRACTION RING ATRAUMATIC 360 DEGREE PROTECTION LATEX FREE 9-14 CM INCISION SUP-270000000 CDM 270 RC outpatient 115.5 113.19 All Payors / Plans All Payors / Plans 115.5 other 115.5 115.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility QUIKCLOT SUP-481000000 CDM 270 RC outpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RADIAL .035 INQWIRE J-TIP WIRE 210CM SUP-481000000 CDM 270 RC outpatient 17.34 16.99 All Payors / Plans All Payors / Plans 17.34 other 17.34 17.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RADPAD SHIELD SUP-481000000 CDM 270 RC outpatient 114.45 112.16 All Payors / Plans All Payors / Plans 114.45 other 114.45 114.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility REINFORCEMENT STAPLE LINE SEAMGUARD BIOABSORBABLE STERILE LATEX FREE DISPOSABLE BLUE GOLD GREEN WHITE ENDOPATH ECHELON FLEX 60 SUP-270000000 CDM 270 RC outpatient 350 343 All Payors / Plans All Payors / Plans 350 other 350 350 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility REINFORCEMENT STAPLE LINE SEAMGUARD BIOABSORBABLE STERILE LATEX FREE DISPOSABLE DST SERIES CEEA 25 CIRCLE STAPLER SUP-270000000 CDM 270 RC outpatient 619.5 607.11 All Payors / Plans All Payors / Plans 619.5 other 619.5 619.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ECHELON ENDOPATH 2.6MM WHITE VASCULAR THIN TISSUE SUP-270000000 CDM 270 RC outpatient 1167.03 1143.69 All Payors / Plans All Payors / Plans 1167.03 other 1167.03 1167.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ECHELON ENDOPATH H2.6 MM VASCULAR THIN TISSUE WHITE SUP-270000000 CDM 270 RC outpatient 165.61 162.3 All Payors / Plans All Payors / Plans 165.61 other 165.61 165.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ECHELON ENDOPATH H4.1 MM THICK TISSUE GREEN SUP-270000000 CDM 270 RC outpatient 737.35 722.6 All Payors / Plans All Payors / Plans 737.35 other 737.35 737.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ECHELON ENDOPATH L45 MM X H3.6 MM H1.5 MM REGULAR TISSUE BLUE SUP-270000000 CDM 270 RC outpatient 174.74 171.25 All Payors / Plans All Payors / Plans 174.74 other 174.74 174.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ECHELON ENDOPATH L60 MM X H3.6 MM H1.5 MM REGULAR TISSUE BLUE SUP-270000000 CDM 270 RC outpatient 389.01 381.23 All Payors / Plans All Payors / Plans 389.01 other 389.01 389.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ECHELON ENDOPATH L60 MM X H3.8 MM H1.8 MM REGULAR THICK TISSUE GOLD SUP-270000000 CDM 270 RC outpatient 389.01 381.23 All Payors / Plans All Payors / Plans 389.01 other 389.01 389.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ENDO GIA TRI-STAPLE 2MM 2.5MM 3MM 60MM TAN TITANIUM DISPOSABLE STERILE LF MED VASCULAR TISSUE ARTICULATE SUP-270000000 CDM 270 RC outpatient 477.03 467.49 All Payors / Plans All Payors / Plans 477.03 other 477.03 477.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ENDO GIA TRI-STAPLE 3MM 3.5MM 4MM 60MM PURPLE TITANIUM DISPOSABLE STERILE LF MED THICK TISSUE ARTICULATE SUP-270000000 CDM 270 RC outpatient 606.46 594.33 All Payors / Plans All Payors / Plans 606.46 other 606.46 606.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ENDO GIA TRI-STAPLE 4MM 4.5MM 5MM 60MM BLACK PVC DISPOSABLE STERILE LF EXTRA THICK TISSUE ARTICULATE SUP-270000000 CDM 270 RC outpatient 699.06 685.08 All Payors / Plans All Payors / Plans 699.06 other 699.06 699.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ENDO GIA TRI-STAPLE TITANIUM 2 MM 2.5 MM 3 MM L45 MM MEDIUM VASCULAR TISSUE ARTICULATE CURVE TIP ANVIL STERILE LATEX FREE DISPOSABLE TAN SUP-270000000 CDM 270 RC outpatient 1045.28 1024.37 All Payors / Plans All Payors / Plans 1045.28 other 1045.28 1045.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ENDO GIA TRI-STAPLE TITANIUM 2 MM 2.5 MM 3 MM L45 MM MEDIUM VASCULAR TISSUE ARTICULATE KNIFE BLADE FIX ANVIL LARGE BUCKET STERILE LATEX FREE DISPOSABLE TAN SUP-270000000 CDM 270 RC outpatient 339.19 332.41 All Payors / Plans All Payors / Plans 339.19 other 339.19 339.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ENDO GIA TRI-STAPLE TITANIUM 3 MM 3.5 MM 4 MM L45 MM MEDIUM THICK TISSUE ARTICULATE KNIFE BLADE FIX ANVIL LARGE BUCKET STERILE LATEX FREE DISPOSABLE PURPLE SUP-270000000 CDM 270 RC outpatient 435.02 426.32 All Payors / Plans All Payors / Plans 435.02 other 435.02 435.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ENDO GIA TRI-STAPLE TITANIUM 3 MM 3.5 MM 4 MM L45 MM MEDIUM THICK TISSUE ARTICULATE REINFORCE STERILE LATEX FREE DISPOSABLE PURPLE SUP-270000000 CDM 270 RC outpatient 631.13 618.51 All Payors / Plans All Payors / Plans 631.13 other 631.13 631.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER ENDO GIA TRI-STAPLE TITANIUM 4 MM 4.5 MM 5 MM L60 MM EXTRA THICK TISSUE ARTICULATE REINFORCE STERILE LATEX FREE DISPOSABLE BLACK SUP-270000000 CDM 270 RC outpatient 873.3 855.83 All Payors / Plans All Payors / Plans 873.3 other 873.3 873.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER PROXIMATE TITANIUM H3.85 MM H1.5 MM REGULAR TISSUE STERILE LATEX FREE DISPOSABLE BLUE ENDOSCOPIC SUP-270009086 CDM 270 RC outpatient 134.98 132.28 All Payors / Plans All Payors / Plans 134.98 other 134.98 134.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER PROXIMATE TX TITANIUM L60 MM X H3.5 MM H1.5 MM REGULAR TISSUE 2 ROW STERILE LATEX FREE DISPOSABLE BLUE ENDOSCOPIC SUP-270009085 CDM 270 RC outpatient 68.68 67.31 All Payors / Plans All Payors / Plans 68.68 other 68.68 68.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER SIGNIA SMALL DIAMETER THIN L45 MM OD8 MM VASCULAR CURVE TIP STERILE LATEX FREE DISPOSABLE CANNULA SUP-270000000 CDM 270 RC outpatient 1102.5 1080.45 All Payors / Plans All Payors / Plans 1102.5 other 1102.5 1102.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER SIGNIA TRI-STAPLE BUTTRESS REINFORCED 60MM MED/THK SUP-270000000 CDM 270 RC outpatient 918.42 900.05 All Payors / Plans All Payors / Plans 918.42 other 918.42 918.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER SUREFORM 45 D2.5 MM STERILE LATEX FREE DISPOSABLE WHITE SUP-270000000 CDM 270 RC outpatient 714 699.72 All Payors / Plans All Payors / Plans 714 other 714 714 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD STAPLER SUREFORM 45 D4.3 MM STERILE LATEX FREE DISPOSABLE GREEN SUP-270000000 CDM 270 RC outpatient 15876 15558.48 All Payors / Plans All Payors / Plans 15876 other 15876 15876 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD SUTURE ASSISTANT ENDO STITCH POLYSORB BRALON LACTOMER NYLON 3-0 ES-9 L48 IN 1 STITCH STERILE DISPOSABLE VIOLET SUP-270000000 CDM 270 RC outpatient 140.38 137.57 All Payors / Plans All Payors / Plans 140.38 other 140.38 140.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD SUTURE ASSISTANT ENDO STITCH SURGIDAC 0 ES-9 48IN GREEN LACTOMER DISPOSABLE STERILE 1 STITCH SUP-270000000 CDM 270 RC outpatient 144.5 141.61 All Payors / Plans All Payors / Plans 144.5 other 144.5 144.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RELOAD SUTURE ENDO STITCH SURGIDAC LACTOMER 2-0 ES-9 L7 IN 1 STITCH DISPOSABLE GREEN SUP-270000000 CDM 270 RC outpatient 1974.4 1934.91 All Payors / Plans All Payors / Plans 1974.4 other 1974.4 1974.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RESERVOIR DRAINAGE JACKSON-PRATT BULB 100CC SILICONE DISPOSABLE STERILE LF SUP-270009038 CDM 270 RC outpatient 8.35 8.18 All Payors / Plans All Payors / Plans 8.35 other 8.35 8.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RESERVOIR SHUNT OMMAYA L2.5 CM 1.14 ML CSF FLAT BOTTOM SIDE INLET STERILE SUP-270000000 CDM 270 RC outpatient 898.74 880.77 All Payors / Plans All Payors / Plans 898.74 other 898.74 898.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRACTOR SURGICAL ALEXIS 360 D MEDIUM FLEXIBLE RING ATRAUMATIC SELF RETAINING WOUND PROTECTOR 5-9 CM INCISION SUP-270000000 CDM 270 RC outpatient 61.2 59.98 All Payors / Plans All Payors / Plans 61.2 other 61.2 61.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRACTOR SURGICAL ALEXIS 360 D XL FLEXIBLE RING ATRAUMATIC SELF RETAINING WOUND PROTECTOR 11-17 CM INCISION SUP-270000000 CDM 270 RC outpatient 144.9 142 All Payors / Plans All Payors / Plans 144.9 other 144.9 144.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRACTOR SURGICAL ALEXIS 360D SM ATRAUMATIC SELF RETAIN FLEXIBLE RING WOUND PROTECTOR 2.5-6CM INCISION SUP-270000000 CDM 270 RC outpatient 61.2 59.98 All Payors / Plans All Payors / Plans 61.2 other 61.2 61.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRACTOR SURGICAL ALEXIS O 360 D LARGE RIGID RING ATRAUMATIC UNIQUE C SECTION 9-14 CM INCISION SUP-270000000 CDM 270 RC outpatient 93.5 91.63 All Payors / Plans All Payors / Plans 93.5 other 93.5 93.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRACTOR/ELEVATOR LAPAROSCOPIC VCARE LG 37MM DISPOSABLE STERILE LF CERVIX UTERUS 2 CUP HOLE MANIPULATOR INFLATABLE SUP-270000000 CDM 270 RC outpatient 149.52 146.53 All Payors / Plans All Payors / Plans 149.52 other 149.52 149.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRACTOR/ELEVATOR LAPAROSCOPIC VCARE MED 34MM DISPOSABLE STERILE LF CERVIX UTERUS 2 CUP LOCK SCREW HYSTERECTOMY SUP-270000000 CDM 270 RC outpatient 72.62 71.17 All Payors / Plans All Payors / Plans 72.62 other 72.62 72.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRIEVER ENDOSCOPIC RESCUENET PROMESH OMNILOOP L5.5 CM X W3CM L230CM OD2.5MM RETRIEVAL NET FOREIGN BODY REMOVAL GREATER VISIBILITY ULTRA STRONG BLUE SUP-270000000 CDM 270 RC outpatient 93.65 91.78 All Payors / Plans All Payors / Plans 93.65 other 93.65 93.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRIEVER ENDOSCOPIC TREVO NXT PROVUE L41 MM OD4 MM TREVO TRAK 21 MICROCATHETER STERILE LATEX FREE DISPOSABLE SUP-27000000 CDM 270 RC outpatient 19313.7 18927.43 All Payors / Plans All Payors / Plans 19313.7 other 19313.7 19313.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RETRIEVER SUTURE ISOTAC STRAIGHT ROTATOR CUFF ISOMETRY STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 47.7 46.75 All Payors / Plans All Payors / Plans 47.7 other 47.7 47.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RIA 2 BONE HARVESTING KIT 520MM STERILE SUP-270000000 CDM 270 RC outpatient 6720.1 6585.7 All Payors / Plans All Payors / Plans 6720.1 other 6720.1 6720.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RING RETRACTOR LONE STAR NORYL PLASTIC L14.1 CM X W14.1 CM 2 PEEL POUCH SELF RETAINING FLEXIBLE LIGHTWEIGHT ELASTIC STAY STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 97.79 95.83 All Payors / Plans All Payors / Plans 97.79 other 97.79 97.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RING RETRACTOR LONE STAR NORYL PLASTIC L32.5 CM X W18.3 CM SELF RETAIN 2 CATHETER CLIP STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 249.26 244.27 All Payors / Plans All Payors / Plans 249.26 other 249.26 249.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROD MARNIER PRECONTOURED 5.5MM X 70 SUP-270000000 CDM 270 RC outpatient 5151 5047.98 All Payors / Plans All Payors / Plans 5151 other 5151 5151 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROD PRECONTOURED 5.5 X 110MM SUP-270010020 CDM 270 RC outpatient 14007 13726.86 All Payors / Plans All Payors / Plans 14007 other 14007 14007 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROD REAMING L950 MM OD2.5 MM BALL TIP STERILE DISPOSABLE SUP-270010022 CDM 270 RC outpatient 443.62 434.75 All Payors / Plans All Payors / Plans 443.62 other 443.62 443.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROLL COTTON LG 8.5X1FT STERILE LF 1LB HIGH ABSORBENT SUP-270000000 CDM 270 RC outpatient 7.71 7.56 All Payors / Plans All Payors / Plans 7.71 other 7.71 7.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROTABLATOR - ROTAWIRE DRIVE FLOPPY SUP-481000000 CDM 270 RC outpatient 424.15 415.67 All Payors / Plans All Payors / Plans 424.15 other 424.15 424.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility ROTAPRO 1.75MM BURR SUP-270000000 CDM 270 RC outpatient 3272.5 3207.05 All Payors / Plans All Payors / Plans 3272.5 other 3272.5 3272.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility RULER SURGICAL PLASTIC PAPER L6 IN FLEXIBLE FIBER FREE STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 1.15 1.13 All Payors / Plans All Payors / Plans 1.15 other 1.15 1.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SAFE SHEATH CSG BRAIDED CORE SUP-481000000 CDM 270 RC outpatient 33.15 32.49 All Payors / Plans All Payors / Plans 33.15 other 33.15 33.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SAFESHEATH 9FR 13CM SUP-275000000 CDM 270 RC outpatient 341.25 334.43 All Payors / Plans All Payors / Plans 341.25 other 341.25 341.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SAFESHEATH CSG BRAIDED CORE SUP-481000000 CDM 270 RC outpatient 33.15 32.49 All Payors / Plans All Payors / Plans 33.15 other 33.15 33.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SAW BLADE SAGITTAL SUP-270000000 CDM 270 RC outpatient 99.67 97.68 All Payors / Plans All Payors / Plans 99.67 other 99.67 99.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCALPEL SURGICAL BARD-PARKER STAINLESS STEEL 10 1 HAND ACTIVATION LOCK RETRACTABLE SHIELD BLADE STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 3.63 3.56 All Payors / Plans All Payors / Plans 3.63 other 3.63 3.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCISSORS LAPAROSCOPIC ENDOPATH 360D CURVE 21CM 5MM DISPOSABLE STERILE LF RATCHET HANDLE MONOPOLAR CAUTERY INSULATE SHAFT SUP-270000000 CDM 270 RC outpatient 140.24 137.44 All Payors / Plans All Payors / Plans 140.24 other 140.24 140.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE 26MM 3.5MM SS NS CORTICAL SELF TAPPING SM FRAGMENT SET SUP-270010022 CDM 270 RC outpatient 56.76 55.62 All Payors / Plans All Payors / Plans 56.76 other 56.76 56.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE 2MM 11MM QUICKFIX TITANIUM FULL THREAD FOOT HAND ANKLE WRIST 3 PRONG SELF SUP-270000000 CDM 270 RC outpatient 504 493.92 All Payors / Plans All Payors / Plans 504 other 504 504 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE COALITION L14 MM OD4.2 MM SPINE SELF DRILL VARIABLE ANGLE NONSTERILE SUP-270010020 CDM 270 RC outpatient 315 308.7 All Payors / Plans All Payors / Plans 315 other 315 315 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 14MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 10 MM OD 4.7MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC outpatient 104.72 102.63 All Payors / Plans All Payors / Plans 104.72 other 104.72 104.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 12MM OD 4.7MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC outpatient 160.16 156.96 All Payors / Plans All Payors / Plans 160.16 other 160.16 160.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 14MM OD 4.7MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC outpatient 104.72 102.63 All Payors / Plans All Payors / Plans 104.72 other 104.72 104.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 36 MM OD 4.7 MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC outpatient 129.36 126.77 All Payors / Plans All Payors / Plans 129.36 other 129.36 129.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 38 MM OD 4.7MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC outpatient 129.36 126.77 All Payors / Plans All Payors / Plans 129.36 other 129.36 129.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 40 MM OD 4.7 MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC outpatient 129.36 126.77 All Payors / Plans All Payors / Plans 129.36 other 129.36 129.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 44 MM OD 4.7MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC outpatient 129.36 126.77 All Payors / Plans All Payors / Plans 129.36 other 129.36 129.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 55 MM OD 4.7 MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC outpatient 104.72 102.63 All Payors / Plans All Payors / Plans 104.72 other 104.72 104.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS FULL THREAD L 65 MM OD 4.7 MM STERILE OSTEOPENIA SUP-270000000 CDM 270 RC outpatient 150.36 147.35 All Payors / Plans All Payors / Plans 150.36 other 150.36 150.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 10MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 11 MM OD 2.7 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 228.96 224.38 All Payors / Plans All Payors / Plans 228.96 other 228.96 228.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 11MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 54.6 53.51 All Payors / Plans All Payors / Plans 54.6 other 54.6 54.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 11MM OD 3.5MM CORTEX STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 12MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 13 MM OD 2.7 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 228.96 224.38 All Payors / Plans All Payors / Plans 228.96 other 228.96 228.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 13MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 13MM OD 3.5MM CORTEX STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 14 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 14MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 15 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 572 560.56 All Payors / Plans All Payors / Plans 572 other 572 572 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 15MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 54.6 53.51 All Payors / Plans All Payors / Plans 54.6 other 54.6 54.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 15MM OD 3.5MM CORTEX STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 15MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 16 MM OD 2.7 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 228.96 224.38 All Payors / Plans All Payors / Plans 228.96 other 228.96 228.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 16 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 17 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 54.6 53.51 All Payors / Plans All Payors / Plans 54.6 other 54.6 54.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 18 MM OD 2.7 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 228.96 224.38 All Payors / Plans All Payors / Plans 228.96 other 228.96 228.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 18 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 20MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 462 452.76 All Payors / Plans All Payors / Plans 462 other 462 462 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 24 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 24 MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 26 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 26 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 28 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 28 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 28 MM OD 3.5 MM SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 30 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 30 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 32 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 32 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 34 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 36 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 52.5 51.45 All Payors / Plans All Payors / Plans 52.5 other 52.5 52.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 38 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 38 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 38MM OD 4.5 MM CORTEX SELF TAP STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 99.32 97.33 All Payors / Plans All Payors / Plans 99.32 other 99.32 99.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 40 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 40 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 187 183.26 All Payors / Plans All Payors / Plans 187 other 187 187 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 40MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 42 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 44 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 44MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 46 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 48 MM OD 3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 50 MM OD 3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 286 280.28 All Payors / Plans All Payors / Plans 286 other 286 286 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 50MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 55MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 60MM OD 3.5MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 462 452.76 All Payors / Plans All Payors / Plans 462 other 462 462 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 70 MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 105 102.9 All Payors / Plans All Payors / Plans 105 other 105 105 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 75MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 52.5 51.45 All Payors / Plans All Payors / Plans 52.5 other 52.5 52.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 80 MM OD 4.5MM SELF TAP LOCK STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 582.75 571.1 All Payors / Plans All Payors / Plans 582.75 other 582.75 582.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L 8MM OD 3.5MM CORTEX STERILE SUP-270000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L12 MM OD 3.5 MM CORTEX SELF TAP SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L36 MM OD 4.5 MM SELF TAP LOCK STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 517.65 507.3 All Payors / Plans All Payors / Plans 517.65 other 517.65 517.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L42 MM OD3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 52.5 51.45 All Payors / Plans All Payors / Plans 52.5 other 52.5 52.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L60 MM OD3.5 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L65 MM OD3.5 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS L76MM OD 4.5 MM CORTEX SELF TAP STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 80.22 78.62 All Payors / Plans All Payors / Plans 80.22 other 80.22 80.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI STAINLESS STEEL T7 L 11MM OD 2.4MM ODSEC 3.8MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC outpatient 263.12 257.86 All Payors / Plans All Payors / Plans 263.12 other 263.12 263.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI STAINLESS STEEL T7 L 15MM OD 2.4MM ODSEC 3.8MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC outpatient 172.04 168.6 All Payors / Plans All Payors / Plans 172.04 other 172.04 172.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI STAINLESS STEEL T7 L 17 MM OD 2.4 MM ODSEC 3.8MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC outpatient 212.52 208.27 All Payors / Plans All Payors / Plans 212.52 other 212.52 212.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI STAINLESS STEEL T7 L 22MM OD 2.4MM ODSEC 3.8MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC outpatient 212.52 208.27 All Payors / Plans All Payors / Plans 212.52 other 212.52 212.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI STAINLESS STEEL T7 L 26 MM OD 2.4 MM ODSEC 3.8MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC outpatient 212.52 208.27 All Payors / Plans All Payors / Plans 212.52 other 212.52 212.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI STAINLESS STEEL T7 L 30 MM OD 2.4 MM OD SEC 3.8 MMLONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC outpatient 263.12 257.86 All Payors / Plans All Payors / Plans 263.12 other 263.12 263.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI STAINLESS STEEL T7L 19 MM OD 2.4 MM OD SEC 3.8MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC outpatient 172.04 168.6 All Payors / Plans All Payors / Plans 172.04 other 172.04 172.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T6 L 13 MM OD 2 MM ODSEC 3.3 MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC outpatient 206.64 202.51 All Payors / Plans All Payors / Plans 206.64 other 206.64 206.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L 12 MM OD 2.4MM ODSEC3.8MM LONG BONE SMALL BONE CORTEX SELF TAP DRIVER STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L 13 MM OD 2.4MM ODSEC 3.8MM LONG BONE SMALL BONE CORTEX SELF TAP DRIVER STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L 14 MM OD 2.4MM ODSEC3.8MM LONG BONE SMALL BONE CORTEX SELF TAP DRIVER STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L 16 MM OD 2.4MM ODSEC3.8MM LONG BONE SMALL BONE CORTEX SELF TAP DRIVER STERILE SUP-270000000 CDM 270 RC outpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L 32 MM OD 2.4 MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L13MM OD 2.4 MM LONG BONE SMALL BONE LOCK DRIVER STERILE SUP-270000000 CDM 270 RC outpatient 212.52 208.27 All Payors / Plans All Payors / Plans 212.52 other 212.52 212.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L18 MM OD 2.4 MM ODSEC 3.8 MM LONG BONE SMALL BONE LOCK DRIVER STERILE SUP-270000000 CDM 270 RC outpatient 263.12 257.86 All Payors / Plans All Payors / Plans 263.12 other 263.12 263.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L20 MM OD 2.4 MM ODSEC 3.8 MM LONG BONE SMALL BONE LOCK DRIVER STERILE SUP-270000000 CDM 270 RC outpatient 172.04 168.6 All Payors / Plans All Payors / Plans 172.04 other 172.04 172.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T7 L30 MM OD 2.4 MNM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS MINI T8 L75 MM OD 2.7 MM LONG BONE SMALL BONE CORTEX SELF TAP SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS STAINLESS STEEL L 26 MM OD 2.4 MM WRIST CORTEX CADDY STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS STAINLESS STEEL T7 L 14MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS STAINLESS STEEL T7 L 16MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS STAINLESS STEEL T7 L 18 MM OD 3.5MM CORTEX SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 176.4 172.87 All Payors / Plans All Payors / Plans 176.4 other 176.4 176.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS STAINLESS STEEL T7 L 20MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS STAINLESS STEEL T7 L 22MM OD 3.5MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T6 L 12 MM OD 2 MM ODSEC 3 MM CORTEX SELF TAP STERILE MINI PLATE SYSTEM SUP-270000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T6 L 18 MM OD 2MM ODSEC 3 MM CORTEX SELF TAP MINI PLATE SYSTEM SUP-270000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T7 L 10 MM OD 2.4 MM SELF-TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 212.52 208.27 All Payors / Plans All Payors / Plans 212.52 other 212.52 212.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T7 L 10MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 54.6 53.51 All Payors / Plans All Payors / Plans 54.6 other 54.6 54.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T7 L 11MM CORTEX SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 109.2 107.02 All Payors / Plans All Payors / Plans 109.2 other 109.2 109.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T7 L 12 MM OD 2.4 MM CORTEX LOCK SELF TAP STERILE SUP-270000000 CDM 270 RC outpatient 212.52 208.27 All Payors / Plans All Payors / Plans 212.52 other 212.52 212.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T7 L 14MM OD2.4MM ODSEC 3.8MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC outpatient 263.12 257.86 All Payors / Plans All Payors / Plans 263.12 other 263.12 263.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T7 L 16MM OD2.4MM ODSEC 3.8MM LONG BONE SMALL BONE LOCK STERILE SUP-270000000 CDM 270 RC outpatient 263.12 257.86 All Payors / Plans All Payors / Plans 263.12 other 263.12 263.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T8 L 11MM OD 2.7 MM ODSEC 4.5MM CORTEX SELF TAP MINI PLATE SYSTEM SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T8 L 12MM OD 2.7 MM ODSEC 4.5MM CORTEX SELF TAP MINI PLATE SYSTEM SUP-270000000 CDM 270 RC outpatient 132.3 129.65 All Payors / Plans All Payors / Plans 132.3 other 132.3 132.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T8 L 12MM OD 2.7 MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 184.93 181.23 All Payors / Plans All Payors / Plans 184.93 other 184.93 184.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T8 L 14MM OD 2.7 MM ODSEC 4.5MM CORTEX SELF TAP MINI PLATE SYSTEM SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T8 L 16MM OD 2.7MM SELF TAP LOCK STERILE SUP-270000000 CDM 270 RC outpatient 184.93 181.23 All Payors / Plans All Payors / Plans 184.93 other 184.93 184.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T8 L 20 MM OD 2.7MM LOCK SUP-270000000 CDM 270 RC outpatient 554.78 543.68 All Payors / Plans All Payors / Plans 554.78 other 554.78 554.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE EVOS T8 L 38 MM OD 2.7 MM SELF TAP LOCK SUP-270000000 CDM 270 RC outpatient 184.93 181.23 All Payors / Plans All Payors / Plans 184.93 other 184.93 184.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L 25 MM OD 5 MM FEMUR LOW PROFILE INTERNAL HEX TRIGEN INTRAMEDULLARY NAIL SYSTEM SUP-270000000 CDM 270 RC outpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L 32.5 MM OD 5 MM FEMUR LOW PROFILE INTERNAL HEX TRIGEN INTRAMEDULLARY NAIL SYSTEM SUP-270000000 CDM 270 RC outpatient 468 458.64 All Payors / Plans All Payors / Plans 468 other 468 468 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L 37.5MM OD 5MM FEMUR LOW PROFILE INTERAL HEX SUP-270000000 CDM 270 RC outpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L 47.5 MM OD 5 MM FEMUR LOW PROFILE INTERNAL HEX TRIGEN INTRAMEDULLARY NAIL SYSTEM SUP-270000000 CDM 270 RC outpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L 52.5 MM OD 5 MM FEMUR LOW PROFILE INTERNAL HEX TRIGEN INTRAMEDULLARY NAIL SYSTEM SUP-270000000 CDM 270 RC outpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L 55 MM OD 5 MM LOW PROFILE INTERNAL HEX SUP-270000000 CDM 270 RC outpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L 70 MM OD 5MM LOW PROFILE INTERNAL HEX SUP-270000000 CDM 270 RC outpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L20 MM OD5.5 MM LOCK PERIPHERAL STERILE SUP-270010030 CDM 270 RC outpatient 88.41 86.64 All Payors / Plans All Payors / Plans 88.41 other 88.41 88.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L40 MM OD3.5 MM ODSEC6 MM PELVIC CORTEX SELF TAP SMALL HEXAGONAL SOCKET SUP-270010022 CDM 270 RC outpatient 112.06 109.82 All Payors / Plans All Payors / Plans 112.06 other 112.06 112.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L45 MM OD3.5 MM PELVIC CORTEX SELF TAP SUP-270010022 CDM 270 RC outpatient 190.58 186.77 All Payors / Plans All Payors / Plans 190.58 other 190.58 190.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L50 MM OD3.5 MM PELVIC CORTEX SELF TAP SUP-270010022 CDM 270 RC outpatient 56.03 54.91 All Payors / Plans All Payors / Plans 56.03 other 56.03 56.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L60 MM OD3.5 MM PELVIC CORTEX SELF TAP SUP-270010022 CDM 270 RC outpatient 59.79 58.59 All Payors / Plans All Payors / Plans 59.79 other 59.79 59.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE L65 MM OD3.5 MM PELVIC CORTEX SELF TAP SUP-270010022 CDM 270 RC outpatient 59.79 58.59 All Payors / Plans All Payors / Plans 59.79 other 59.79 59.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE LC-DCP DCP STAINLESS STEEL FULL THREAD HEXAGON L20 MM OD3.5 MM ODSEC6 MM CLAVICLE HUMERUS TIBIA CORTICAL SELF TAP NONSTERILE SMALL FRAGMENT SET SUP-270010022 CDM 270 RC outpatient 45.84 44.92 All Payors / Plans All Payors / Plans 45.84 other 45.84 45.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE LC-DCP DCP STAINLESS STEEL FULL THREAD L32 MM OD3.5 MM ODSEC6 MM CLAVICLE HUMERUS TIBIA CORTICAL SELF TAPPING SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET SUP-270010022 CDM 270 RC outpatient 45.84 44.92 All Payors / Plans All Payors / Plans 45.84 other 45.84 45.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE LOW PROFILE TITANIUM T 15 FULL THREAD L 14 MM OD 3.5 MM MIDFOOT CORTICAL SELF DRILL SOLID HEXALOBE SUP-270000000 CDM 270 RC outpatient 252 246.96 All Payors / Plans All Payors / Plans 252 other 252 252 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE MARINER L45 MM OD6.5 MM SPINE CANNULATED NONSTERILE SUP-270010020 CDM 270 RC outpatient 5950 5831 All Payors / Plans All Payors / Plans 5950 other 5950 5950 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE MARINER L55 MM OD6.5 MM SPINAL SOLID SUP-270000000 CDM 270 RC outpatient 1190 1166.2 All Payors / Plans All Payors / Plans 1190 other 1190 1190 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE MATRIXNEURO TITANIUM L4 MM OD1.5 MM CRANIOMAXILLOFACIAL SELF DRILLING NONSTERILE SUP-270010013 CDM 270 RC outpatient 292.52 286.67 All Payors / Plans All Payors / Plans 292.52 other 292.52 292.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE OD 3.5 MM T7 L 18MM OD 2.4MM CORTEX SELF RETAINING SCREWDRIVER SELF TAP FLAT HEAD STERILE EVOS MINI SUP-270000000 CDM 270 RC outpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE OD 3.5 MM T7 L 65 MM OD 2.4MM ODSEC 3.8MM CORTEX SELF RETAINING SCREWDRIVER SELF TAP FLAT HEAD STERILE EVOS MINI SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE OD 3.5MM T7 L 80 MM OD 2.4MM ODSEC 3.8MM CORTEX SELF RETAINING SCREWDRIVER SELF TAP FLAT HEAD STERILE EVOS MINI SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE PERI-LOC STAINLESS STEEL 2.5 MM FLUTE L 36MM L 14MM OD 4MM ODSEC 6MM HIP SELF TAP CANNULATED TROCAR STERILE SUP-270000000 CDM 270 RC outpatient 389.13 381.35 All Payors / Plans All Payors / Plans 389.13 other 389.13 389.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE PERI-LOC STAINLESS STEEL 2.5MM FLUTE L 34 MM L 14MM OD 4 MM ODSEC 6 MM HIP CANNULATED SELF TAP TROCAR STERILE SUP-270000000 CDM 270 RC outpatient 389.13 381.35 All Payors / Plans All Payors / Plans 389.13 other 389.13 389.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE PERI-LOCK STAINLESS STEEL 2.5 MM FLUTE L 38 MM L 14 MM OD 4 MM ODSEC 6 MM HIP CANNULATED SELF TAP TROCAR STERILE SUP-270000000 CDM 270 RC outpatient 389.13 381.35 All Payors / Plans All Payors / Plans 389.13 other 389.13 389.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 20 MM OD 2.4 MM CORITCAL STERILE SUP-270000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 22MM OD 2.7MM CORTICAL STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 24 MM OD 2.4 MM CORTICAL STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 24 MM OD 2.7 MM CORTICAL STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 28 MM OD 2.4 MM CORTICAL STERILE SUP-270000000 CDM 270 RC outpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 30 MM OD 2.7 MM CORTICAL STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 32MM OD 2.7MM CORTICAL STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 34 MM OD 2.4 MM CORTICAL STERILE SUP-270000000 CDM 270 RC outpatient 71.4 69.97 All Payors / Plans All Payors / Plans 71.4 other 71.4 71.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 34MM OD 2.7MM CORTICAL STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 36 MM OD 2.4 MM CORTICAL STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 38MM OD 2.7MM CORTICAL STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 44 MM OD 2.4 MM CORTICAL STERILE SUP-270000000 CDM 270 RC outpatient 54.6 53.51 All Payors / Plans All Payors / Plans 54.6 other 54.6 54.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 46 MM OD 2.4 MM CORTICAL STERILE SUP-270000000 CDM 270 RC outpatient 54.6 53.51 All Payors / Plans All Payors / Plans 54.6 other 54.6 54.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 60 MM OD 2.4 MM CORTICAL STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 70MM OD 2.7MM CORTICAL STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 8 MM OD 2 MM CORTICAL STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STEEL L 8 MM OD 2 MM LOCK STERILE SUP-270000000 CDM 270 RC outpatient 206.64 202.51 All Payors / Plans All Payors / Plans 206.64 other 206.64 206.64 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STAINLESS STELL L 26 MM OD 2.7 MM CORTICAL STERILE SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE STANDARD L14 MM OD3.6 MM SPINE VARIABLE ANGLE SELF DRILL STERILE SUP-270010020 CDM 270 RC outpatient 1575 1543.5 All Payors / Plans All Payors / Plans 1575 other 1575 1575 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE T7 L 60 MM OD 2.7 MM ODSEC 4.5 MM CORTEX SELF RETAINING SCREWDRIVER SELF TAP FLAT HEAD STERILE EVOS MINI SUP-270000000 CDM 270 RC outpatient 44.1 43.22 All Payors / Plans All Payors / Plans 44.1 other 44.1 44.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE T8 OD 2MM L 14MM OD 2.7MM ODSEC 4.3MM SMALL BONE LONG BONE SELF TAP LOCK EVOS SUP-270000000 CDM 270 RC outpatient 184.93 181.23 All Payors / Plans All Payors / Plans 184.93 other 184.93 184.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TITANIUM L36 MM OD3 MM COMPRESSION CANNULATED NONSTERILE SUP-270000000 CDM 270 RC outpatient 1624.35 1591.86 All Payors / Plans All Payors / Plans 1624.35 other 1624.35 1624.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TITANIUM L38 MM OD3 MM COMPRESSION CANNULATED NONSTERILE SUP-270000000 CDM 270 RC outpatient 919.8 901.4 All Payors / Plans All Payors / Plans 919.8 other 919.8 919.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TITANIUM L65 MM OD5.5 MM COMPRESSION CANNULATED NONSTERILE SUP-270000000 CDM 270 RC outpatient 2216.63 2172.3 All Payors / Plans All Payors / Plans 2216.63 other 2216.63 2216.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SCREW BONE TITANIUM SHORT THREAD L44 MM L11 MM OD3.5 MM COMPRESSION SELF TAP, SELF DRILL CANNULATED NONSTERILE" SUP-270000000 CDM 270 RC outpatient 966.88 947.54 All Payors / Plans All Payors / Plans 966.88 other 966.88 966.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TRIDENT II L15 MM OD6.5 MM LOW PROFILE HEXAGONAL STERILE SUP-270010024 CDM 270 RC outpatient 207.9 203.74 All Payors / Plans All Payors / Plans 207.9 other 207.9 207.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TRIDENT II L20 MM OD6.5 MM LOW PROFILE HEXAGONAL STERILE SUP-270010024 CDM 270 RC outpatient 142.8 139.94 All Payors / Plans All Payors / Plans 142.8 other 142.8 142.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TRIDENT II L30 MM OD6.5 MM LOW PROFILE HEXAGONAL STERILE SUP-270010024 CDM 270 RC outpatient 207.9 203.74 All Payors / Plans All Payors / Plans 207.9 other 207.9 207.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TRIGEN L 27.5 MM OD 5 MM TIBIAL INTERNAL CAPTURE SUP-270000000 CDM 270 RC outpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TRIGEN L 30 MM OD 5 MM TIBIAL INTERNAL CAPTURE SUP-270000000 CDM 270 RC outpatient 225 220.5 All Payors / Plans All Payors / Plans 225 other 225 225 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TRIGEN L 35MM OD 5MM TIBIAL INTERNAL CAPTURE SUP-270000000 CDM 270 RC outpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE TRIGEN L 40 MM OD 5 MM TIBIAL INTERNAL CAPTURE SUP-270000000 CDM 270 RC outpatient 378 370.44 All Payors / Plans All Payors / Plans 378 other 378 378 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VELYS L100 MM OD4 MM STERILE SUP-270010025 CDM 270 RC outpatient 71.4 69.97 All Payors / Plans All Payors / Plans 71.4 other 71.4 71.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VELYS L125 MM OD4 MM STERILE SUP-270010025 CDM 270 RC outpatient 138.72 135.95 All Payors / Plans All Payors / Plans 138.72 other 138.72 138.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP 15D 2.5 MM L28 MM X H 3.3MM OD 5MM ODSEC 5.4MM MIDFOOT HINDFOOT LOCKING LOW PROFILE HEAD HEXAGONAL RECESS DRIVE OSTEOPENIA SUP-270000000 CDM 270 RC outpatient 376.32 368.79 All Payors / Plans All Payors / Plans 376.32 other 376.32 376.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP 15D 2.5 MM L30 MM X H 3.3MM OD 5MM ODSEC 5.4MM MIDFOOT HINDFOOT LOCKING LOW PROFILE HEAD HEXAGONAL RECESS DRIVE OSTEOPENIA SUP-270000000 CDM 270 RC outpatient 376.32 368.79 All Payors / Plans All Payors / Plans 376.32 other 376.32 376.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM L 13 MM OD 2.4 MM FOOT LOCK SELF TAP T7 DRIVER SUP-270000000 CDM 270 RC outpatient 286.02 280.3 All Payors / Plans All Payors / Plans 286.02 other 286.02 286.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM L 14 MM OD 2.4 MM FOOT LOCK SELF TAP T7 DRIVER SUP-270000000 CDM 270 RC outpatient 858.06 840.9 All Payors / Plans All Payors / Plans 858.06 other 858.06 858.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM L 20 MM OD 2.4MM FOOT LOCK SELF TAP SUP-270000000 CDM 270 RC outpatient 286.02 280.3 All Payors / Plans All Payors / Plans 286.02 other 286.02 286.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM T7 L 12 MM OD 2.4 MM FOOT LOCK SELF TAP SUP-270000000 CDM 270 RC outpatient 286.02 280.3 All Payors / Plans All Payors / Plans 286.02 other 286.02 286.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM T7 L 15 MM OD 2.4 MM FOOT LOCK SELF TAP SUP-270000000 CDM 270 RC outpatient 572.04 560.6 All Payors / Plans All Payors / Plans 572.04 other 572.04 572.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM T7 L 6 MM OD 2.4 MM FOOT CORTICAL SELF TAP SUP-270000000 CDM 270 RC outpatient 272.16 266.72 All Payors / Plans All Payors / Plans 272.16 other 272.16 272.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM T7 L 6 MM OD 2.4 MM FOOT LOCK SELF TAP SUP-270000000 CDM 270 RC outpatient 858.06 840.9 All Payors / Plans All Payors / Plans 858.06 other 858.06 858.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM T7 L 8 MM OD 2.4 MM FOOT LOCK SELF TAP SUP-270000000 CDM 270 RC outpatient 286.02 280.3 All Payors / Plans All Payors / Plans 286.02 other 286.02 286.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE VLP TITANIUM T7 L7 MM OD 2.4 MM FOOT LOCK SELF TAP SUP-270000000 CDM 270 RC outpatient 286.02 280.3 All Payors / Plans All Payors / Plans 286.02 other 286.02 286.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW BONE ZEVO TITANIUM L15 MM OD3.5 MM SPINE CERVICAL ANTERIOR VARIABLE SELF DRILL SUP-270010020 CDM 270 RC outpatient 840 823.2 All Payors / Plans All Payors / Plans 840 other 840 840 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW CORTICAL SHANK CANNULATED 5.5MM X 35MM SUP-270000000 CDM 270 RC outpatient 1470 1440.6 All Payors / Plans All Payors / Plans 1470 other 1470 1470 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW DISTRACTION 14MM SS DISPOSABLE STERILE LF SPINE CERVICAL ANTERIOR SHARP TIP SELF TAP THREAD PIN UNIVERSAL BULLET SUP-270000000 CDM 270 RC outpatient 95.61 93.7 All Payors / Plans All Payors / Plans 95.61 other 95.61 95.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW EVOS BLT TIP LCK 4.5MM X 12MM SUP-270000000 CDM 270 RC outpatient 905.1 887 All Payors / Plans All Payors / Plans 905.1 other 905.1 905.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW EVOS LOCKING 4.5MM X 30MM STERILE SUP-270000000 CDM 270 RC outpatient 517.65 507.3 All Payors / Plans All Payors / Plans 517.65 other 517.65 517.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW EVOS LOCKING 4.5MM X 72MM STERILE SUP-270000000 CDM 270 RC outpatient 517.65 507.3 All Payors / Plans All Payors / Plans 517.65 other 517.65 517.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW LOCKING EVOS 4.5MM X 20 MM S-T SUP-270000000 CDM 270 RC outpatient 1035.3 1014.59 All Payors / Plans All Payors / Plans 1035.3 other 1035.3 1035.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW LOCKING EVOS 4.5MM X 66MM S-T SUP-270000000 CDM 270 RC outpatient 616.25 603.93 All Payors / Plans All Payors / Plans 616.25 other 616.25 616.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW LOCKING EVOS L 40MM 4.5 MM S-T SUP-270000000 CDM 270 RC outpatient 517.65 507.3 All Payors / Plans All Payors / Plans 517.65 other 517.65 517.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW PERIPHERAL LOCKING 5.5MM X 24MM SUP-270010030 CDM 270 RC outpatient 89.22 87.44 All Payors / Plans All Payors / Plans 89.22 other 89.22 89.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW PINNACLE CANCELLOUS BONE 6.5MM X 35MM SUP-270010024 CDM 270 RC outpatient 318.78 312.4 All Payors / Plans All Payors / Plans 318.78 other 318.78 318.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SCREW SELF DRILLING 1.5MM 4MM SUP-270000000 CDM 270 RC outpatient 911.4 893.17 All Payors / Plans All Payors / Plans 911.4 other 911.4 911.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SCREW, BONE REMOVER" SUP-270000000 CDM 270 RC outpatient 338 331.24 All Payors / Plans All Payors / Plans 338 other 338 338 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEAL 12MM STAPLER CANNULA SUP-270000000 CDM 270 RC outpatient 35.7 34.99 All Payors / Plans All Payors / Plans 35.7 other 35.7 35.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEAL 5-8MM UNIVERSAL SUP-270000000 CDM 270 RC outpatient 39.69 38.9 All Payors / Plans All Payors / Plans 39.69 other 39.69 39.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEALANT TISSUE CLOSURE DURASEAL EXACT 5ML DISPOSABLE STERILE LF SPINE SUP-270000000 CDM 270 RC outpatient 1395.9 1367.98 All Payors / Plans All Payors / Plans 1395.9 other 1395.9 1395.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEALER TISSUE ENSEAL G2 STRAIGHT L45 CM OD5 MM ARTICULATE SUP-270000000 CDM 270 RC outpatient 578.25 566.69 All Payors / Plans All Payors / Plans 578.25 other 578.25 578.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEALER TISSUE SYNCHROSEAL DA VINCI L8MM SUP-270000000 CDM 270 RC outpatient 1521.45 1491.02 All Payors / Plans All Payors / Plans 1521.45 other 1521.45 1521.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEALER VESSEL SUP-270000000 CDM 270 RC outpatient 669.46 656.07 All Payors / Plans All Payors / Plans 669.46 other 669.46 669.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEALER/DIVIDER BIPOLAR LIGASURE 180D STRAIGHT 37CM 19.5MM 5MM DISPOSABLE STERILE LF HANDSWITCH 2 ACTION CONTOUR BLUNT SUP-270000000 CDM 270 RC outpatient 814.7 798.41 All Payors / Plans All Payors / Plans 814.7 other 814.7 814.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEALER/DIVIDER BIPOLAR LIGASURE IMPACT 180 D L34 MM LARGE L7.1 IN L36 MM OD13.5 MM HAND ACTIVATION CURVE JAW THERMAL SPREAD LIGHTWEIGHT STERILE DISPOSABLE FORCETRIAD SUP-270000000 CDM 270 RC outpatient 2408.1 2359.94 All Payors / Plans All Payors / Plans 2408.1 other 2408.1 2408.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SEALER/DIVIDER LAPAROSCOPIC LIGASURE 350 D L18.5 MM L44 CM L20.3 MM MARYLAND CURVE JAW NANO COAT VALLEYLAB FT10 LS10 FORCETRIAD ENERGY PLATFORM SUP-270000000 CDM 270 RC outpatient 960.19 940.99 All Payors / Plans All Payors / Plans 960.19 other 960.19 960.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SENSOR PULSE OXIMETER FINGER DISPOSABLE ADULT 18IN SUP-270009154 CDM 270 RC outpatient 10.8 10.58 All Payors / Plans All Payors / Plans 10.8 other 10.8 10.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET ACCESS MICROPUNCTURE STAINLESS STEEL PLATINUM .018 IN L40 CM L10 CM L7 CM OD4 FR ODSEC21 GA GUIDEWIRE PART NEEDLE TRANSITIONLESS TIP COAXIAL CATHETER STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 58.67 57.5 All Payors / Plans All Payors / Plans 58.67 other 58.67 58.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET ADMINISTRATION INFUSOMAT 15GTT/ML L122IN 22ML SPACE PUMP FREE FLOW PROTECTION CLAMP SPIN LOCK CONNECTOR UNIVERSAL SPIKE LATEX FREE SUP-270000000 CDM 270 RC outpatient 8.29 8.12 All Payors / Plans All Payors / Plans 8.29 other 8.29 8.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET ADMINISTRATION L48 IN FLUID NONVENTED SPIKE PINCH CLAMP LARGE BORE TUBING SUP-270000000 CDM 270 RC outpatient 3.98 3.9 All Payors / Plans All Payors / Plans 3.98 other 3.98 3.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET ADMINISTRATION LIFESHIELD CAIR CLAVE OPTION-LOK 15 GTT/ML L100 IN ID.1 IN 16 ML CONVERTIBLE PIERCE PIN FILTER VENT COVER SLIDE CLAMP PRIMARY NONSTERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 5.63 5.52 All Payors / Plans All Payors / Plans 5.63 other 5.63 5.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET AIRSEAL BIFURCATED SMOKE EVAC FILTERED TUBE SET SUP-270000000 CDM 270 RC outpatient 195.49 191.58 All Payors / Plans All Payors / Plans 195.49 other 195.49 195.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET ANGIOGRAPHY STANDARD BORE L135 IN MALE LUER LOCK FILTER MICRO DRIP CHAMBER STERILE LATEX FREE DISPOSABLE CLEAR SUP-270000000 CDM 270 RC outpatient 26.04 25.52 All Payors / Plans All Payors / Plans 26.04 other 26.04 26.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET DALL-MILES CABLE & SLEEVE USE 17984 SUP-270010024 CDM 270 RC outpatient 534.65 523.96 All Payors / Plans All Payors / Plans 534.65 other 534.65 534.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET DILATOR STAINLESS STEEL POLYETHYLENE STRAIGHT L37 CM L80 CM OD8-24 FR ODSEC.038 IN URETHRAL RADIOPAQUE GUIDEWIRE SAFETY INDEX MARK SUP-270000000 CDM 270 RC outpatient 671.2 657.78 All Payors / Plans All Payors / Plans 671.2 other 671.2 671.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET DRAINAGE PLEURX PERITONEUM LINE LOCKABLE STERILE LATEX FREE DISPOSABLE CATHETER SYSTEM SUP-270000000 CDM 270 RC outpatient 36.62 35.89 All Payors / Plans All Payors / Plans 36.62 other 36.62 36.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET EXTENSION L35 IN 3.9 ML INTRAVENOUS 3 WAY STOPCOCK MALE LUER LOCK CAP INJECTION SITE STANDARD BORE STERILE LATEX FREE DISPOSABLE WHITE SUP-270000000 CDM 270 RC outpatient 1.67 1.64 All Payors / Plans All Payors / Plans 1.67 other 1.67 1.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET IMPLANT SUTUREBRIDGE ANCHOR DRILL GUIDE PUNCH TAP ACHILLES PACK SUP-270000000 CDM 270 RC outpatient 3654 3580.92 All Payors / Plans All Payors / Plans 3654 other 3654 3654 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET INTRODUCER MICROPUNCTURE PUSH-PLUS NITINOL .018 IN L40 CM L10 CM OD4 FR TRANSITIONLESS STIFFENED CANNULA PLATINUM TIP NITINOL WIREGUIDE COAXIAL CATHETER STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 50.15 49.15 All Payors / Plans All Payors / Plans 50.15 other 50.15 50.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET INTRODUCER MICROPUNCTURE SILHOUETTE STAINLESS STEEL L40 CM L10 CM OD5 FR OD.018 IN WIRE GUIDE PLATINUM TIP TRANSITIONLESS COAXIAL CATHETER DILATOR STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 28.5 27.93 All Payors / Plans All Payors / Plans 28.5 other 28.5 28.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET INTRODUCER PEEL-AWAY MICROPUNCTURE ECHOTIP TORQ-FLEX STAINLESS STEEL .018 IN T L65 CM L9 CM OD5.5 FR LUER LOCK SHEATH ENTRY NEEDLE GUIDEWIRE PICC DENNY MODIFICATION STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 169.07 165.69 All Payors / Plans All Payors / Plans 169.07 other 169.07 169.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET INTRODUCER PERFORMER L13 CM OD16 FR ACCEPTS .038 IN GUIDEWIRE SUP-272000000 CDM 270 RC outpatient 249.48 244.49 All Payors / Plans All Payors / Plans 249.48 other 249.48 249.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET IRRIGATION DEHP C100 ML STANDARD Y 2 BRANCH L100 IN ID.28 IN UROLOGICAL CONNECTOR 2 NONVENT PIERCING PIN 3 PINCH CLAMP STERILE LATEX FREE ARTHROSCOPY SUP-270000000 CDM 270 RC outpatient 21.06 20.64 All Payors / Plans All Payors / Plans 21.06 other 21.06 21.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET IRRIGATION HUMMER II 2 TUBE HOLDER MICRODEBRIDER LF DISPOSABLE SUP-270000000 CDM 270 RC outpatient 96.84 94.9 All Payors / Plans All Payors / Plans 96.84 other 96.84 96.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET IRRIGATION L77 IN ID.241 IN BLADDER GRAVITY FLOW LARGE BORE NONVENT PIERCING PIN SIGHT CHAMBER STERILE LATEX FREE CYSTOSCOPY SUP-270000000 CDM 270 RC outpatient 11.57 11.34 All Payors / Plans All Payors / Plans 11.57 other 11.57 11.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET IRRIGATION LEVEL 1 NORMOFLO 300 MMHG GAS VENT SURGE CHAMBER 2 SPIKE POSTOPERATIVE CBI SETUP STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 78.89 77.31 All Payors / Plans All Payors / Plans 78.89 other 78.89 78.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET IRRIGATION MALIS BIPOLAR CORD INTEGRATE TUBE ROTARY DISPOSABLE SUP-270000000 CDM 270 RC outpatient 56.38 55.25 All Payors / Plans All Payors / Plans 56.38 other 56.38 56.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET STENT ZIMMON POLYETHYLENE 2 PIGTAIL CURVE L5 CM OD10 FR BILIARY PUSH CATHETER SMOOTH CANNULATION TAPER TIP STERILE PURPLE ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 312.9 306.64 All Payors / Plans All Payors / Plans 312.9 other 312.9 312.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET TUBING AIRSEAL ACTIVATE CHARCOAL 3 LUMEN FILTER STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 98.31 96.34 All Payors / Plans All Payors / Plans 98.31 other 98.31 98.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET TUBING COOL POINT L2.6 MR 2 WAY COMMUNICATION IRRIGATION PUMP CATHETER SUP-270000000 CDM 270 RC outpatient 51 49.98 All Payors / Plans All Payors / Plans 51 other 51 51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET TUBING DUALWAVE CASSETTE OUTFLOW STERILE DISPOSABLE ARTHROSCOPY PUMP SUP-270000000 CDM 270 RC outpatient 68.88 67.5 All Payors / Plans All Payors / Plans 68.88 other 68.88 68.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET TUBING ULTRASONIC ASPIRATOR SONASTAR SUP-270000000 CDM 270 RC outpatient 176.26 172.73 All Payors / Plans All Payors / Plans 176.26 other 176.26 176.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SET VENTRICULAR DRAINAGE TRAUMACATH L35 CM OD10 FR ODSEC3.3 MM ID1.9 MM CONNECTOR TROCAR SUTURE COLLAR STYLET STERILE LATEX FREE SUP-270009149 CDM 270 RC outpatient 96 94.08 All Payors / Plans All Payors / Plans 96 other 96 96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEARS ELECTROSURGICAL HARMONIC ACE CURVE 36CM 5MM TITANIUM DISPOSABLE STERILE LF SHAFT PISTOL HANDLE HANDCONTROL SUP-270000000 CDM 270 RC outpatient 875.16 857.66 All Payors / Plans All Payors / Plans 875.16 other 875.16 875.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEARS ELECTROSURGICAL HARMONIC FOCUS+ CURVE TAPER 9CM DISPOSABLE STERILE 2 HAND CONTROL ADAPTIVE TISSUE TECHNOLOGY SOFT SUP-270000000 CDM 270 RC outpatient 950.18 931.18 All Payors / Plans All Payors / Plans 950.18 other 950.18 950.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEARS LAPAROSCOPIC HARMONIC ACE +7 L45 CM OD5 MM CURVE TIP ADVANCE HEMOSTASIS ULTRASONIC SUP-270000000 CDM 270 RC outpatient 1198.29 1174.32 All Payors / Plans All Payors / Plans 1198.29 other 1198.29 1198.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH ACCESS FLEXOR 55CM 12FR AQ DISPOSABLE STERILE LATEX URETERAL DILATION CONTINUOUS WORK CHANNEL FLEXIBLE SCOPE SUP-270000000 CDM 270 RC outpatient 384.43 376.74 All Payors / Plans All Payors / Plans 384.43 other 384.43 384.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH ACCESS NAVIGATOR HD STAINLESS STEEL HYDROPHILIC L28 CM OD11-13 FR URETERAL 2 DUROMETER DILATOR RADIOPAQUE INNOVATIVE HUB LATEX FREE URETEROSCOPIC SUP-270000000 CDM 270 RC outpatient 267.56 262.21 All Payors / Plans All Payors / Plans 267.56 other 267.56 267.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH ACCESS NAVIGATOR HD STAINLESS STEEL HYDROPHILIC L36 CM OD11-13 FR URETERAL 2 DUROMETER DILATOR RADIOPAQUE INNOVATIVE HUB LATEX FREE URETEROSCOPIC SUP-270000000 CDM 270 RC outpatient 267.56 262.21 All Payors / Plans All Payors / Plans 267.56 other 267.56 267.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH ACCESS NAVIGATOR HD STAINLESS STEEL HYDROPHILIC L46 CM OD11-13 FR URETERAL 2 DUROMETER DILATOR RADIOPAQUE INNOVATIVE HUB LATEX FREE URETEROSCOPIC SUP-270000000 CDM 270 RC outpatient 267.56 262.21 All Payors / Plans All Payors / Plans 267.56 other 267.56 267.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH AXS INFINITY LS LONG 80 CM SUP-270000000 CDM 270 RC outpatient 1113 1090.74 All Payors / Plans All Payors / Plans 1113 other 1113 1113 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH AXS INFINITY LS LONG 90 CM SUP-270000000 CDM 270 RC outpatient 1245.3 1220.39 All Payors / Plans All Payors / Plans 1245.3 other 1245.3 1245.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH CATHETER TOURGUIDE HYDROPHILIC 180 D L70 CM L55 CM ID6.5 FR STEERABLE SUP-270000000 CDM 270 RC outpatient 1037 1016.26 All Payors / Plans All Payors / Plans 1037 other 1037 1037 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH GUIDING FLEXOR CHECK-FLO 55CM 6FR 2.2MM RAABE MODIFICATION ACCEPTS .038IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 99.86 97.86 All Payors / Plans All Payors / Plans 99.86 other 99.86 99.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH GUIDING FLEXOR SHUTTLE-SL 90CM 6FR .087IN HYDROPHILIC DISPOSABLE STERILE TUOHY BORST SIDEARM RADIOPAQUE STIFFEN SUP-270000000 CDM 270 RC outpatient 228.86 224.28 All Payors / Plans All Payors / Plans 228.86 other 228.86 228.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH GUIDING PREFACE MULTIPURPOSE CURVE L62 CM OD8 FR ID.11 IN 2 WIRE BRAID MULTISEGMENT OBLIQUE CUT VALVE SUP-272000000 CDM 270 RC outpatient 367.5 360.15 All Payors / Plans All Payors / Plans 367.5 other 367.5 367.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER FLEXCATH PEBAX BARIUM SULFATE 135 D L65 CM L81 CM OD15 FR ID12 FR STERRABLE ARCTIC FRONT ADVANCE CRYOBALLOON ACHIEVE MAPPING CATHETER DILATOR RADIOPAQUE MARKER STERILE REUSABLE SUP-270000000 CDM 270 RC outpatient 1700 1666 All Payors / Plans All Payors / Plans 1700 other 1700 1700 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER GORE DRYSEAL L33 CM OD12 FR ODSEC4.7 MM ID4 MM DILATOR VALVE INFLATION SYRINGE SUP-270000000 CDM 270 RC outpatient 1684.8 1651.1 All Payors / Plans All Payors / Plans 1684.8 other 1684.8 1684.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER GORE DRYSEAL L33 CM OD14 FR ODSEC5.3 MM ID4.7 MM DILATOR VALVE INFLATION SYRINGE SUP-481000000 CDM 270 RC outpatient 1360.8 1333.58 All Payors / Plans All Payors / Plans 1360.8 other 1360.8 1360.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER GORE DRYSEAL L33 CM OD18 FR ODSEC6.7 MM ID6 MM DILATOR VALVE INFLATION SYRINGE SUP-270010015 CDM 270 RC outpatient 2145 2102.1 All Payors / Plans All Payors / Plans 2145 other 2145 2145 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER PINNACLE .038IN 10CM 2.5CM 5FR HYDROPHILIC PTFE KINK RESISTANT DILATOR GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 8.93 8.75 All Payors / Plans All Payors / Plans 8.93 other 8.93 8.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER PINNACLE DESTINATION PTFE HYDROPHILIC L10 CM L2.5 CM OD7 FR PERIPHERAL KINK RESISTANT DESIGN CROSS CUT VALVE SMOOTH TRANSITION DILATOR SUP-270000000 CDM 270 RC outpatient 18.38 18.01 All Payors / Plans All Payors / Plans 18.38 other 18.38 18.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER PINNACLE HYDROPHILIC PTFE .038 IN L10 CM L2.5 CM OD11 FR PERIPHERAL GUIDEWIRE DILATOR KINK RESISTANT SUP-481000000 CDM 270 RC outpatient 18.69 18.32 All Payors / Plans All Payors / Plans 18.69 other 18.69 18.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER PINNACLE HYDROPHILIC PTFE .038 IN L10 CM L2.5 CM OD9 FR GUIDEWIRE DILATOR KINK RESISTANT SUP-270000000 CDM 270 RC outpatient 14.88 14.58 All Payors / Plans All Payors / Plans 14.88 other 14.88 14.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER PINNACLE STAINLESS STEEL .035 IN L10 CM L2.5 CM ID5 FR PERIPHERAL SNAP ON DILATOR LOCK KINK RESISTANT SMOOTH TRANSITION SPRING COIL GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 89.25 87.47 All Payors / Plans All Payors / Plans 89.25 other 89.25 89.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER PINNACLE STAINLESS STEEL .035 IN L10 CM L2.5 CM ID6 FR PERIPHERAL SNAP ON DILATOR LOCK KINK RESISTANT SMOOTH TRANSITION SPRING COIL GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 148.75 145.78 All Payors / Plans All Payors / Plans 148.75 other 148.75 148.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER PINNACLE STAINLESS STEEL .035IN L10 CM L2.5 CM ID11 FR PERIPHERAL SNAP ON DILATOR LOCK KINK RESISTANT SMOOTH TRANSITION SPRING COIL GUIDEWIRE SUP-272000000 CDM 270 RC outpatient 18.48 18.11 All Payors / Plans All Payors / Plans 18.48 other 18.48 18.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER VIZIGO CURVE ID8.5 FR LGC SUP-270000000 CDM 270 RC outpatient 2181.9 2138.26 All Payors / Plans All Payors / Plans 2181.9 other 2181.9 2181.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH INTRODUCER VIZIGO CURVE ID8.5 FR MDC SUP-270000000 CDM 270 RC outpatient 1766.3 1730.97 All Payors / Plans All Payors / Plans 1766.3 other 1766.3 1766.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH LAPAROSCOPIC L45 MM STAPLER SUP-270000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH MICRA INTRODUCER SUP-275000000 CDM 270 RC outpatient 1560 1528.8 All Payors / Plans All Payors / Plans 1560 other 1560 1560 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH SAFE 7 FRENCH SUP-275000000 CDM 270 RC outpatient 86.7 84.97 All Payors / Plans All Payors / Plans 86.7 other 86.7 86.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH VERSA CROSS STEERABLE 8.5F MEDIUM BIDIRECTIONAL SUP-481000000 CDM 270 RC outpatient 2205 2160.9 All Payors / Plans All Payors / Plans 2205 other 2205 2205 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHEATH16 FR X 45CM CHECK-FLO SUP-481000000 CDM 270 RC outpatient 262.23 256.99 All Payors / Plans All Payors / Plans 262.23 other 262.23 262.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHELL ACETABULAR PINNACLE POROCOAT OD56 MM HIP SECTOR SUP-270010024 CDM 270 RC outpatient 1890 1852.2 All Payors / Plans All Payors / Plans 1890 other 1890 1890 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHELL ACETABULAR TRIDENT II TRITANIUM E OD52 MM HIP MULTIHOLE STERILE SUP-270010024 CDM 270 RC outpatient 3139.2 3076.42 All Payors / Plans All Payors / Plans 3139.2 other 3139.2 3139.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHERPA NX BALANCED 6F EBU 3.75 SUP-481000000 CDM 270 RC outpatient 88.2 86.44 All Payors / Plans All Payors / Plans 88.2 other 88.2 88.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOCKWAVE 3.0X12MM SUP-270000000 CDM 270 RC outpatient 9870 9672.6 All Payors / Plans All Payors / Plans 9870 other 9870 9870 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOCKWAVE C2 SUP-270000000 CDM 270 RC outpatient 9870 9672.6 All Payors / Plans All Payors / Plans 9870 other 9870 9870 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOCKWAVE C2 3.0 X 12MM SUP-270000000 CDM 270 RC outpatient 9870 9672.6 All Payors / Plans All Payors / Plans 9870 other 9870 9870 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOE POSTOPERATIVE AEGIS 10.5-12 LG RUBBER NS LF MALE FOOT BILATERAL SEMIRIGID SOLE LOOP LOCK CLOSURE REINFORCED PAD SUP-270009115 CDM 270 RC outpatient 5.83 5.71 All Payors / Plans All Payors / Plans 5.83 other 5.83 5.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOE POSTOPERATIVE AEGIS 6.5-8 MED RUBBER NS LF FEMALE FOOT BILATERAL SEMIRIGID SOLE LOOP LOCK CLOSURE REINFORCED PAD SUP-270009115 CDM 270 RC outpatient 5.83 5.71 All Payors / Plans All Payors / Plans 5.83 other 5.83 5.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOE POSTOPERATIVE AEGIS 8.5-10 LG RUBBER NS LF FEMALE FOOT BILATERAL SEMIRIGID SOLE LOOP LOCK CLOSURE REINFORCED PAD SUP-270009115 CDM 270 RC outpatient 5.83 5.71 All Payors / Plans All Payors / Plans 5.83 other 5.83 5.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOE POSTOPERATIVE AEGIS 8.5-10 MED RUBBER NS LF MALE FOOT BILATERAL SEMIRIGID SOLE LOOP LOCK CLOSURE REINFORCED PAD SUP-270009115 CDM 270 RC outpatient 5.83 5.71 All Payors / Plans All Payors / Plans 5.83 other 5.83 5.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOE POSTOPERATIVE CANVAS RUBBER FEMALE 4-6 SMALL UNIVERSAL FOOT BILATERAL RIGID SOLE HOOK LOOP CLOSURE CLOSED HEEL NONSTERILE LATEX FREE BEIGE SUP-270009115 CDM 270 RC outpatient 5.83 5.71 All Payors / Plans All Payors / Plans 5.83 other 5.83 5.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHOE POSTOPERATIVE CANVAS RUBBER MALE 6-8 SMALL BOTTOM RIGID SOLE HOOK LOOP CLOSURE OPEN TOE NONSTERILE LATEX FREE BEIGE SUP-270009115 CDM 270 RC outpatient 5.83 5.71 All Payors / Plans All Payors / Plans 5.83 other 5.83 5.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHORT MICRO PROCEDURE TRAY SUP-270000000 CDM 270 RC outpatient 1264.2 1238.92 All Payors / Plans All Payors / Plans 1264.2 other 1264.2 1264.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHUNT CARDIOVASCULAR CLEARVIEW SILICONE L14 MM OD1 MM INTRACORONARY BULB TAPERED TIP RADIOPAQUE STERILE ARTERIOTOMY SUP-270000000 CDM 270 RC outpatient 174.3 170.81 All Payors / Plans All Payors / Plans 174.3 other 174.3 174.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SHUNT CAROTID BARD JAVID TAPER L27.5 CM OD10-17 FR TYPE 1852 KINK RESISTANT POLISH TIP BYPASS SUP-270000000 CDM 270 RC outpatient 26.67 26.14 All Payors / Plans All Payors / Plans 26.67 other 26.67 26.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SIGMOIDOSCOPE RIGID KLEENSPEC HALOGEN 35V L25 CM OD19 MM HIGHLY VISIBLE GRADUATION EXAM OBTURATOR ILLUMINATION SYSTEM DISPOSABLE SUP-270000000 CDM 270 RC outpatient 5.12 5.02 All Payors / Plans All Payors / Plans 5.12 other 5.12 5.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE ADAPTER V40 TITANIUM ALUMINA CERAMIC SUP-270010024 CDM 270 RC outpatient 373.8 366.32 All Payors / Plans All Payors / Plans 373.8 other 373.8 373.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE COMPRESSION KENDALL SCD EXPRESS LG KNEE LENGTH NYLON DISPOSABLE NS LF ADJUSTABLE CIRCUMFERENTIAL BLADDER SUP-270009045 CDM 270 RC outpatient 33.86 33.18 All Payors / Plans All Payors / Plans 33.86 other 33.86 33.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE COMPRESSION KENDALL SCD EXPRESS MEDIUM KNEE LENGTH OD21- IN ADJUSTABLE CIRCUMFERENTIAL BLADDER STREAMLINE CONNECTOR NONSTERILE LATEX FREE DISPOSABLE SUP-270009045 CDM 270 RC outpatient 33.86 33.18 All Payors / Plans All Payors / Plans 33.86 other 33.86 33.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE COMPRESSION MED KNEE LENGTH KENDALL SCD EXPRESS ADJUSTABLE CIRCUMFERENTIAL SUP-270009045 CDM 270 RC outpatient 33.86 33.18 All Payors / Plans All Payors / Plans 33.86 other 33.86 33.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE LAPAROSCOPIC ENDOPATH XCEL UNIVERSAL 100MM 12MM DISPOSABLE STERILE STABILITY BLADELESS OBTURATOR OPTIONAL PISTOL SUP-270000000 CDM 270 RC outpatient 17.39 17.04 All Payors / Plans All Payors / Plans 17.39 other 17.39 17.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE LAPAROSCOPIC ENDOPATH XCEL UNIVERSAL 100MM 5MM DISPOSABLE STERILE STABILITY BLADELESS OBTURATOR OPTIONAL PISTOL SUP-270000000 CDM 270 RC outpatient 17.39 17.04 All Payors / Plans All Payors / Plans 17.39 other 17.39 17.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE SCLERAL SILICONE ROUND STYLE 72 BUCKLING SUP-270000000 CDM 270 RC outpatient 24.36 23.87 All Payors / Plans All Payors / Plans 24.36 other 24.36 24.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE SURGICAL ECLIPSE L23 IN CSR WRAP GOWN STERILE LATEX FREE BLUE SUP-270000000 CDM 270 RC outpatient 1.29 1.26 All Payors / Plans All Payors / Plans 1.29 other 1.29 1.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLEEVE W/BALLOON 12MM X 100MM SUP-270000000 CDM 270 RC outpatient 102 99.96 All Payors / Plans All Payors / Plans 102 other 102 102 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLING GYNECOLOGICAL GYNECARE TVT EXACT OD3 MM TROCAR SHAFT ERGONOMIC HANDLE STRESS URINARY INCONTINENCE RETROPUBIC SUP-270000000 CDM 270 RC outpatient 2736.55 2681.82 All Payors / Plans All Payors / Plans 2736.55 other 2736.55 2736.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SLING ORTHOPEDIC TIETEX LARGE ARM ENVELOPE SHOULDER STRAP SLIDE BUCKLE SUP-270009116 CDM 270 RC outpatient 3.89 3.81 All Payors / Plans All Payors / Plans 3.89 other 3.89 3.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SMARTCAP AQUASHIELD SUP-270000000 CDM 270 RC outpatient 26.78 26.24 All Payors / Plans All Payors / Plans 26.78 other 26.78 26.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SNARE ENDOSCOPIC CAPTIFLEX MICRO OVAL L240 CM OD2.4 MM ODSEC13 MM FLEXIBLE STERILE DISPOSABLE POLYPECTOMY SUP-270000000 CDM 270 RC outpatient 21.2 20.78 All Payors / Plans All Payors / Plans 21.2 other 21.2 21.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SNARE ENDOSCOPIC CAPTIFLEX XS OVAL L240 CM W11 MM OD2.4 MM LOOP FLEXIBLE BRAID WIRE HOT COLD INDICATION STERILE DISPOSABLE POLYPECTOMY SUP-270000000 CDM 270 RC outpatient 14.28 13.99 All Payors / Plans All Payors / Plans 14.28 other 14.28 14.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SNARE ENDOSCOPIC JUMBO LARGE OVAL MEDIUM STIFF DISPOSABLE OLYMPUS SUP-270000000 CDM 270 RC outpatient 18.7 18.33 All Payors / Plans All Payors / Plans 18.7 other 18.7 18.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SNARE SURGICAL ROUND OD20 MM COLD SUP-270000000 CDM 270 RC outpatient 23.19 22.73 All Payors / Plans All Payors / Plans 23.19 other 23.19 23.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION ANTIFOG DEVON DEFOGGER FOG-OUT ISOPROPANOL FOAM PAD NONTOXIC NONFLAMMABLE STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 1.53 1.5 All Payors / Plans All Payors / Plans 1.53 other 1.53 1.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION ANTISEPTIC 70% ISOPROPYL ALCOHOL 16 OZ BOTTLE LATEX FREE SUP-270000000 CDM 270 RC outpatient 1.8 1.76 All Payors / Plans All Payors / Plans 1.8 other 1.8 1.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION BSS 15ML SUP-270000000 CDM 270 RC outpatient 7.89 7.73 All Payors / Plans All Payors / Plans 7.89 other 7.89 7.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IRRIGATION 1000ML WATER STERILE LF PLASTIC POUR BOTTLE SUP-270000000 CDM 270 RC outpatient 1.75 1.72 All Payors / Plans All Payors / Plans 1.75 other 1.75 1.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IRRIGATION SODIUM CHLORIDE 0.9% POUR BOTTLE 1000ML SUP-270000000 CDM 270 RC outpatient 4.62 4.53 All Payors / Plans All Payors / Plans 4.62 other 4.62 4.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IRRIGATION SODIUM CHLORIDE 0.9% POUR BOTTLE 500ML SUP-270000000 CDM 270 RC outpatient 1.74 1.71 All Payors / Plans All Payors / Plans 1.74 other 1.74 1.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IRRIGATION UROMATIC 2000ML WATER STERILE LF PLASTIC CONTAINER SUP-270009079 CDM 270 RC outpatient 4.79 4.69 All Payors / Plans All Payors / Plans 4.79 other 4.79 4.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IV INJECTION SODIUM CHLORIDE 0.9% 1000ML SUP-270000000 CDM 270 RC outpatient 1.61 1.58 All Payors / Plans All Payors / Plans 1.61 other 1.61 1.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IV INJECTION SODIUM CHLORIDE 0.9% 100ML SUP-270000000 CDM 270 RC outpatient 2.82 2.76 All Payors / Plans All Payors / Plans 2.82 other 2.82 2.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IV IRRIGATION GLYCINE 1.5% UROMATIC PLASTIC BAG 3000ML SUP-270009078 CDM 270 RC outpatient 7.01 6.87 All Payors / Plans All Payors / Plans 7.01 other 7.01 7.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IV IRRIGATION SODIUM CHLORIDE 0.9% 3000ML SUP-270009079 CDM 270 RC outpatient 5.56 5.45 All Payors / Plans All Payors / Plans 5.56 other 5.56 5.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IV IRRIGATION SODIUM CHLORIDE 0.9% PLASTIC BAG 1000ML SUP-270009181 CDM 270 RC outpatient 30 29.4 All Payors / Plans All Payors / Plans 30 other 30 30 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IV IRRIGATION WATER STERILE 3000ML SUP-270009077 CDM 270 RC outpatient 5.06 4.96 All Payors / Plans All Payors / Plans 5.06 other 5.06 5.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION IV VIAFLEX 500ML 0.9% SODIUM CHLORIDE LF PLASTIC CONTAINER SUP-270000000 CDM 270 RC outpatient 2.78 2.72 All Payors / Plans All Payors / Plans 2.78 other 2.78 2.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION OPHTHALMIC SILIKON 1000 8.5ML POLYDIMETHYLSILOXANE STERILE LF OIL SUP-270000000 CDM 270 RC outpatient 770.73 755.32 All Payors / Plans All Payors / Plans 770.73 other 770.73 770.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION PREP 10% PVP IODINE 3/4 OZ POUCH PACKET CONTAINER STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 2.77 2.71 All Payors / Plans All Payors / Plans 2.77 other 2.77 2.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION PREP 3M DURAPREP 26ML 74% ISOPROPYL ALCOHOL 0.7% IODINE POVACRYLEX STERILE SKIN COATED SELF CONTAIN APPLICATOR SUP-270000000 CDM 270 RC outpatient 3.76 3.68 All Payors / Plans All Payors / Plans 3.76 other 3.76 3.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION PREP 3M DURAPREP 74% ISOPROPYL ALCOHOL 0.7% IODINE POVACRYLEX 6 ML SKIN 1 COAT SELF CONTAIN APPLICATOR STERILE PREOPERATIVE SUP-270009184 CDM 270 RC outpatient 2.96 2.9 All Payors / Plans All Payors / Plans 2.96 other 2.96 2.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION PREP BETADINE 10% PVP IODINE 4 OZ FLIPTOP CAP SUP-270000000 CDM 270 RC outpatient 2.26 2.21 All Payors / Plans All Payors / Plans 2.26 other 2.26 2.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION SURGICAL SCRUB HIBICLENS 4% CHLORHEXIDINE GLUCONATE 4 OZ SKIN BOTTLE LIQUID ANTIMICROBIAL CLEAR PINK SCENTED SUP-270000000 CDM 270 RC outpatient 4.18 4.1 All Payors / Plans All Payors / Plans 4.18 other 4.18 4.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SOLUTION WOUND CLEANSING BACTISURE SUP-270000000 CDM 270 RC outpatient 535.5 524.79 All Payors / Plans All Payors / Plans 535.5 other 535.5 535.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SPACER SPINAL INTERBODY 16X14X7MM, 7 DEGREE, 3D" SUP-270010020 CDM 270 RC outpatient 6760 6624.8 All Payors / Plans All Payors / Plans 6760 other 6760 6760 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPACER SPINAL PROLIFT 15 D L28 MM X W10 MM X H8 MM EXPAND STERILE LATEX FREE SUP-270010020 CDM 270 RC outpatient 5100 4998 All Payors / Plans All Payors / Plans 5100 other 5100 5100 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPHINCTEROTOME ENDOSCOPIC ULTRATOME XL L5 MM L200 CM L5 MM OD5.5 FR BILIARY PANCREAS 3 LUMEN CUT WIRE SHORT NOSE STERILE DISPOSABLE ACCEPTS .035 IN DREAMWIRE SUP-270000000 CDM 270 RC outpatient 146.34 143.41 All Payors / Plans All Payors / Plans 146.34 other 146.34 146.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPIKE ANGIOGRAPHY L6.5 IN 3 WAY STOPCOCK MANAGEMENT SUP-270000000 CDM 270 RC outpatient 2.15 2.11 All Payors / Plans All Payors / Plans 2.15 other 2.15 2.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPLINT NASAL DOYLE II SILICONE SEPTUM COMPRESS ANTERIOR TIP INTEGRAL AIRWAY STERILE LATEX FREE DISPOSABLE WHITE SUP-270000000 CDM 270 RC outpatient 170.1 166.7 All Payors / Plans All Payors / Plans 170.1 other 170.1 170.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPLINT ORTHOPEDIC ORTHO-GLASS FIBERGLASS L15 FT X W4 IN WRIST IMMOBILIZER WRINKLE FREE STRETCH PAD COVER INTERLOCK PERFORMANCE TECHNOLOGY LATEX FREE SUP-270000000 CDM 270 RC outpatient 121.72 119.29 All Payors / Plans All Payors / Plans 121.72 other 121.72 121.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPONGE EYE SURGICAL SPEAR STERILE CELLULOSE SUP-270000000 CDM 270 RC outpatient 5.15 5.05 All Payors / Plans All Payors / Plans 5.15 other 5.15 5.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPONGE RAY-COT RAYON 1/2INX 6 IN SUP-270000000 CDM 270 RC outpatient 34.65 33.96 All Payors / Plans All Payors / Plans 34.65 other 34.65 34.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPONGE SURGICAL UNIQCOT RAYON .55 MM THIN L1 IN X W1 IN LOW ADHESION PROFILE STRONG RADIOPAQUE STERILE SUP-270000000 CDM 270 RC outpatient 2.98 2.92 All Payors / Plans All Payors / Plans 2.98 other 2.98 2.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPONGE SURGICAL UNIQCOT RAYON L1/2 IN X W1/2 IN RADIOPAQUE PATTY STERILE SUP-270000000 CDM 270 RC outpatient 7.45 7.3 All Payors / Plans All Payors / Plans 7.45 other 7.45 7.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SPYSCOPE DS II SUP-270000000 CDM 270 RC outpatient 4628.25 4535.69 All Payors / Plans All Payors / Plans 4628.25 other 4628.25 4628.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STABILIZER SURGICAL OCTOPUS TISSUE EVOLUTION SUP-270000000 CDM 270 RC outpatient 2509.5 2459.31 All Payors / Plans All Payors / Plans 2509.5 other 2509.5 2509.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ECHELON CIRCULAR 29 MM 26 L5.2 MM X H1.5-2.2 MM 3D GRIP SURFACE POWER ADJUSTABLE STAPLE SUP-270000000 CDM 270 RC outpatient 878.2 860.64 All Payors / Plans All Payors / Plans 878.2 other 878.2 878.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ECHELON FLEX ENDOPATH L45 MM L340 MM 6 ROW 12 FIRING ARTICULATION ROTATE KNOB STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 296.43 290.5 All Payors / Plans All Payors / Plans 296.43 other 296.43 296.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ECHELON FLEX POWERED PLUS LONG 440MM 60MM LINEAR CUTTER ENDOSCOPIC SUP-270000000 CDM 270 RC outpatient 825.1 808.6 All Payors / Plans All Payors / Plans 825.1 other 825.1 825.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ECHELON FLEX POWERED PLUS STANDARD 340MM 60MM LF LINEAR CUT ENDOSCOPIC SUP-270000000 CDM 270 RC outpatient 781.96 766.32 All Payors / Plans All Payors / Plans 781.96 other 781.96 781.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ENDO GIA ULTRA TRI-STAPLE SHORT UNIVERSAL 6CM 12MM TITANIUM DISPOSABLE STERILE LF THIN VASCULAR TISSUE SUP-270000000 CDM 270 RC outpatient 235.75 231.04 All Payors / Plans All Payors / Plans 235.75 other 235.75 235.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ENDO GIA ULTRA TRI-STAPLE UNIVERSAL STANDARD 16CMX4MM PVC DISPOSABLE STERILE LF EXTRA THICK TISSUE SUP-270000000 CDM 270 RC outpatient 212.01 207.77 All Payors / Plans All Payors / Plans 212.01 other 212.01 212.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ENDO GIA ULTRA TRI-STAPLE XL UNIVERSAL 26CMX4MM BLACK TITANIUM EXTRA THICK TISSUE ARTICULATE HAND GRASP SUP-270000000 CDM 270 RC outpatient 339.19 332.41 All Payors / Plans All Payors / Plans 339.19 other 339.19 339.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ENDOPATH 45MM 300MM BLUE DISPOSABLE STERILE LF 8 FIRING LINEAR CUTTER RELOAD NO ARTICULATION SUP-270009088 CDM 270 RC outpatient 132.68 130.03 All Payors / Plans All Payors / Plans 132.68 other 132.68 132.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ENDOPATH CURVE CIRCLE 5.5MM 28CMX1-2.5MM 29MM DISPOSABLE STERILE LF INTRALUMINAL LINEAR CUTTER SUP-270000000 CDM 270 RC outpatient 446.49 437.56 All Payors / Plans All Payors / Plans 446.49 other 446.49 446.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL ENDOPATH CURVE CIRCLE H5.5 MM L28 CM X H1-2.5 MM OD25 MM INTRALUMINAL LINEAR CUTTER ADJUSTABLE FLEXIBLE STERILE LATEX FREE DISPOSABLE 16.4 MM LUMEN ENDOSCOPIC SUP-270000000 CDM 270 RC outpatient 551.55 540.52 All Payors / Plans All Payors / Plans 551.55 other 551.55 551.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL PROTACK TITANIUM L35.5 MM X W5 MM VASCULAR 30 HELICAL FASTENER STERILE LATEX FREE DISPOSABLE HERNIA MESH SUP-270000000 CDM 270 RC outpatient 2563 2511.74 All Payors / Plans All Payors / Plans 2563 other 2563 2563 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL PROXIMATE PPH 33MM DISPOSABLE STERILE LF SET PROLAPSE HEMORRHOID SUP-270000000 CDM 270 RC outpatient 834.81 818.11 All Payors / Plans All Payors / Plans 834.81 other 834.81 834.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL PROXIMATE TITANIUM STANDARD H1.5 MM L75 MM X H4.5 MM H2 MM REGULAR TISSUE 4 ROW LINEAR CUTTER SAFETY LOCKOUT HEAVY WIRE STERILE LATEX FREE DISPOSABLE BLUE ENDOSCOPIC SUP-270009226 CDM 270 RC outpatient 198 194.04 All Payors / Plans All Payors / Plans 198 other 198 198 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL PROXIMATE TITANIUM STANDARD L55 MM X H3.81 MM H1.5 MM REGULAR TISSUE 4 ROW LINEAR CUTTER CARTRIDGE SAFETY LOCK OUT STERILE LATEX FREE DISPOSABLE BLUE ENDOSCOPIC SUP-270009088 CDM 270 RC outpatient 132.68 130.03 All Payors / Plans All Payors / Plans 132.68 other 132.68 132.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL PROXIMATE TITANIUM STANDARD L60 MM X H3.5 MM H1.5 MM REGULAR TISSUE 2 ROW LINEAR RELOADABLE PARALLEL JAW CLOSURE STERILE LATEX FREE DISPOSABLE BLUE SUP-270009088 CDM 270 RC outpatient 132.68 130.03 All Payors / Plans All Payors / Plans 132.68 other 132.68 132.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER INTERNAL SUREFORM 45 OD14 MM STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 821.1 804.68 All Payors / Plans All Payors / Plans 821.1 other 821.1 821.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER SKIN PROXIMATE PX STAINLESS STEEL WIDE RECTANGULAR L3.9 MM X W6.9 MM OD.58 MM 35 COUNT MULTIDIRECTIONAL RELEASE FIX HEAD ERGONOMIC PISTOL GRIP HANDLE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 7.7 7.55 All Payors / Plans All Payors / Plans 7.7 other 7.7 7.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STAPLER SKIN PROXIMATE RH STAINLESS STEEL 360 D WIDE RECTANGULAR L3.9 MM X W6.9 MM OD.58 MM 35 COUNT ROTATE HEAD ERGONOMIC PISTOL GRIP HANDLE RATCHET MECHANISM STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 37.12 36.38 All Payors / Plans All Payors / Plans 37.12 other 37.12 37.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STEM ACTIS COLLARED ST SIZE 3 SUP-270010024 CDM 270 RC outpatient 6460 6330.8 All Payors / Plans All Payors / Plans 6460 other 6460 6460 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STEM FEMORAL ACTIS DUOFIX 6 STANDARD OFFSET HIP COLLAR STERILE SUP-270010024 CDM 270 RC outpatient 6460 6330.8 All Payors / Plans All Payors / Plans 6460 other 6460 6460 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STEM FEMORAL RESTORATION HA STRAIGHT CONICAL L155 MM OD18 MM HIP MODULAR SYSTEM SUP-270010024 CDM 270 RC outpatient 2891.2 2833.38 All Payors / Plans All Payors / Plans 2891.2 other 2891.2 2891.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STEM HUMERAL ARTHREX UNIVERS REVERS 6 SHOULDER STERILE SUP-270010030 CDM 270 RC outpatient 12650 12397 All Payors / Plans All Payors / Plans 12650 other 12650 12650 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STEM HUMERAL ARTHREX UNIVERS REVERS 7 SHOULDER STERILE SUP-270010030 CDM 270 RC outpatient 1836 1799.28 All Payors / Plans All Payors / Plans 1836 other 1836 1836 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STEM HUMERAL PERFORM 2+ SHOULDER STERILE LATEX FREE SUP-270010030 CDM 270 RC outpatient 4246.26 4161.33 All Payors / Plans All Payors / Plans 4246.26 other 4246.26 4246.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT ARGYLE CAROTID SUP-270000000 CDM 270 RC outpatient 75.94 74.42 All Payors / Plans All Payors / Plans 75.94 other 75.94 75.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY EXPRESS LD L40 MM L37 MM L75 CM OD10 MM ILIAC OTW PREMOUNT CATHETER ACCEPTS 7 FR SHEATH SUP-270000000 CDM 270 RC outpatient 1995 1955.1 All Payors / Plans All Payors / Plans 1995 other 1995 1995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY EXPRESS LD TANDEM ARCHITECTURE METAL L30 MM L27 MM L75 CM OD7 MM OTW PREMOUNT BALLOON EXPAND STERILE DISPOSABLE ACCEPTS 6 FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC outpatient 969 949.62 All Payors / Plans All Payors / Plans 969 other 969 969 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY EXPRESS LD TANDEM ARCHITECTURE METAL L40 MM L37 MM L75 CM OD6 MM OTW PREMOUNT BALLOON EXPAND STERILE DISPOSABLE ACCEPTS 6 FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC outpatient 1942.5 1903.65 All Payors / Plans All Payors / Plans 1942.5 other 1942.5 1942.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY EXPRESS LD TANDEM ARCHITECTURE METAL L40 MM L37 MM L75 CM OD8 MM OTW PREMOUNT BALLOON EXPAND STERILE DISPOSABLE ACCEPTS 6 FR INTRODUCER SHEATH SUP-270000000 CDM 270 RC outpatient 1995 1955.1 All Payors / Plans All Payors / Plans 1995 other 1995 1995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY FLEXIMA PLASTIC DUODENAL BEND L10 CM OD7 FR TEMPORARY DELIVERY SYSTEM DISPOSABLE ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 250.78 245.76 All Payors / Plans All Payors / Plans 250.78 other 250.78 250.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY FLEXIMA PLASTIC DUODENAL BEND L7 CM OD10 FR TEMPORARY DELIVERY SYSTEM DISPOSABLE ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 140.83 138.01 All Payors / Plans All Payors / Plans 140.83 other 140.83 140.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY FLEXIMA PLASTIC DUODENAL BEND L7 CM OD7 FR TEMPORARY DELIVERY SYSTEM DISPOSABLE ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 253.07 248.01 All Payors / Plans All Payors / Plans 253.07 other 253.07 253.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY WALLFLEX PERMALUME .035 IN L60 MM L3.2 MM OD10 MM ODSEC8.5 FR FLUOROSCOPY MARKER RAPID EXCHANGE PARTIAL COVER CATHETER SUP-270000000 CDM 270 RC outpatient 4657.56 4564.41 All Payors / Plans All Payors / Plans 4657.56 other 4657.56 4657.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT BILIARY WALLFLEX PERMALUME L60 MM OD10 MM ODSEC8.5 FR RAPID EXCHANGE SELF EXPAND ACCEPTS .035 IN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 6076.73 5955.2 All Payors / Plans All Payors / Plans 6076.73 other 6076.73 6076.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT ENDOPROSTHESIS XACT TAPERED 7-9 FRENCH X 40MM SUP-270000000 CDM 270 RC outpatient 4189.5 4105.71 All Payors / Plans All Payors / Plans 4189.5 other 4189.5 4189.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT ENDOPROSTHESIS GORE VIABAHN HEPARIN L15 CM L120 CM OD6 MM ODSEC6 FR SUPERFICIAL FEMORAL ARTERY ILIAC STERILE LATEX FREE ACCEPTS .014/.018 IN GUIDEWIRE 4.8-5.5 MM VESSEL SUP-270000000 CDM 270 RC outpatient 6422.6 6294.15 All Payors / Plans All Payors / Plans 6422.6 other 6422.6 6422.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT ENDOPROSTHESIS XACT TAPERED 6-8 FRENCH X 40MM SUP-270000000 CDM 270 RC outpatient 4189.5 4105.71 All Payors / Plans All Payors / Plans 4189.5 other 4189.5 4189.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT PANCREATIC ZIMMON POLYETHYLENE TAPER PIGTAIL CURVE SPIRAL L5 CM OD5 FR STERILE DISPOSABLE BLUE SUP-270000000 CDM 270 RC outpatient 157.5 154.35 All Payors / Plans All Payors / Plans 157.5 other 157.5 157.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT TRACHEOBRONCHIAL ULTRAFLEX NITINOL SILICONE L95 CM OD4 MM L30 MM L15 MM OD12 MM ODSEC20 FR FLEXIBLE OPEN LOOP RADIOPAQUE LOW PROFILE KNIT STERILE DISPOSABLE ACCEPTS .035 IN PULMONARY JAGWIRE SUP-270000000 CDM 270 RC outpatient 6392.93 6265.07 All Payors / Plans All Payors / Plans 6392.93 other 6392.93 6392.93 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT URETERAL CONTOUR PERCUFLEX HYDROPLUS PIGTAIL CURVE L 22 CM OD 6 FR TAPER TIP BLADDER MARK LOW PROFILE LARGE INNER LUMEN SUP-270000000 CDM 270 RC outpatient 234.55 229.86 All Payors / Plans All Payors / Plans 234.55 other 234.55 234.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT URETERAL CONTOUR PERCUFLEX HYDROPLUS PIGTAIL CURVE L24 CM OD6 FR TAPER TIP BLADDER MARK LOW PROFILE LARGE INNER LUMEN LATEX FREE SUP-270000000 CDM 270 RC outpatient 234.55 229.86 All Payors / Plans All Payors / Plans 234.55 other 234.55 234.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT URETERAL CONTOUR PERCUFLEX HYDROPLUS PIGTAIL CURVE L26 CM OD6 FR TAPER TIP BLADDER MARK LOW PROFILE LARGE INNER LUMEN LATEX FREE SUP-270000000 CDM 270 RC outpatient 189.87 186.07 All Payors / Plans All Payors / Plans 189.87 other 189.87 189.87 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT URETERAL CONTOUR PERCUFLEX PLUS HYDROPLUS PIGTAIL CURVE L24 CM OD8 FR LARGE INNER LUMEN LOW PROFILE BLADDER MARK TAPER TIP LATEX FREE SUP-270000000 CDM 270 RC outpatient 234.55 229.86 All Payors / Plans All Payors / Plans 234.55 other 234.55 234.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT URETERAL CONTOUR PERCUFLEX PLUS HYDROPLUS PIGTAIL CURVE L26 CM OD8 FR LARGE INNER LUMEN LOW PROFILE BLADDER MARK TAPER TIP LATEX FREE SUP-270000000 CDM 270 RC outpatient 234.55 229.86 All Payors / Plans All Payors / Plans 234.55 other 234.55 234.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT URETERAL PERCUFLEX 8X24CM SUP-270000000 CDM 270 RC outpatient 234.55 229.86 All Payors / Plans All Payors / Plans 234.55 other 234.55 234.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT URETERAL PERCUFLEX PLUS HYDROPLUS PIGTAIL CURVE L22 CM OD4.8 FR TAPER TIP BLADDER MARK LOW PROFILE LARGE INNER LUMEN LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 234.55 229.86 All Payors / Plans All Payors / Plans 234.55 other 234.55 234.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT URETERAL PERCUFLEX PLUS HYDROPLUS PIGTAIL CURVE L24 CM OD4.8 FR TAPER TIP BLADDER MARK LOW PROFILE LARGE INNER LUMEN LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 234.55 229.86 All Payors / Plans All Payors / Plans 234.55 other 234.55 234.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT VASCULAR ENROUTE UBER FLEX STRAIGHT L30 MM L57 CM OD 8MM DELIVERY SYSTEM ANGLE TIP DYNAMIC FLOW CONTROLLER ACCEPTS .014/.038 IN GUIDEWIRE 6-7MM VESSEL TRANSCAROTID ARTERY REVASCULARIZATION SUP-270000000 CDM 270 RC outpatient 5985 5865.3 All Payors / Plans All Payors / Plans 5985 other 5985 5985 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT VASCULAR ENROUTE UBER FLEX STRAIGHT L30 MM L57 CM OD 9MM DELIVERY SYSTEM ANGLE TIP DYNAMIC FLOW CONTROLLER ACCEPTS .014/.038 IN GUIDEWIRE 7-8MM VESSEL TRANSCAROTID ARTERY REVASCULARIZATION SUP-270000000 CDM 270 RC outpatient 2907 2848.86 All Payors / Plans All Payors / Plans 2907 other 2907 2907 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT VASCULAR ENROUTE UBER FLEX STRAIGHT L40 MM L57 CM OD 9MM DELIVERY SYSTEM ANGLE TIP DYNAMIC FLOW CONTROLLER ACCEPTS .014/.038 IN GUIDEWIRE 7-8MM VESSEL TRANSCAROTID ARTERY REVASCULARIZATION SUP-270000000 CDM 270 RC outpatient 5985 5865.3 All Payors / Plans All Payors / Plans 5985 other 5985 5985 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT VASCULAR EPIC 110CM 40MM 75CM 10MM NITINOL ILIAC ARTERY OTW RADIOPAQUE SELF EXPAND ACCEPTS .035IN GUIDEWIRE 6FR SUP-270000000 CDM 270 RC outpatient 1680 1646.4 All Payors / Plans All Payors / Plans 1680 other 1680 1680 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT VASCULAR EPIC NITINOL .035 IN L40 MM L75 CM OD8 MM ILIAC ARTERY SELF EXPAND OTW GUIDEWIRE RADIOPAQUE MARKER ACCEPTS 6 FR SHEATH SUP-270000000 CDM 270 RC outpatient 1360 1332.8 All Payors / Plans All Payors / Plans 1360 other 1360 1360 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT VASCULAR EPIC NITINOL L20 MM L75 CM OD8 MM ILIUM SELF EXPAND ACCEPTS 6 FR SHEATH SUP-270000000 CDM 270 RC outpatient 1360 1332.8 All Payors / Plans All Payors / Plans 1360 other 1360 1360 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT VASCULAR EPIC NITINOL L75 CM L80 MM L114 CM OD10 MM ILIAC ARTERY SELF EXPAND ACCEPTS 6 FR SHEATH SUP-270000000 CDM 270 RC outpatient 1360 1332.8 All Payors / Plans All Payors / Plans 1360 other 1360 1360 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STENT VASCULAR XACT NITINOL TAPER L40 MM OD8-6 MM SUP-270000000 CDM 270 RC outpatient 4315.5 4229.19 All Payors / Plans All Payors / Plans 4315.5 other 4315.5 4315.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STEPPED REAMER SUP-270000000 CDM 270 RC outpatient 1105 1082.9 All Payors / Plans All Payors / Plans 1105 other 1105 1105 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STOCKINETTE ORTHOPEDIC CONVERTORS POLYESTER LARGE L48 IN X W9 IN IMPERVIOUS BARRIER DRAPE WOVEN STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 3.7 3.63 All Payors / Plans All Payors / Plans 3.7 other 3.7 3.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STOCKINETTE ORTHOPEDIC COTTON L54 IN X W16 IN IMPERVIOUS STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 13.52 13.25 All Payors / Plans All Payors / Plans 13.52 other 13.52 13.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STOCKING COMPRESSION CAP NYLON 19 MMHG REGULAR XL KNEE LENGTH OD18-21 IN ODSEC11-12 IN COOL LIGHTWEIGHT INSPECTION TOE FLOAT DESIGN LATEX FREE GREEN SUP-270009044 CDM 270 RC outpatient 4.32 4.23 All Payors / Plans All Payors / Plans 4.32 other 4.32 4.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STOCKING COMPRESSION SMALL THIGH LENGTH ANTIEMBOLISM SUP-270009042 CDM 270 RC outpatient 7.62 7.47 All Payors / Plans All Payors / Plans 7.62 other 7.62 7.62 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STOPCOCK ANGIOGRAPHY 1050 PSI 3 WAY ROTATE ADAPTER RIGHT PORT SUP-270000000 CDM 270 RC outpatient 4.86 4.76 All Payors / Plans All Payors / Plans 4.86 other 4.86 4.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STOPCOCK ANGIOGRAPHY NAMIC 1050 PSI 3 WAY ROTATE ADAPTER RIGHT PORT SUP-270000000 CDM 270 RC outpatient 6.8 6.66 All Payors / Plans All Payors / Plans 6.8 other 6.8 6.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STOPCOCK INTRAVENOUS PLASTIC ID .07IN PERIPHERAL 1 WAY FEMALE TO MALE LUER LOCK STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 11.97 11.73 All Payors / Plans All Payors / Plans 11.97 other 11.97 11.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STOPCOCK INTRAVENOUS ULTRA 4 WAY MALE LUER LOCK STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 23.8 23.32 All Payors / Plans All Payors / Plans 23.8 other 23.8 23.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STRAP CATHETER VELCRO FOAM UNIVERSAL L22 IN X W2 IN ELASTIC SKIN IRRITATE TAPE HOOK LOOP FASTENER SOFT NONSTERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 4.38 4.29 All Payors / Plans All Payors / Plans 4.38 other 4.38 4.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STRAP POSITIONING TECLIN L19 IN X W3.5 IN STIRRUP SLIP RING NONSTERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 6.55 6.42 All Payors / Plans All Payors / Plans 6.55 other 6.55 6.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STRIP SCLERAL SILICONE L125 MM X W3.5 MM X H.75 MM STYLE 41 SUP-270000000 CDM 270 RC outpatient 38.22 37.46 All Payors / Plans All Payors / Plans 38.22 other 38.22 38.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STYLET STRAIGHTENING SUP-270000000 CDM 270 RC outpatient 127.5 124.95 All Payors / Plans All Payors / Plans 127.5 other 127.5 127.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility STYLETS ABBOTT/ST JUDE CRM _34810_ SUP-270000000 CDM 270 RC outpatient 22 21.56 All Payors / Plans All Payors / Plans 22 other 22 22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUNDT EXTERNAL SHUNT 4MMX5MM SUP-270000000 CDM 270 RC outpatient 1089.25 1067.47 All Payors / Plans All Payors / Plans 1089.25 other 1089.25 1089.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUPERBAG 15 2XL NYLON SPECIMEN RETRIEVAL BAG SUP-270000000 CDM 270 RC outpatient 137.53 134.78 All Payors / Plans All Payors / Plans 137.53 other 137.53 137.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUPERBAG 1O MED NYLON SPECIMEN RETRIEVAL BAG SUP-270000000 CDM 270 RC outpatient 51.83 50.79 All Payors / Plans All Payors / Plans 51.83 other 51.83 51.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUPPORT MAMMARY SURGI-BRA 42-44IN 2XL 96% COTTON 4% SPANDEX VELCRO LF BREAST PAD SUP-270009195 CDM 270 RC outpatient 45.24 44.34 All Payors / Plans All Payors / Plans 45.24 other 45.24 45.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUPPORTER ATHLETIC BAUER & BLACK LG 39-44IN 3IN LATEX ADULT ELASTIC WAISTBAND SUP-270009039 CDM 270 RC outpatient 4.98 4.88 All Payors / Plans All Payors / Plans 4.98 other 4.98 4.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUREFORM 60 RELOAD BLUE SUP-270000000 CDM 270 RC outpatient 507.15 497.01 All Payors / Plans All Payors / Plans 507.15 other 507.15 507.15 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUREFORM 60 RELOAD WHITE SUP-270000000 CDM 270 RC outpatient 2028.6 1988.03 All Payors / Plans All Payors / Plans 2028.6 other 2028.6 2028.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUREFORM 60 STAPLER SUP-270000000 CDM 270 RC outpatient 1168.65 1145.28 All Payors / Plans All Payors / Plans 1168.65 other 1168.65 1168.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SURGICAL ABLATION SYSTEM OPEN, LONG JAW WITH GLIDEPATH MAGNETIC GUIDE" SUP-270000000 CDM 270 RC outpatient 5400 5292 All Payors / Plans All Payors / Plans 5400 other 5400 5400 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SURGICAL IRRIGATION TUBE SUP-270000000 CDM 270 RC outpatient 356.2 349.08 All Payors / Plans All Payors / Plans 356.2 other 356.2 356.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE 0 MH 27IN CHROMIC MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 9.32 9.13 All Payors / Plans All Payors / Plans 9.32 other 9.32 9.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 0 CT-1 L27 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC outpatient 5.75 5.64 All Payors / Plans All Payors / Plans 5.75 other 5.75 5.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 1 CT L36 IN MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 7.83 7.67 All Payors / Plans All Payors / Plans 7.83 other 7.83 7.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 1 CT-1 L27 IN MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 4.83 4.73 All Payors / Plans All Payors / Plans 4.83 other 4.83 4.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 2-0 CT-1 L27 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC outpatient 5.58 5.47 All Payors / Plans All Payors / Plans 5.58 other 5.58 5.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 2-0 SH L27 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC outpatient 5.31 5.2 All Payors / Plans All Payors / Plans 5.31 other 5.31 5.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 3-0 CT-1 L36 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC outpatient 5 4.9 All Payors / Plans All Payors / Plans 5 other 5 5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 3-0 FS-2 L27 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC outpatient 5.23 5.13 All Payors / Plans All Payors / Plans 5.23 other 5.23 5.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 3-0 SH L27 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC outpatient 4.65 4.56 All Payors / Plans All Payors / Plans 4.65 other 4.65 4.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 4-0 J-1 L18 IN MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 5.54 5.43 All Payors / Plans All Payors / Plans 5.54 other 5.54 5.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 4-0 RB-1 L27 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC outpatient 6.03 5.91 All Payors / Plans All Payors / Plans 6.03 other 6.03 6.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE CHROMIC 4-0 SH L27 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC outpatient 6.43 6.3 All Payors / Plans All Payors / Plans 6.43 other 6.43 6.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL 0 CT-1 L36 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC outpatient 3.61 3.54 All Payors / Plans All Payors / Plans 3.61 other 3.61 3.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL 2-0 CT-1 L36 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC outpatient 3.69 3.62 All Payors / Plans All Payors / Plans 3.69 other 3.69 3.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL 3-0 CT-1 L36 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC outpatient 3.65 3.58 All Payors / Plans All Payors / Plans 3.65 other 3.65 3.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL 3-0 KS L27 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC outpatient 6.59 6.46 All Payors / Plans All Payors / Plans 6.59 other 6.59 6.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL 3-0 SH L27 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC outpatient 138.98 136.2 All Payors / Plans All Payors / Plans 138.98 other 138.98 138.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL 3-0 SH L27 IN MONOFILAMENT VIOLET SUP-270000000 CDM 270 RC outpatient 3.13 3.07 All Payors / Plans All Payors / Plans 3.13 other 3.13 3.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL MULTIPASS 4-0 PS-2 L27 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC outpatient 5.44 5.33 All Payors / Plans All Payors / Plans 5.44 other 5.44 5.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL MULTIPASS 6-0 P-3 L18 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC outpatient 11.34 11.11 All Payors / Plans All Payors / Plans 11.34 other 11.34 11.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MONOCRYL PLUS MULTIPASS 3-0 PS-2 27IN UNDYED MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 5.38 5.27 All Payors / Plans All Payors / Plans 5.38 other 5.38 5.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MULTIPASS 5-0 PS-4 18IN YELLOWISH TAN PLAIN MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 10.86 10.64 All Payors / Plans All Payors / Plans 10.86 other 10.86 10.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE MULTIPASS CHROMIC 5-0 P-3 L18 IN MONOFILAMENT BROWN SUP-270000000 CDM 270 RC outpatient 11.68 11.45 All Payors / Plans All Payors / Plans 11.68 other 11.68 11.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 0 CT-1 L27 IN MONOFILAMENT VIOLET SUP-270000000 CDM 270 RC outpatient 4.89 4.79 All Payors / Plans All Payors / Plans 4.89 other 4.89 4.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 0 CTX L60 IN MONOFILAMENT LOOP VIOLET SUP-270000000 CDM 270 RC outpatient 10.88 10.66 All Payors / Plans All Payors / Plans 10.88 other 10.88 10.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 0 TP-1 L60 IN MONOFILAMENT LOOP VIOLET SUP-270000000 CDM 270 RC outpatient 20.91 20.49 All Payors / Plans All Payors / Plans 20.91 other 20.91 20.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 1 CT-1 L27 IN MONOFILAMENT VIOLET SUP-270000000 CDM 270 RC outpatient 2.3 2.25 All Payors / Plans All Payors / Plans 2.3 other 2.3 2.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 1 CTX L36 IN MONOFILAMENT VIOLET SUP-270000000 CDM 270 RC outpatient 4.56 4.47 All Payors / Plans All Payors / Plans 4.56 other 4.56 4.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 1 TP-1 L96 IN MONOFILAMENT LOOP VIOLET SUP-270000000 CDM 270 RC outpatient 18.35 17.98 All Payors / Plans All Payors / Plans 18.35 other 18.35 18.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 2-0 SH L27 IN MONOFILAMENT VIOLET SUP-270000000 CDM 270 RC outpatient 4.69 4.6 All Payors / Plans All Payors / Plans 4.69 other 4.69 4.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 3-0 FS-2 L27 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC outpatient 14.02 13.74 All Payors / Plans All Payors / Plans 14.02 other 14.02 14.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 3-0 SH L27 IN MONOFILAMENT VIOLET SUP-270000000 CDM 270 RC outpatient 5.06 4.96 All Payors / Plans All Payors / Plans 5.06 other 5.06 5.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II 4-0 FS-2 L27 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC outpatient 9.99 9.79 All Payors / Plans All Payors / Plans 9.99 other 9.99 9.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II MULTIPASS 4-0 P-3 L18 IN MONOFILAMENT UNDYED SUP-270000000 CDM 270 RC outpatient 9.95 9.75 All Payors / Plans All Payors / Plans 9.95 other 9.95 9.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS II MULTIPASS 4-0 PS-2 18IN UNDYED MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 11.27 11.04 All Payors / Plans All Payors / Plans 11.27 other 11.27 11.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS PLUS 2-0 CT L 27 IN ANTIBACTERIAL VIOLET SUP-270000000 CDM 270 RC outpatient 11.48 11.25 All Payors / Plans All Payors / Plans 11.48 other 11.48 11.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PDS PLUS MULTIPASS 5-0 P-3 18IN UNDYED MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 13.99 13.71 All Payors / Plans All Payors / Plans 13.99 other 13.99 13.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PLAIN 0 L54 IN MONOFILAMENT TIES YELLOWISH TAN SUP-270000000 CDM 270 RC outpatient 5.3 5.19 All Payors / Plans All Payors / Plans 5.3 other 5.3 5.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE PLAIN 3-0 CT-1 L18 IN MONOFILAMENT 3 STRAND SUP-270000000 CDM 270 RC outpatient 15.58 15.27 All Payors / Plans All Payors / Plans 15.58 other 15.58 15.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE QUILL PDO 2 1/2 CIRCLE L36 CM L48 MM 2 ARM MONOFILAMENT BARB TAPER POINT VIOLET SUP-270000000 CDM 270 RC outpatient 20.45 20.04 All Payors / Plans All Payors / Plans 20.45 other 20.45 20.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE ULTIMA CHROMIC 7-0 CS175-8 L18 IN 2 ARM MONOFILAMENT BROWN SUP-270000000 CDM 270 RC outpatient 18.7 18.33 All Payors / Plans All Payors / Plans 18.7 other 18.7 18.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 CT-1 L18 IN CONTROL RELEASE BRAID 8 STRAND COATED UNDYED SUP-270000000 CDM 270 RC outpatient 10.63 10.42 All Payors / Plans All Payors / Plans 10.63 other 10.63 10.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 CT-1 L18 IN CONTROL RELEASE BRAID 8 STRAND COATED VIOLET SUP-270000000 CDM 270 RC outpatient 10.61 10.4 All Payors / Plans All Payors / Plans 10.61 other 10.61 10.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 CT-1 L27 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC outpatient 1.4 1.37 All Payors / Plans All Payors / Plans 1.4 other 1.4 1.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 CT-1 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC outpatient 2.91 2.85 All Payors / Plans All Payors / Plans 2.91 other 2.91 2.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 CT-1 L36 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC outpatient 2.48 2.43 All Payors / Plans All Payors / Plans 2.48 other 2.48 2.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 CTX L36 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC outpatient 2.57 2.52 All Payors / Plans All Payors / Plans 2.57 other 2.57 2.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 STANDARD SHORT L18 IN BRAID TIES 3 STRAND COATED VIOLET SUP-270000000 CDM 270 RC outpatient 4.42 4.33 All Payors / Plans All Payors / Plans 4.42 other 4.42 4.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 UR-5 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC outpatient 3.42 3.35 All Payors / Plans All Payors / Plans 3.42 other 3.42 3.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 0 UR-6 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC outpatient 1.86 1.82 All Payors / Plans All Payors / Plans 1.86 other 1.86 1.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 1 CP L27 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC outpatient 1.45 1.42 All Payors / Plans All Payors / Plans 1.45 other 1.45 1.45 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 1 CT L36 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC outpatient 3.58 3.51 All Payors / Plans All Payors / Plans 3.58 other 3.58 3.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2 CP L27 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC outpatient 3.22 3.16 All Payors / Plans All Payors / Plans 3.22 other 3.22 3.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 18IN UNDYED BRAID TIE 3 STRAND COATED SUP-270000000 CDM 270 RC outpatient 4.28 4.19 All Payors / Plans All Payors / Plans 4.28 other 4.28 4.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 CP-1 L27 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC outpatient 1.51 1.48 All Payors / Plans All Payors / Plans 1.51 other 1.51 1.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 CP-2 L18 IN CONTROL RELEASE BRAID 8 STRAND COATED UNDYED SUP-270000000 CDM 270 RC outpatient 12.9 12.64 All Payors / Plans All Payors / Plans 12.9 other 12.9 12.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 CT L36 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC outpatient 3.33 3.26 All Payors / Plans All Payors / Plans 3.33 other 3.33 3.33 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 CT-1 L18 IN CONTROL RELEASE BRAID 8 STRAND COATED VIOLET SUP-270000000 CDM 270 RC outpatient 21.77 21.33 All Payors / Plans All Payors / Plans 21.77 other 21.77 21.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 CT-1 L27 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC outpatient 2.78 2.72 All Payors / Plans All Payors / Plans 2.78 other 2.78 2.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 CT-1 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC outpatient 1.71 1.68 All Payors / Plans All Payors / Plans 1.71 other 1.71 1.71 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 CT-2 L18 IN CONTROL RELEASE BRAID 8 STRAND COATED VIOLET SUP-270000000 CDM 270 RC outpatient 123.52 121.05 All Payors / Plans All Payors / Plans 123.52 other 123.52 123.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 CT-2 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC outpatient 2.78 2.72 All Payors / Plans All Payors / Plans 2.78 other 2.78 2.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 SH L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC outpatient 2.32 2.27 All Payors / Plans All Payors / Plans 2.32 other 2.32 2.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 2-0 UR-6 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC outpatient 3.4 3.33 All Payors / Plans All Payors / Plans 3.4 other 3.4 3.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 3-0 CT-1 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC outpatient 2.34 2.29 All Payors / Plans All Payors / Plans 2.34 other 2.34 2.34 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 3-0 SH L18 IN CONTROL RELEASE BRAID 8 STRAND COATED UNDYED SUP-270000000 CDM 270 RC outpatient 17.59 17.24 All Payors / Plans All Payors / Plans 17.59 other 17.59 17.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 3-0 SH L18 IN CONTROL RELEASE BRAID 8 STRAND COATED VIOLET SUP-270000000 CDM 270 RC outpatient 17.38 17.03 All Payors / Plans All Payors / Plans 17.38 other 17.38 17.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 3-0 SH L27 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC outpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 3-0 SH L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC outpatient 1.4 1.37 All Payors / Plans All Payors / Plans 1.4 other 1.4 1.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 3-0 SH-1 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC outpatient 2.57 2.52 All Payors / Plans All Payors / Plans 2.57 other 2.57 2.57 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 4-0 FS-2 L27 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC outpatient 5.58 5.47 All Payors / Plans All Payors / Plans 5.58 other 5.58 5.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 4-0 SH L27 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC outpatient 2.73 2.68 All Payors / Plans All Payors / Plans 2.73 other 2.73 2.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 4-0 SH-1 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC outpatient 2.83 2.77 All Payors / Plans All Payors / Plans 2.83 other 2.83 2.83 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 4-0 TF L18 IN CONTROL RELEASE BRAID 8 STRAND COATED VIOLET SUP-270000000 CDM 270 RC outpatient 28.2 27.64 All Payors / Plans All Payors / Plans 28.2 other 28.2 28.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 5-0 P-1 L18 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC outpatient 10.4 10.19 All Payors / Plans All Payors / Plans 10.4 other 10.4 10.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 5-0 RB-1 L27 IN BRAID COATED VIOLET SUP-270000000 CDM 270 RC outpatient 2.78 2.72 All Payors / Plans All Payors / Plans 2.78 other 2.78 2.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL 6-0 P-1 18IN VIOLET BRAID COATED D SPECIAL SUP-270000000 CDM 270 RC outpatient 199.68 195.69 All Payors / Plans All Payors / Plans 199.68 other 199.68 199.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL LIGAPAK 2-0 L54 IN BRAID REEL COATED VIOLET SUP-270000000 CDM 270 RC outpatient 1.89 1.85 All Payors / Plans All Payors / Plans 1.89 other 1.89 1.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL LIGAPAK 3-0 L54 IN BRAID REEL COATED VIOLET SUP-270000000 CDM 270 RC outpatient 1.98 1.94 All Payors / Plans All Payors / Plans 1.98 other 1.98 1.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL MICROPOINT 6-0 S-14 12IN VIOLET 2 ARM BRAID COATED SUP-270000000 CDM 270 RC outpatient 12.44 12.19 All Payors / Plans All Payors / Plans 12.44 other 12.44 12.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL MICROPOINT 7-0 TG140-8 18IN VIOLET 2 ARM BRAID COATED SUP-270000000 CDM 270 RC outpatient 12.59 12.34 All Payors / Plans All Payors / Plans 12.59 other 12.59 12.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL MULTIPASS 3-0 PS-1 27IN UNDYED BRAID COATED SUP-270000000 CDM 270 RC outpatient 4.75 4.66 All Payors / Plans All Payors / Plans 4.75 other 4.75 4.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL MULTIPASS 4-0 P-3 18IN UNDYED BRAID COATED SUP-270000000 CDM 270 RC outpatient 8.02 7.86 All Payors / Plans All Payors / Plans 8.02 other 8.02 8.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL MULTIPASS 4-0 PS-2 27IN UNDYED BRAID COATED SUP-270000000 CDM 270 RC outpatient 7.32 7.17 All Payors / Plans All Payors / Plans 7.32 other 7.32 7.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL MULTIPASS 5-0 P-3 18IN UNDYED BRAID COATED SUP-270000000 CDM 270 RC outpatient 8.68 8.51 All Payors / Plans All Payors / Plans 8.68 other 8.68 8.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL MULTIPASS 5-0 PS-3 L18 IN BRAID COATED UNDYED SUP-270000000 CDM 270 RC outpatient 8.27 8.1 All Payors / Plans All Payors / Plans 8.27 other 8.27 8.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL MULTIPASS 8-0 BV130-5 5IN VIOLET BRAID COATED SUP-270000000 CDM 270 RC outpatient 29.32 28.73 All Payors / Plans All Payors / Plans 29.32 other 29.32 29.32 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL PLUS 0 CT-1 L18 IN CONTROL RELEASE BRAID 8 STRAND ANTIBACTERIAL UNDYED SUP-270000000 CDM 270 RC outpatient 20.4 19.99 All Payors / Plans All Payors / Plans 20.4 other 20.4 20.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL PLUS 2-0 CP-2 L18 IN CONTROL RELEASE BRAID 8 STRAND ANTIBACTERIAL UNDYED SUP-270000000 CDM 270 RC outpatient 75.72 74.21 All Payors / Plans All Payors / Plans 75.72 other 75.72 75.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL PLUS 4-0 SH L27 IN BRAID ANTIBACTERIAL COATED VIOLET SUP-270000000 CDM 270 RC outpatient 3.7 3.63 All Payors / Plans All Payors / Plans 3.7 other 3.7 3.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL PLUS LIGAPAK 3-0 L54 IN BRAID REEL ANTIBACTERIAL COATED VIOLET SUP-270000000 CDM 270 RC outpatient 4.68 4.59 All Payors / Plans All Payors / Plans 4.68 other 4.68 4.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ABSORBABLE VICRYL PLUS MULTIPASS 3-0 PS-1 L27 IN BRAID ANTIBACTERIAL COATED UNDYED SUP-270000000 CDM 270 RC outpatient 9.68 9.49 All Payors / Plans All Payors / Plans 9.68 other 9.68 9.68 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE CLOSURE V-LOC 2-0 V-20 L12IIN NONABSORBABLE BLUE SUP-270000000 CDM 270 RC outpatient 43.22 42.36 All Payors / Plans All Payors / Plans 43.22 other 43.22 43.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE ETHILON MONOFILAMENT BLACK NEEDLE:PS-1 SIZE:3-0 LENGTH:18IN SUP-270000000 CDM 270 RC outpatient 6.7 6.57 All Payors / Plans All Payors / Plans 6.7 other 6.7 6.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE FIBERLOOP 4-0 SUP-270000000 CDM 270 RC outpatient 1260 1234.8 All Payors / Plans All Payors / Plans 1260 other 1260 1260 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE FIBERTAPE CERCLAGE SUP-270000000 CDM 270 RC outpatient 1995 1955.1 All Payors / Plans All Payors / Plans 1995 other 1995 1995 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE DOUBLEWIRE 8 BE-3 14IN 2 WIRE HIGH STRENGTH STERNOTOMY SUP-270000000 CDM 270 RC outpatient 227.5 222.95 All Payors / Plans All Payors / Plans 227.5 other 227.5 227.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 0 CT-1 L30 IN BRAID GREEN SUP-270000000 CDM 270 RC outpatient 3.1 3.04 All Payors / Plans All Payors / Plans 3.1 other 3.1 3.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 0 CT-2 18IN GREEN POLYESTER CONTROL RELEASE BRAID 8 STRAND SUP-270000000 CDM 270 RC outpatient 28.22 27.66 All Payors / Plans All Payors / Plans 28.22 other 28.22 28.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 0 CTX 18IN GREEN POLYESTER CONTROL RELEASE BRAID 8 STRAND SUP-270000000 CDM 270 RC outpatient 245.3 240.39 All Payors / Plans All Payors / Plans 245.3 other 245.3 245.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 0 SH L36 IN 2 ARM BRAID GREEN SUP-270000000 CDM 270 RC outpatient 7.97 7.81 All Payors / Plans All Payors / Plans 7.97 other 7.97 7.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 1 CT-1 L30 IN BRAID GREEN SUP-270000000 CDM 270 RC outpatient 1.67 1.64 All Payors / Plans All Payors / Plans 1.67 other 1.67 1.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 2 V-37 L30 IN BRAID 4 STRAND GREEN SUP-270000000 CDM 270 RC outpatient 28.16 27.6 All Payors / Plans All Payors / Plans 28.16 other 28.16 28.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 2-0 CT-1 L30 IN BRAID GREEN SUP-270000000 CDM 270 RC outpatient 6.88 6.74 All Payors / Plans All Payors / Plans 6.88 other 6.88 6.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 2-0 CT-2 18IN GREEN POLYESTER CONTROL RELEASE BRAID 8 STRAND SUP-270000000 CDM 270 RC outpatient 306.96 300.82 All Payors / Plans All Payors / Plans 306.96 other 306.96 306.96 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 2-0 SH L36 IN 2 ARM BRAID GREEN SUP-270000000 CDM 270 RC outpatient 7.84 7.68 All Payors / Plans All Payors / Plans 7.84 other 7.84 7.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 3-0 SH L30 IN BRAID GREEN SUP-270000000 CDM 270 RC outpatient 7.44 7.29 All Payors / Plans All Payors / Plans 7.44 other 7.44 7.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND 5 V-37 L30 IN BRAID 4 STRAND GREEN SUP-270000000 CDM 270 RC outpatient 24.28 23.79 All Payors / Plans All Payors / Plans 24.28 other 24.28 24.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND EXCEL 2 30IN GREEN LIGHT GREEN WHITE TIES BRAID D SUP-270000000 CDM 270 RC outpatient 54.44 53.35 All Payors / Plans All Payors / Plans 54.44 other 54.44 54.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND EXCEL TAPERCUT THK1.5 MM 2-0 V-4 L30 IN L7 MM X W3 MM 2 ARM BRAID 10 STRAND FIRM PLEDGET GREEN WHITE SUP-270000000 CDM 270 RC outpatient 2611.47 2559.24 All Payors / Plans All Payors / Plans 2611.47 other 2611.47 2611.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHIBOND EXCEL THK1.5 MM 0 SH L30 IN L7 MM X W3 MM 2 ARM BRAID 10 STRAND FIRM PLEDGET GREEN WHITE SUP-270000000 CDM 270 RC outpatient 262.44 257.19 All Payors / Plans All Payors / Plans 262.44 other 262.44 262.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON 2 LR 20IN BLACK MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 8.37 8.2 All Payors / Plans All Payors / Plans 8.37 other 8.37 8.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON 2-0 FS L18 IN MONOFILAMENT BLACK SUP-270000000 CDM 270 RC outpatient 1.81 1.77 All Payors / Plans All Payors / Plans 1.81 other 1.81 1.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON 2-0 FSLX L30 IN MONOFILAMENT BLACK SUP-270000000 CDM 270 RC outpatient 3.66 3.59 All Payors / Plans All Payors / Plans 3.66 other 3.66 3.66 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON 4-0 PS-2 L18 IN BLACK SUP-270000000 CDM 270 RC outpatient 7.19 7.05 All Payors / Plans All Payors / Plans 7.19 other 7.19 7.19 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON MICROPOINT 10-0 TG160-6 6IN BLACK 2 ARM MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 17.1 16.76 All Payors / Plans All Payors / Plans 17.1 other 17.1 17.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON MULTIPASS 3-0 PS-1 18IN BLACK MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 3.98 3.9 All Payors / Plans All Payors / Plans 3.98 other 3.98 3.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON MULTIPASS 4-0 P-3 L18 IN MONOFILAMENT BLACK SUP-270000000 CDM 270 RC outpatient 7.97 7.81 All Payors / Plans All Payors / Plans 7.97 other 7.97 7.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON MULTIPASS 4-0 PS-2 18IN UNDYED MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 7.59 7.44 All Payors / Plans All Payors / Plans 7.59 other 7.59 7.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON MULTIPASS 5-0 P-3 18IN BLACK MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 7.11 6.97 All Payors / Plans All Payors / Plans 7.11 other 7.11 7.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON MULTIPASS 5-0 PS-2 18IN BLACK MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 7.06 6.92 All Payors / Plans All Payors / Plans 7.06 other 7.06 7.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON MULTIPASS 5-0 PS-4 18IN BLACK MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 22.99 22.53 All Payors / Plans All Payors / Plans 22.99 other 22.99 22.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON MULTIPASS 8-0 BV130-5 L5 IN MONOFILAMENT BLACK SUP-270000000 CDM 270 RC outpatient 29.55 28.96 All Payors / Plans All Payors / Plans 29.55 other 29.55 29.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON SABRELOC 5-0 S-24 18IN BLACK 2 ARM MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 24.77 24.27 All Payors / Plans All Payors / Plans 24.77 other 24.77 24.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE ETHILON ULTIMA NYLON 66 8-0 CS175-8 L12 IN 2 ARM MONOFILAMENT BLACK SUP-270000000 CDM 270 RC outpatient 15.51 15.2 All Payors / Plans All Payors / Plans 15.51 other 15.51 15.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE FIBERLINK FIBERWIRE 2 L26 IN L1.5 IN BRAID TIES MULTISTRAND CLOSE LOOP BLUE SUP-270000000 CDM 270 RC outpatient 115.5 113.19 All Payors / Plans All Payors / Plans 115.5 other 115.5 115.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE FIBERTAPE FIBERWIRE 2 TAPER L54 IN L36 IN X W2 MM BRAID BLUE SUP-270000000 CDM 270 RC outpatient 220.5 216.09 All Payors / Plans All Payors / Plans 220.5 other 220.5 220.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE FIBERWIRE 2 T-5 L38 IN BRAID TIES MULTISTRAND LOWER KNOT PROFILE BLUE SUP-270000000 CDM 270 RC outpatient 22.44 21.99 All Payors / Plans All Payors / Plans 22.44 other 22.44 22.44 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE FIBERWIRE 2 T-8 L38 IN 2 ARM BRAID MULTISTRAND LOWER KNOT PROFILE BARB BLUE SUP-270000000 CDM 270 RC outpatient 44.88 43.98 All Payors / Plans All Payors / Plans 44.88 other 44.88 44.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE FIBERWIRE 5 CCS-1 L38 IN BRAID TIES MULTISTRAND LOWER KNOT PROFILE BLUE SUP-270000000 CDM 270 RC outpatient 84 82.32 All Payors / Plans All Payors / Plans 84 other 84 84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE GORE-TEX CV-3 TH-26 L36IN MONOFILAMENT WHITE SUP-270000000 CDM 270 RC outpatient 191.63 187.8 All Payors / Plans All Payors / Plans 191.63 other 191.63 191.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE GORE-TEX CV-6 PT-13 L30 IN 2 ARM MONOFILAMENT WHITE SUP-270000000 CDM 270 RC outpatient 153.88 150.8 All Payors / Plans All Payors / Plans 153.88 other 153.88 153.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE GORE-TEX CV-6 PT-9 L30 IN 2 ARM MONOFILAMENT WHITE SUP-270000000 CDM 270 RC outpatient 159.37 156.18 All Payors / Plans All Payors / Plans 159.37 other 159.37 159.37 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE GORE-TEX CV-7 PT-13 L24 IN 2 ARM MONOFILAMENT WHITE SUP-270000000 CDM 270 RC outpatient 101.04 99.02 All Payors / Plans All Payors / Plans 101.04 other 101.04 101.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE GORE-TEX CV-8 TTC-9 L18 IN 2 ARM MONOFILAMENT WHITE SUP-270000000 CDM 270 RC outpatient 84.17 82.49 All Payors / Plans All Payors / Plans 84.17 other 84.17 84.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE MERSILENE 5 MM CTX L12 IN 2 ARM WOVEN WHITE SUP-270000000 CDM 270 RC outpatient 50.97 49.95 All Payors / Plans All Payors / Plans 50.97 other 50.97 50.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE NUROLON 2-0 SH 18IN BLACK NYLON 6 6 CONTROL RELEASE BRAID 8 STRAND SUP-270000000 CDM 270 RC outpatient 9.31 9.12 All Payors / Plans All Payors / Plans 9.31 other 9.31 9.31 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE NUROLON 4-0 TF 18IN BLACK NYLON 6 6 CONTROL RELEASE BRAID 8 STRAND SUP-270000000 CDM 270 RC outpatient 13.38 13.11 All Payors / Plans All Payors / Plans 13.38 other 13.38 13.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 0 18IN BLACK SILK BRAID TIE 6 STRAND PRECUT SUP-270000000 CDM 270 RC outpatient 52.75 51.7 All Payors / Plans All Payors / Plans 52.75 other 52.75 52.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 0 30IN BLACK SILK BRAID TIE 6 STRAND PRECUT SUP-270000000 CDM 270 RC outpatient 1.25 1.23 All Payors / Plans All Payors / Plans 1.25 other 1.25 1.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 1 30IN BLACK SILK BRAID TIE 6 STRAND PRECUT SUP-270000000 CDM 270 RC outpatient 2.18 2.14 All Payors / Plans All Payors / Plans 2.18 other 2.18 2.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 2-0 18IN BLACK SILK BRAID TIES 12 STRAND PRECUT SUP-270000000 CDM 270 RC outpatient 1.39 1.36 All Payors / Plans All Payors / Plans 1.39 other 1.39 1.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 2-0 30IN BLACK SILK BRAID TIE 12 STRAND PRECUT SUP-270000000 CDM 270 RC outpatient 3.81 3.73 All Payors / Plans All Payors / Plans 3.81 other 3.81 3.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 3-0 18IN BLACK SILK BRAID TIES 12 STRAND PRECUT SUP-270000000 CDM 270 RC outpatient 1.65 1.62 All Payors / Plans All Payors / Plans 1.65 other 1.65 1.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 3-0 30IN BLACK SILK BRAID TIE 12 STRAND PRECUT SUP-270000000 CDM 270 RC outpatient 4.63 4.54 All Payors / Plans All Payors / Plans 4.63 other 4.63 4.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 4-0 144IN BLACK SILK BRAID REEL SUP-270000000 CDM 270 RC outpatient 38.77 37.99 All Payors / Plans All Payors / Plans 38.77 other 38.77 38.77 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND 4-0 18IN BLACK SILK BRAID TIES 12 STRAND PRECUT SUP-270000000 CDM 270 RC outpatient 3.23 3.17 All Payors / Plans All Payors / Plans 3.23 other 3.23 3.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND MULTIPASS 6-0 P-3 18IN BLACK SILK BRAID SUP-270000000 CDM 270 RC outpatient 7.63 7.48 All Payors / Plans All Payors / Plans 7.63 other 7.63 7.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND MULTIPASS SILK 3-0 PS-1 L18 IN BRAID BLACK SUP-270000000 CDM 270 RC outpatient 8.43 8.26 All Payors / Plans All Payors / Plans 8.43 other 8.43 8.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SILK 0 CT-1 L18 IN CONTROL RELEASE BRAID 8 STRAND BLACK SUP-270000000 CDM 270 RC outpatient 14.04 13.76 All Payors / Plans All Payors / Plans 14.04 other 14.04 14.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SILK 0 MH L30 IN BRAID BLACK SUP-270000000 CDM 270 RC outpatient 1.99 1.95 All Payors / Plans All Payors / Plans 1.99 other 1.99 1.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SILK 1 MH L30 IN BRAID BLACK SUP-270000000 CDM 270 RC outpatient 3.46 3.39 All Payors / Plans All Payors / Plans 3.46 other 3.46 3.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SILK 2-0 MH L30 IN BRAID BLACK SUP-270000000 CDM 270 RC outpatient 2.21 2.17 All Payors / Plans All Payors / Plans 2.21 other 2.21 2.21 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SILK 2-0 SH L18 IN CONTROL RELEASE BRAID 8 STRAND BLACK SUP-270000000 CDM 270 RC outpatient 15.86 15.54 All Payors / Plans All Payors / Plans 15.86 other 15.86 15.86 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SILK 2-0 SH L30 IN BRAID BLACK SUP-270000000 CDM 270 RC outpatient 1.11 1.09 All Payors / Plans All Payors / Plans 1.11 other 1.11 1.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SILK 3-0 SH L18 IN CONTROL RELEASE BRAID 8 STRAND BLACK SUP-270000000 CDM 270 RC outpatient 8.16 8 All Payors / Plans All Payors / Plans 8.16 other 8.16 8.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SILK 3-0 SH L30 IN BRAID BLACK SUP-270000000 CDM 270 RC outpatient 2.27 2.22 All Payors / Plans All Payors / Plans 2.27 other 2.27 2.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PERMA-HAND SUTUPAK SILK 1 L18 IN BRAID TIES 6 STRAND PRECUT BLACK SUP-270000000 CDM 270 RC outpatient 1.56 1.53 All Payors / Plans All Payors / Plans 1.56 other 1.56 1.56 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 1 CTX L30 IN MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 3.72 3.65 All Payors / Plans All Payors / Plans 3.72 other 3.72 3.72 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 2-0 CT-1 L30 IN MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 18.27 17.9 All Payors / Plans All Payors / Plans 18.27 other 18.27 18.27 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 2-0 FS L18 IN MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 4.92 4.82 All Payors / Plans All Payors / Plans 4.92 other 4.92 4.92 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 2-0 MH L48 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 10.97 10.75 All Payors / Plans All Payors / Plans 10.97 other 10.97 10.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 2-0 SH L36 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 9.04 8.86 All Payors / Plans All Payors / Plans 9.04 other 9.04 9.04 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 3-0 FS-1 L18 IN MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 2.85 2.79 All Payors / Plans All Payors / Plans 2.85 other 2.85 2.85 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 3-0 MH L36 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 8.99 8.81 All Payors / Plans All Payors / Plans 8.99 other 8.99 8.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 3-0 SH L36 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 10.76 10.54 All Payors / Plans All Payors / Plans 10.76 other 10.76 10.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 4-0 BB L24 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 14.52 14.23 All Payors / Plans All Payors / Plans 14.52 other 14.52 14.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 4-0 RB-1 L36 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 18.42 18.05 All Payors / Plans All Payors / Plans 18.42 other 18.42 18.42 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 4-0 SH L36 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 9.29 9.1 All Payors / Plans All Payors / Plans 9.29 other 9.29 9.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 5-0 C-1 L36 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 22.2 21.76 All Payors / Plans All Payors / Plans 22.2 other 22.2 22.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 6-0 BV-1 L24 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 32.24 31.6 All Payors / Plans All Payors / Plans 32.24 other 32.24 32.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 6-0 BV-1 L30 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 27.84 27.28 All Payors / Plans All Payors / Plans 27.84 other 27.84 27.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 6-0 C-1 L30 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 17.14 16.8 All Payors / Plans All Payors / Plans 17.14 other 17.14 17.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 6-0 P-1 L18 IN MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 23.54 23.07 All Payors / Plans All Payors / Plans 23.54 other 23.54 23.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE 7-0 BV-1 L30 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 35.59 34.88 All Payors / Plans All Payors / Plans 35.59 other 35.59 35.59 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE MULTIPASS 4-0 P-3 18IN BLUE MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 10.99 10.77 All Payors / Plans All Payors / Plans 10.99 other 10.99 10.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE MULTIPASS 4-0 PS-2 18IN BLUE MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 8.73 8.56 All Payors / Plans All Payors / Plans 8.73 other 8.73 8.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE MULTIPASS 5-0 P-3 18IN BLUE MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 9.53 9.34 All Payors / Plans All Payors / Plans 9.53 other 9.53 9.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE MULTIPASS 8-0 BV130-5 24IN BLUE 2 ARM MONOFILAMENT SUP-270000000 CDM 270 RC outpatient 81.08 79.46 All Payors / Plans All Payors / Plans 81.08 other 81.08 81.08 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE POLYPROPYLENE 0 CT L30 IN MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 2.24 2.2 All Payors / Plans All Payors / Plans 2.24 other 2.24 2.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE PROLENE POLYPROPYLENE 5-0 C-1 L36 IN 2 ARM MONOFILAMENT BLUE SUP-270000000 CDM 270 RC outpatient 30.9 30.28 All Payors / Plans All Payors / Plans 30.9 other 30.9 30.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE SUTURETAPE L40 IN OD1.3 MM X 2 STRAND BLACK BLUE WHITE SUP-270000000 CDM 270 RC outpatient 66.3 64.97 All Payors / Plans All Payors / Plans 66.3 other 66.3 66.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE TAPERCUT STAINLESS STEEL 6 V-40 L18 IN MONOFILAMENT 4 STRAND SUP-270000000 CDM 270 RC outpatient 25.05 24.55 All Payors / Plans All Payors / Plans 25.05 other 25.05 25.05 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE TI-CRON CARDIOPOINT 2-0 CV-316 L 30 IN 2 ARM BRAID 10 STRAND COATED BLUE WHITE SUP-270000000 CDM 270 RC outpatient 940.8 921.98 All Payors / Plans All Payors / Plans 940.8 other 940.8 940.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE TI-CRON CARDIOPOINT 2-0CV-331 L30IN 2 ARM BRAID 8 STRAND COATED BLUE WHITE SUP-270000000 CDM 270 RC outpatient 871.25 853.83 All Payors / Plans All Payors / Plans 871.25 other 871.25 871.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE NONABSORBABLE TIGERLINK FIBERWIRE 2 L26 IN CLOSED LOOP BLACK WHITE SUP-270000000 CDM 270 RC outpatient 231 226.38 All Payors / Plans All Payors / Plans 231 other 231 231 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE PROLENE 7/0 24IN BV175-6 SUP-270000000 CDM 270 RC outpatient 47.46 46.51 All Payors / Plans All Payors / Plans 47.46 other 47.46 47.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTURE VICRYL 2-0 SUP-270000000 CDM 270 RC outpatient 5.39 5.28 All Payors / Plans All Payors / Plans 5.39 other 5.39 5.39 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility "SUTURE VLOC NON ABS DVC 1BL 18""L GS-21" SUP-270000000 CDM 270 RC outpatient 36.88 36.14 All Payors / Plans All Payors / Plans 36.88 other 36.88 36.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SUTUTE NONABSORABLE ETHILON 6-0 SUP-270000000 CDM 270 RC outpatient 8.74 8.57 All Payors / Plans All Payors / Plans 8.74 other 8.74 8.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SWITCH FLOW HIGH PRESSURE SUP-270000000 CDM 270 RC outpatient 5.8 5.68 All Payors / Plans All Payors / Plans 5.8 other 5.8 5.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE ANGIOGRAPHY MEDALLION 1 ML CLEAR POLYCARBONATE BARREL FIXED MALE LUER PLUNGER YELLOW SUP-270000000 CDM 270 RC outpatient 7.14 7 All Payors / Plans All Payors / Plans 7.14 other 7.14 7.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE ANGIOGRAPHY MEDRAD FASTURN 150ML DISPOSABLE STERILE LF FILL TUBE MARK V PROVIS SUP-270000000 CDM 270 RC outpatient 8.74 8.57 All Payors / Plans All Payors / Plans 8.74 other 8.74 8.74 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE BULB DOVER 60 CC PROTECTOR CAP STERILE SUP-270000000 CDM 270 RC outpatient 1.38 1.35 All Payors / Plans All Payors / Plans 1.38 other 1.38 1.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE EAR PVC 2 OZ SOFT PLIABLE IRRIGATION SUCTION STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 1.3 1.27 All Payors / Plans All Payors / Plans 1.3 other 1.3 1.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE INJECTION 10ML FLUID DISPENSING SYSTEM SUP-270000000 CDM 270 RC outpatient 25.13 24.63 All Payors / Plans All Payors / Plans 25.13 other 25.13 25.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE IRRIGATION TOOMEY CONTRO-PISTON TYVEK 70CC GRADUATE ELONGATE TIP EXTRA LONG ORIFICE LUER ADAPTER STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 2.18 2.14 All Payors / Plans All Payors / Plans 2.18 other 2.18 2.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE MEDICAL 60 ML LUER LOCK STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 1.25 1.23 All Payors / Plans All Payors / Plans 1.25 other 1.25 1.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE MEDICAL BD BD LUER-LOK 10ML CLEAR POLYPROPYLENE DISPOSABLE STERILE LF GRADUATE CONTROL NONPYROGENIC DEHP FREE SUP-270000000 CDM 270 RC outpatient 1.24 1.22 All Payors / Plans All Payors / Plans 1.24 other 1.24 1.24 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE MEDICAL PERIFIX BISPHENOL A PLASTIC 8 ML LOSS OF RESISTANCE LUER LOCK DEHP FREE PVC FREE LATEX FREE SUP-270000000 CDM 270 RC outpatient 1.7 1.67 All Payors / Plans All Payors / Plans 1.7 other 1.7 1.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYRINGE TUBERCULIN BD BD PRECISIONGLIDE REGULAR BEVEL REGULAR WALL L1/2 IN OD27 GA 1 ML DETACHABLE NEEDLE SLIP TIP HUB STERILE LATEX FREE DISPOSABLE GRAY SUP-270000000 CDM 270 RC outpatient 32.11 31.47 All Payors / Plans All Payors / Plans 32.11 other 32.11 32.11 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM BONE CEMENT REVOLUTION FEMORAL MIX BREAKAWAY NOZZLE LATEX SUP-270000000 CDM 270 RC outpatient 88.88 87.1 All Payors / Plans All Payors / Plans 88.88 other 88.88 88.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM CARDIAC MONITOR LINQ II RECORDER SUP-270000000 CDM 270 RC outpatient 4590 4498.2 All Payors / Plans All Payors / Plans 4590 other 4590 4590 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM CLOSURE VASCADE MVP ID6-12 FR VENOUS SUP-270000000 CDM 270 RC outpatient 2652 2598.96 All Payors / Plans All Payors / Plans 2652 other 2652 2652 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM CORONARY STENT SYNERGY XD MR 2.25 X 8MM SUP-270000000 CDM 270 RC outpatient 935 916.3 All Payors / Plans All Payors / Plans 935 other 935 935 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM CORONARY STENT SYNERGY XD MR 2.50 X 24MM SUP-270000000 CDM 270 RC outpatient 1155 1131.9 All Payors / Plans All Payors / Plans 1155 other 1155 1155 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM CORONARY STENT SYNERGY XD MR 3.00 X 20MM SUP-270000000 CDM 270 RC outpatient 1155 1131.9 All Payors / Plans All Payors / Plans 1155 other 1155 1155 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM CORONARY STENT SYNERGY XD MR 4.00 X 20MM SUP-270000000 CDM 270 RC outpatient 1155 1131.9 All Payors / Plans All Payors / Plans 1155 other 1155 1155 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM DELIVERY MITRACLIP XTW CLIP 4TH GENERATION SUP-270000000 CDM 270 RC outpatient 40500 39690 All Payors / Plans All Payors / Plans 40500 other 40500 40500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM DELIVERY SAPIEN 3 OD23 MM COMMANDER DELIVERY SYSTEM STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 46000 45080 All Payors / Plans All Payors / Plans 46000 other 46000 46000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM DELIVERY SAPIEN 3 OD26 MM COMMANDER DELIVERY SYSTEM STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 46000 45080 All Payors / Plans All Payors / Plans 46000 other 46000 46000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM DETACHMENT INZONE SUP-270000000 CDM 270 RC outpatient 606.9 594.76 All Payors / Plans All Payors / Plans 606.9 other 606.9 606.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM DIAGNOSTIC CATHETER IVAS ELITE L10 MM OD10 GA STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 5756.29 5641.16 All Payors / Plans All Payors / Plans 5756.29 other 5756.29 5756.29 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM EMBOLIC PROTECTION EMBOSHIELD NAV6 STAINLESS STEEL PTFE .014 IN LARGE L190 CM OD4-7 MM SUP-270000000 CDM 270 RC outpatient 5623.8 5511.32 All Payors / Plans All Payors / Plans 5623.8 other 5623.8 5623.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM FIXATION SPEEDBRIDGE SWIVELOCK FIBERTAPE PEEK OD4.75 MM 2 PRELOAD LOOP DISPOSABLE PUNCH BLACK BLUE WHITE SUP-270000000 CDM 270 RC outpatient 3360 3292.8 All Payors / Plans All Payors / Plans 3360 other 3360 3360 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM FIXATION TIGHTROPE XP STAINLESS STEEL SYNDESMOSIS REPAIR SUP-270000000 CDM 270 RC outpatient 3139.5 3076.71 All Payors / Plans All Payors / Plans 3139.5 other 3139.5 3139.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM INTRODUCER ACCUSTICK II L15 CM OD21 GA NEEDLE STYLET RADIOPAQUE SUP-270000000 CDM 270 RC outpatient 20.58 20.17 All Payors / Plans All Payors / Plans 20.58 other 20.58 20.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM NEGATIVE PRESSURE PICO 7 L20 CM X W10 CM STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 173.63 170.16 All Payors / Plans All Payors / Plans 173.63 other 173.63 173.63 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM THROMBECTOMY ANGIOJET ULTRA SOLENT PROXI PERIPHERAL CATHETER WASTE BAG PUMP SET SCALABLE SUP-270000000 CDM 270 RC outpatient 4207.5 4123.35 All Payors / Plans All Payors / Plans 4207.5 other 4207.5 4207.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility SYSTEM VITRECTOMY EDGEPLUS 6 MM OD25 GA 1 COUNT VALVED ENTRY LOCKING MECHANISM CANNULA LOW FRICTION SUP-270000000 CDM 270 RC outpatient 105.13 103.03 All Payors / Plans All Payors / Plans 105.13 other 105.13 105.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAPE SURGICAL 3M DURAPORE 10YDX1IN WHITE CLOTH LF HYPOALLERGENIC WATER RESISTANT BIDIRECTIONAL TEAR SUP-270000000 CDM 270 RC outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAPE SURGICAL 3M DURAPORE 10YDX3IN WHITE CLOTH LF HYPOALLERGENIC WATER RESISTANT BIDIRECTIONAL TEAR SUP-270000000 CDM 270 RC outpatient 1.55 1.52 All Payors / Plans All Payors / Plans 1.55 other 1.55 1.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAPE SURGICAL 3M MICROFOAM 5.5YDX3IN WHITE FOAM LF HYPOALLERGENIC WATER RESISTANT MULTIDIRECTIONAL STRETCH ELASTIC SUP-270000000 CDM 270 RC outpatient 6.6 6.47 All Payors / Plans All Payors / Plans 6.6 other 6.6 6.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAPE SURGICAL 3M TRANSPORE 10YDX1IN CLEAR PLASTIC DISPOSABLE LF HYPOALLERGENIC WATER RESISTANT BIDIRECTIONAL TEAR SUP-270000000 CDM 270 RC outpatient 1.09 1.07 All Payors / Plans All Payors / Plans 1.09 other 1.09 1.09 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAPE SURGICAL 3M TRANSPORE 10YDX2IN CLEAR PLASTIC DISPOSABLE LF HYPOALLERGENIC WATER RESISTANT BIDIRECTION TEAR SUP-270000000 CDM 270 RC outpatient 1.12 1.1 All Payors / Plans All Payors / Plans 1.12 other 1.12 1.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAPE UMBILICAL 36X1/8IN COTTON STERILE LF TIE WOVEN NONABSORBABLE MULTIPACK SUP-270000000 CDM 270 RC outpatient 3.88 3.8 All Payors / Plans All Payors / Plans 3.88 other 3.88 3.88 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAPE UMBILICAL COTTON FLAT L30 IN X W1/8 IN STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 8.26 8.09 All Payors / Plans All Payors / Plans 8.26 other 8.26 8.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAVR CONFIDA BRECKER GUIDEWIRE 260CM SUP-481000000 CDM 270 RC outpatient 331.5 324.87 All Payors / Plans All Payors / Plans 331.5 other 331.5 331.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TAVR COOK 10F DILATOR 20CM SUP-270000000 CDM 270 RC outpatient 16.99 16.65 All Payors / Plans All Payors / Plans 16.99 other 16.99 16.99 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility THERAPY COLD SUP-270000000 CDM 270 RC outpatient 145.95 143.03 All Payors / Plans All Payors / Plans 145.95 other 145.95 145.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIP APPLICATOR PROGEL L29 CM SPRAYER EXTENDED SUP-270000000 CDM 270 RC outpatient 350.28 343.27 All Payors / Plans All Payors / Plans 350.28 other 350.28 350.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIP PHACOEMULSIFICATION GRIESHABER REVOLUTION DSP POLYMERIC 360 D OD 25 GA TISSUE BACK FLUSH LIGHTWEIGHT ERGONOMIC HANDLE STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 213.84 209.56 All Payors / Plans All Payors / Plans 213.84 other 213.84 213.84 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIP PULSED LAVAGE L12.7 CM MULTIORIFICE FAN SPRAY SPLASH SHIELD HIGH CAPACITY STERILE INTRAMEDULLARY NAIL SUP-270000000 CDM 270 RC outpatient 7.94 7.78 All Payors / Plans All Payors / Plans 7.94 other 7.94 7.94 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIP PULSED LAVAGE L22.86 CM OD.89 CM FEMUR RADIAL SPRAY HIGH CAPACITY STERILE INTRAMEDULLARY NAIL PULSAVAC PLUS PULSAVAC PLUS AC SUP-270000000 CDM 270 RC outpatient 15.12 14.82 All Payors / Plans All Payors / Plans 15.12 other 15.12 15.12 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIP SUCTION ARGYLE YANKAUER VINYL PEDIATRIC L25 CM OD12 FR FINE FLEXIBLE NONBREAKABLE SMOOTH INNER LUMEN STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 1.07 1.05 All Payors / Plans All Payors / Plans 1.07 other 1.07 1.07 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIP SUCTION MEDI-VAC YANKAUER BULBOUS WITHOUT CONTROL VENT HANDLE STERILE LATEX FREE CLEAR SUP-270000000 CDM 270 RC outpatient 1.03 1.01 All Payors / Plans All Payors / Plans 1.03 other 1.03 1.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIP SUCTION POOLE 32FR 8.75IN STRAIGHT GENTLE SUMP SUP-270000000 CDM 270 RC outpatient 40.13 39.33 All Payors / Plans All Payors / Plans 40.13 other 40.13 40.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TIP SUCTION YANKAUER PLASTIC STANDARD TUBE RIGID TRANSPARENT SLIP RESISTANT HANDLE STERILE LATEX FREE CLEAR SUP-270000000 CDM 270 RC outpatient 1.1 1.08 All Payors / Plans All Payors / Plans 1.1 other 1.1 1.1 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MIDAS REX LEGEND CYLINDER L10 CM OD4 MM STERILE BURR SUP-270000000 CDM 270 RC outpatient 367.23 359.89 All Payors / Plans All Payors / Plans 367.23 other 367.23 367.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MIDAS REX LEGEND MATCH HEAD FLUTE L9 CM OD3 MM BURR SUP-270010028 CDM 270 RC outpatient 313.55 307.28 All Payors / Plans All Payors / Plans 313.55 other 313.55 313.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MIDAS REX MR8 7 CM TAPER OD2.3 MM STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 156.18 153.06 All Payors / Plans All Payors / Plans 156.18 other 156.18 156.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MIDAS REX MR8 BALL L9 CM OD5 MM SYMMETRICAL STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 986.58 966.85 All Payors / Plans All Payors / Plans 986.58 other 986.58 986.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MIDAS REX MR8 MATCH HEAD L9 CM OD3 MM STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 188.13 184.37 All Payors / Plans All Payors / Plans 188.13 other 188.13 188.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MR8 CYLINDER L10 CM OD4 MM SUP-270000000 CDM 270 RC outpatient 367.23 359.89 All Payors / Plans All Payors / Plans 367.23 other 367.23 367.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MR8 MATCH HEAD L10 CM OD3 MM STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 343.48 336.61 All Payors / Plans All Payors / Plans 343.48 other 343.48 343.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MR8 MATCH HEAD L14 CM OD3 MM STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 315.03 308.73 All Payors / Plans All Payors / Plans 315.03 other 315.03 315.03 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TOOL DISSECTING MR8 TAPER L7 CM OD1.1 MM SUP-270000000 CDM 270 RC outpatient 290.49 284.68 All Payors / Plans All Payors / Plans 290.49 other 290.49 290.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRACKER NAVIGATION FUSION AXIEM ENT INSTRUMENT STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 432.6 423.95 All Payors / Plans All Payors / Plans 432.6 other 432.6 432.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRACKER NAVIGATION FUSION AXIEM NONINVASIVE STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 525 514.5 All Payors / Plans All Payors / Plans 525 other 525 525 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRANSFORM 7X10 SUP-270000000 CDM 270 RC outpatient 3255.5 3190.39 All Payors / Plans All Payors / Plans 3255.5 other 3255.5 3255.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETER ARGYLE SWAN NECK CURL L122.3 CM OD15 FR PRESTERNAL CUFF STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 676.6 663.07 All Payors / Plans All Payors / Plans 676.6 other 676.6 676.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETER POWERLINE 577ML/HR 5FR POLYURETHANE STERILE LF 2 LUMEN POWER INJECTABLE MICROINTRODUCER SUP-270000000 CDM 270 RC outpatient 1208.97 1184.79 All Payors / Plans All Payors / Plans 1208.97 other 1208.97 1208.97 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETER POWERPICC NITINOL .018 IN L70 CM OD5 FR 2 LUMEN GUIDEWIRE SUP-270000000 CDM 270 RC outpatient 96.89 94.95 All Payors / Plans All Payors / Plans 96.89 other 96.89 96.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETER SURESTEP LUBRI-SIL IC COMPLETE CARE OD 16 FRENCH 350ML FOLEY URINE METER TEMPERATURE SENSING STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 83.58 81.91 All Payors / Plans All Payors / Plans 83.58 other 83.58 83.58 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETERIZATION BARD OD16 FR 350ML URINE METER SUP-270009006 CDM 270 RC outpatient 41.75 40.92 All Payors / Plans All Payors / Plans 41.75 other 41.75 41.75 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETERIZATION BARDEX COMPLETE CARE OD16 FR FOLEY URINE METER ADVANCE STERILE 400 SUP-270009006 CDM 270 RC outpatient 12.49 12.24 All Payors / Plans All Payors / Plans 12.49 other 12.49 12.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETERIZATION BARDEX STATLOCK 16FR BACTI-GUARD HYDROGEL NATURAL RUBBER DISPOSABLE STERILE LATEX FOLEY URINE METER SUP-270009006 CDM 270 RC outpatient 12.49 12.24 All Payors / Plans All Payors / Plans 12.49 other 12.49 12.49 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETERIZATION COMPLETE CARE BARDEX IC STATLOCK BARD 60IN 16FR 5ML BACTI-GUARD NATURAL RUBBER HYDROGEL DISPOSABLE SUP-270009004 CDM 270 RC outpatient 8.5 8.33 All Payors / Plans All Payors / Plans 8.5 other 8.5 8.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETERIZATION COMPLETE CARE BARDEX IC STATLOCK BARD BACTI-GUARD NATURAL RUBBER HYDROGEL L60 IN OD18 FR 5 ML ADVANCE FOLEY ANTIREFLUX CHAMBER DRAINAGE BAG STERILE LATEX DISPOSABLE SUP-270009004 CDM 270 RC outpatient 8.5 8.33 All Payors / Plans All Payors / Plans 8.5 other 8.5 8.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETERIZATION LUBRI SIL ADVANCE 16 FR 2 CONNECTOR FOLEY URINE METER TEMP SENSING LATEX FREE SUP-270000000 CDM 270 RC outpatient 38.69 37.92 All Payors / Plans All Payors / Plans 38.69 other 38.69 38.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY CATHETERIZATION LUBRI-SIL COMPLETE CARE STATLOCK 60IN 16FR BACTI-GUARD HYDROGEL DISPOSABLE STERILE LF FOLEY URINE SUP-270000000 CDM 270 RC outpatient 33.65 32.98 All Payors / Plans All Payors / Plans 33.65 other 33.65 33.65 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY GASTRIC LAVAGE MONOJECT ARGYLE EDLICH PVC LARGE L36 IN OD34 FR 140 CC 4 EYE CLOSED END GRADUATED SYRINGE TRANSPARENT STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 12.78 12.52 All Payors / Plans All Payors / Plans 12.78 other 12.78 12.78 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY SKIN PREP PVP-1 SCRUB CARE SUP-270009183 CDM 270 RC outpatient 5.76 5.64 All Payors / Plans All Payors / Plans 5.76 other 5.76 5.76 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY SKIN SCRUB 4OZ CHG VINYL COTTON STERILE LF WET SUP-270000000 CDM 270 RC outpatient 24.3 23.81 All Payors / Plans All Payors / Plans 24.3 other 24.3 24.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY SKIN SCRUB VINYL WET SMALL WING SPONGE STICK COTTON TIP APPLICATOR LATEX FREE SUP-270009183 CDM 270 RC outpatient 6.01 5.89 All Payors / Plans All Payors / Plans 6.01 other 6.01 6.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY STERLIZATION SPHERES SUP-270000000 CDM 270 RC outpatient 308.23 302.07 All Payors / Plans All Payors / Plans 308.23 other 308.23 308.23 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY SURGICAL 54X54IN STERILE LF 2 BASIN GRADUATED SUP-270000000 CDM 270 RC outpatient 6.18 6.06 All Payors / Plans All Payors / Plans 6.18 other 6.18 6.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRAY SURGICAL WAYNE CHLORAPREP L29 CM L5 CM OD14 FR ODSEC18 GA PERCUTANEOUS 19 SIDEPORT CATHETER ECHOGENIC ENTRY NEEDLE GUIDEWIRE DILATOR STERILE DISPOSABLE PNEUMOTHORAX SUP-270000000 CDM 270 RC outpatient 723.38 708.91 All Payors / Plans All Payors / Plans 723.38 other 723.38 723.38 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR BLADELESS W/BALLOON 12MMX100MM SUP-270000000 CDM 270 RC outpatient 204 199.92 All Payors / Plans All Payors / Plans 204 other 204 204 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR HASSON 12MM SUP-270000000 CDM 270 RC outpatient 252 246.96 All Payors / Plans All Payors / Plans 252 other 252 252 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL 100MM 11MM DISPOSABLE STERILE LF STABILITY SLEEVE BLADELESS OBTURATOR OPTIONAL PISTOL SUP-270000000 CDM 270 RC outpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL 100MM 12MM DISPOSABLE STERILE STABILITY SLEEVE DILATE SUP-270000000 CDM 270 RC outpatient 51.47 50.44 All Payors / Plans All Payors / Plans 51.47 other 51.47 51.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL 150MM 5MM DISPOSABLE STERILE STABILITY SLEEVE SUP-270000000 CDM 270 RC outpatient 51.47 50.44 All Payors / Plans All Payors / Plans 51.47 other 51.47 51.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL L100 MM OD12 MM BLADELESS OPTICAL TIP OBTURATOR RADIOLUCENT SLEEVE STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL L100 MM OD15 MM BLADELESS OPTICAL TIP OBTURATOR RADIOLUCENT SLEEVE STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 72.46 71.01 All Payors / Plans All Payors / Plans 72.46 other 72.46 72.46 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL L100 MM OD8 MM STABILITY SLEEVE BLADELESS OPTICAL TIP OBTURATOR STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 42.28 41.43 All Payors / Plans All Payors / Plans 42.28 other 42.28 42.28 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL L150 MM OD12 MM STABILITY SLEEVE BLADELESS LOW SYSTEM DRAG FORCE OPTIONAL PISTOL HANDLE STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 64.89 63.59 All Payors / Plans All Payors / Plans 64.89 other 64.89 64.89 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL OPTIVIEW 100MM 12MM DISPOSABLE STERILE SMOOTH SLEEVE OBTURATOR BLUNT TIP PISTOL HANDLE SUP-270000000 CDM 270 RC outpatient 51.47 50.44 All Payors / Plans All Payors / Plans 51.47 other 51.47 51.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL OPTIVIEW 100MM 5MM DISPOSABLE STERILE STABILITY SLEEVE BLADELESS OBTURATOR RADIOLUCENT SUP-270000000 CDM 270 RC outpatient 25 24.5 All Payors / Plans All Payors / Plans 25 other 25 25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR LAPAROSCOPIC ENDOPATH XCEL OPTIVIEW L100 MM OD5 MM STABILITY SLEEVE DILAT TIP STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 51.47 50.44 All Payors / Plans All Payors / Plans 51.47 other 51.47 51.47 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR SLEEVE W/BALLOON 5MM X 100MM SUP-270000000 CDM 270 RC outpatient 93.5 91.63 All Payors / Plans All Payors / Plans 93.5 other 93.5 93.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR SURGICAL ARGYLE L18 3/4 CM FALLER TUNNEL STERILE LATEX FREE PERITONEAL DIALYSIS SUP-270000000 CDM 270 RC outpatient 225.98 221.46 All Payors / Plans All Payors / Plans 225.98 other 225.98 225.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TROCAR W BALLOON 5MM X 100MM SUP-270000000 CDM 270 RC outpatient 187 183.26 All Payors / Plans All Payors / Plans 187 other 187 187 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TRUE DILATATION BALLOON 24MM X 4.5CM SUP-481000000 CDM 270 RC outpatient 3000 2940 All Payors / Plans All Payors / Plans 3000 other 3000 3000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBE CONNECTING DRAINAGE BAG SUP-270000000 CDM 270 RC outpatient 11.91 11.67 All Payors / Plans All Payors / Plans 11.91 other 11.91 11.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBE GASTROSTOMY SILICONE L9.5 IN OD20 FR 15 CC 3 PORT GASTRIC BALLOON ROUND TIP LATEX FREE WHITE SUP-270009103 CDM 270 RC outpatient 75.73 74.22 All Payors / Plans All Payors / Plans 75.73 other 75.73 75.73 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBE JEJUNOSTOMY MIC SECUR-LOK 45CM 18FR 7-10ML SILICONE DISPOSABLE STERILE LF RADIOPAQUE STRIPE RETENTION BALLOON SUP-270000000 CDM 270 RC outpatient 474.26 464.77 All Payors / Plans All Payors / Plans 474.26 other 474.26 474.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBE NASOGASTRIC SALEM SUMP SENTINEL LINE SENTINEL EYE 48IN 18FR PVC STERILE STOMACH 2 LUMEN DEHP FREE 5IN 1 ADAPTER SUP-270000000 CDM 270 RC outpatient 2.18 2.14 All Payors / Plans All Payors / Plans 2.18 other 2.18 2.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBE NASOGASTRIC TUM-E-VAC ADULT L48 IN OD32 FR 1 LUMEN RADIOPAQUE NONSTERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 8.95 8.77 All Payors / Plans All Payors / Plans 8.95 other 8.95 8.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBE SUCTION ARGYLE YANKAUER VINYL L25 CM OD22 FR SET LARGE TIP NO VACUUM CONTROL INNER LUMEN LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 1.01 0.99 All Payors / Plans All Payors / Plans 1.01 other 1.01 1.01 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBE TRACHEOSTOMY PORTEX BLUSELECT L 26.74 MM ID 8.0 MM WEDGE CUFF NONFEN STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 66.26 64.93 All Payors / Plans All Payors / Plans 66.26 other 66.26 66.26 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBE VENTILATION ARMSTRONG FLUOROPLASTIC BEVEL GROMMET ID1.14 MM EAR SUP-270000000 CDM 270 RC outpatient 1643.67 1610.8 All Payors / Plans All Payors / Plans 1643.67 other 1643.67 1643.67 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING ABLATION CARTO SMARTABLATE PUMP STERILE SUP-270000000 CDM 270 RC outpatient 92.82 90.96 All Payors / Plans All Payors / Plans 92.82 other 92.82 92.82 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING ANGIOGRAPHY PVC 900 PSI L48 IN OD.158 IN ID.071 IN RIGID CONTRAST INJECTION FIXED MALE CONNECTOR CLEAR SUP-270000000 CDM 270 RC outpatient 2.41 2.36 All Payors / Plans All Payors / Plans 2.41 other 2.41 2.41 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING ASPIRATION AXS UNIVERSAL L300 CM OD8 MM STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 663.6 650.33 All Payors / Plans All Payors / Plans 663.6 other 663.6 663.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING DRAINAGE ARGYLE PENROSE RUBBER FLAT L12 IN X W5/8 IN OD3/8 IN RADIOPAQUE STERILE LATEX DISPOSABLE SUP-270000000 CDM 270 RC outpatient 1.16 1.14 All Payors / Plans All Payors / Plans 1.16 other 1.16 1.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING DRAINAGE ARGYLE PENROSE RUBBER L30 CM OD16 MM THORACIC RADIOPAQUE STERILE LATEX DISPOSABLE SUP-270000000 CDM 270 RC outpatient 1.16 1.14 All Payors / Plans All Payors / Plans 1.16 other 1.16 1.16 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING INSUFFLATION DYOPNEUMATIC .1UM 10FT STERILE LF ABDOMINAL BACTERIAL VIRAL FILTER 1 LUER LOCK CPC CONNECTOR SUP-270000000 CDM 270 RC outpatient 31.52 30.89 All Payors / Plans All Payors / Plans 31.52 other 31.52 31.52 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING INSUFFLATION L10 FT 40 L LUER LOCK HIGH FLOW HEATED PATIENT KIT STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 18.48 18.11 All Payors / Plans All Payors / Plans 18.48 other 18.48 18.48 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING IRRIGATION TIP DISPOSABLE SUP-270000000 CDM 270 RC outpatient 32.53 31.88 All Payors / Plans All Payors / Plans 32.53 other 32.53 32.53 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING PRESSURE MONITOR POLYETHYLENE L48 IN MALE TO FEMALE CONNECTOR LUER LOCK TRANSDUCER LINE FIX STERILE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 20.79 20.37 All Payors / Plans All Payors / Plans 20.79 other 20.79 20.79 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING PRESSURE MONITOR TRUWAVE L12 IN MALE TO FEMALE CONNECTOR TRANSDUCER DISPOSABLE SUP-270000000 CDM 270 RC outpatient 4.51 4.42 All Payors / Plans All Payors / Plans 4.51 other 4.51 4.51 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING SMOKE EVACUATOR PUREVIEW PLUME-AWAY FILTRATION LAPAROSCOPIC SUP-270000000 CDM 270 RC outpatient 36.55 35.82 All Payors / Plans All Payors / Plans 36.55 other 36.55 36.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING SUCTION BERKELEY SAFETOUCH L18 IN BOTTLE TO BOTTLE HOSE CONNECT LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 2.54 2.49 All Payors / Plans All Payors / Plans 2.54 other 2.54 2.54 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING SUCTION L6 FT OD1/2 IN UTERINE SWIVEL HANDLE STERILE LATEX DISPOSABLE AMUVAC SUP-270000000 CDM 270 RC outpatient 15.14 14.84 All Payors / Plans All Payors / Plans 15.14 other 15.14 15.14 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING SUCTION MEDI-VAC L12 FT ID1/4 IN NONCONDUCTIVE MALE TO MALE CONNECTOR STERILE LATEX FREE CLEAR SUP-270000000 CDM 270 RC outpatient 1.18 1.16 All Payors / Plans All Payors / Plans 1.18 other 1.18 1.18 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING SUCTION MEDI-VAC MAXI-GRIP L6 FT ID1/4 IN NONCONDUCTIVE MALE TO MALE STERILE CLEAR SUP-270000000 CDM 270 RC outpatient 1.22 1.2 All Payors / Plans All Payors / Plans 1.22 other 1.22 1.22 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility TUBING SUCTION POOLE GENTLE SUMP STERILE LATEX FREE DISPOSABLE SUP-270000000 CDM 270 RC outpatient 3.02 2.96 All Payors / Plans All Payors / Plans 3.02 other 3.02 3.02 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility UNIT ELECTROSURGICAL GENESYS HTA PROCEDURE SET SUP-270000000 CDM 270 RC outpatient 3759 3683.82 All Payors / Plans All Payors / Plans 3759 other 3759 3759 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC CARBO-SEAL GELWEAVE VALSALVA OD21 MM ID24 MM MECHANICAL ROTATABLE CONDUIT LOW PROFILE HOLDER SUP-270000000 CDM 270 RC outpatient 16252.5 15927.45 All Payors / Plans All Payors / Plans 16252.5 other 16252.5 16252.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC EDWARDS SAPIEN 3 COMMANDER OD 29MM DELIVERY SYSTEM SUP-270000000 CDM 270 RC outpatient 43000 42140 All Payors / Plans All Payors / Plans 43000 other 43000 43000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC EVOLUT FX 26 MM SUP-270000000 CDM 270 RC outpatient 43500 42630 All Payors / Plans All Payors / Plans 43500 other 43500 43500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC EVOLUT FX 29 MM SUP-270000000 CDM 270 RC outpatient 43500 42630 All Payors / Plans All Payors / Plans 43500 other 43500 43500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC EVOLUT FX 34 MM SUP-270000000 CDM 270 RC outpatient 46500 45570 All Payors / Plans All Payors / Plans 46500 other 46500 46500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC INSPIRIS RESILIA 21MM SUP-270000000 CDM 270 RC outpatient 16485 16155.3 All Payors / Plans All Payors / Plans 16485 other 16485 16485 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC INSPIRIS RESILIA 23MM SUP-270000000 CDM 270 RC outpatient 13345 13078.1 All Payors / Plans All Payors / Plans 13345 other 13345 13345 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC SAPIEN 3 BOVINE OD29 MM TRANSCATHETER STERILE SUP-270000000 CDM 270 RC outpatient 46000 45080 All Payors / Plans All Payors / Plans 46000 other 46000 46000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC SAPIEN 3 EDWARDS OD23 MM HEART TRANSCATHETER STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 46000 45080 All Payors / Plans All Payors / Plans 46000 other 46000 46000 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE AORTIC SAPIEN 3 EDWARDS OD26 MM HEART TRANSCATHETER STERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 43500 42630 All Payors / Plans All Payors / Plans 43500 other 43500 43500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE HEMOSTASIS ACCESS PLUS VALUELINK LARGE BORE SUP-270000000 CDM 270 RC outpatient 49.06 48.08 All Payors / Plans All Payors / Plans 49.06 other 49.06 49.06 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE HEMOSTASIS PHD METAL POLYCARBONATE SILICONE ID 7.3 FR INSERTION TOOL TORQUE DEVICE COMPRESSION SEAL PUSH RELEASE MECHANISM CLEAR SUP-481000000 CDM 270 RC outpatient 37.4 36.65 All Payors / Plans All Payors / Plans 37.4 other 37.4 37.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE MITRAL EPIC FLEXFIT PORCINE PERICARDIAL LOW PROFILE H19 MM OD29 MM ID27 MM BIOPROSTHESIS STENT HOLDER SUP-270000000 CDM 270 RC outpatient 9618 9425.64 All Payors / Plans All Payors / Plans 9618 other 9618 9618 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE MITRAL MASTER-SERIES PYROLYTIC CARBON 85 D 5.18 SQ CM STANDARD OD31 MM ID26.1 MM HEART CUFF LEAFLET OPEN CONTROL TORQUE ROTATION MECHANISM SUP-270000000 CDM 270 RC outpatient 12708.8 12454.62 All Payors / Plans All Payors / Plans 12708.8 other 12708.8 12708.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVE SUCTION VISERA FLEXIBLE ATTACHMENT STERILE DISPOSABLE BRONCHOSCOPE SUP-270000000 CDM 270 RC outpatient 29.69 29.1 All Payors / Plans All Payors / Plans 29.69 other 29.69 29.69 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VALVULOTOME ANGIOSCOPIC HYDRO LEMAITRE L98 CM OD1.5 MM IRRIGATION PORT CUT BLADE BULLET HEAD HANDLE STERILE DISPOSABLE GREEN WHITE SUP-270000000 CDM 270 RC outpatient 6297.9 6171.94 All Payors / Plans All Payors / Plans 6297.9 other 6297.9 6297.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERACROSS ZERO EXCHANGE WATCHMAN SHEATH DELIVERY SUP-272000000 CDM 270 RC outpatient 1116.9 1094.56 All Payors / Plans All Payors / Plans 1116.9 other 1116.9 1116.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VERSA CROSS TRANSSEPTAL ACCESS 8.5F FIXED SYSTEM W/45 SHEATH AND PIGTAIL_62301_ SUP-481000000 CDM 270 RC outpatient 1734 1699.32 All Payors / Plans All Payors / Plans 1734 other 1734 1734 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VIABAHN BALLOON SUP-270000000 CDM 270 RC outpatient 6755.8 6620.68 All Payors / Plans All Payors / Plans 6755.8 other 6755.8 6755.8 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VIABAHN BX BALLOON SUP-270000000 CDM 270 RC outpatient 8345.4 8178.49 All Payors / Plans All Payors / Plans 8345.4 other 8345.4 8345.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VIABAHN BX BALLOON ENDO SUP-270000000 CDM 270 RC outpatient 6665.7 6532.39 All Payors / Plans All Payors / Plans 6665.7 other 6665.7 6665.7 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VISTASEAL FIBRIN SEALANT (HUMAN) 10 ML-12 PACK KIT SUP-270000000 CDM 270 RC outpatient 542.95 532.09 All Payors / Plans All Payors / Plans 542.95 other 542.95 542.95 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VNS SENTIVA GENERATOR SUP-270010003 CDM 270 RC outpatient 52073.25 51031.79 All Payors / Plans All Payors / Plans 52073.25 other 52073.25 52073.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VOLCANO EAGLE EYE PLATINUM IVUS CATHETER SUP-481000000 CDM 270 RC outpatient 739.5 724.71 All Payors / Plans All Payors / Plans 739.5 other 739.5 739.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VOLCANO REFINITY SUP-270000000 CDM 270 RC outpatient 1232.5 1207.85 All Payors / Plans All Payors / Plans 1232.5 other 1232.5 1232.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VOLCANO REFINITY IVUS CATHETER SUP-270000000 CDM 270 RC outpatient 1522.5 1492.05 All Payors / Plans All Payors / Plans 1522.5 other 1522.5 1522.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VOLCANO REFINITY ROTATIONAL IVUS CATHETER SUP-481000000 CDM 270 RC outpatient 1522.5 1492.05 All Payors / Plans All Payors / Plans 1522.5 other 1522.5 1522.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VSI .018 GUIDEWIRE SUP-481000000 CDM 270 RC outpatient 47.25 46.31 All Payors / Plans All Payors / Plans 47.25 other 47.25 47.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility VSI TRU-TORQUE STRAIGHT TIP GUIDEWIRE 180CM SUP-481000000 CDM 270 RC outpatient 153.3 150.23 All Payors / Plans All Payors / Plans 153.3 other 153.3 153.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WARMER SCOPE SUP-270000000 CDM 270 RC outpatient 5.61 5.5 All Payors / Plans All Payors / Plans 5.61 other 5.61 5.61 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WASHER ORTHOPEDIC STAINLESS STEEL THK 1 MM OD 8 MM ID 4 MM STERILE SUP-270000000 CDM 270 RC outpatient 96.36 94.43 All Payors / Plans All Payors / Plans 96.36 other 96.36 96.36 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WATCHMAN FLX 27MM _62666_ SUP-481000000 CDM 270 RC outpatient 18500 18130 All Payors / Plans All Payors / Plans 18500 other 18500 18500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WATCHMAN FLX 35 _62668_ SUP-481000000 CDM 270 RC outpatient 21500 21070 All Payors / Plans All Payors / Plans 21500 other 21500 21500 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WAX BONE 2.5 GM ABSORBABLE HEMOSTATIC AGENT SUP-270000000 CDM 270 RC outpatient 4.81 4.71 All Payors / Plans All Payors / Plans 4.81 other 4.81 4.81 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WAX BONE MONTAGE STERILE SUP-270000000 CDM 270 RC outpatient 3777.9 3702.34 All Payors / Plans All Payors / Plans 3777.9 other 3777.9 3777.9 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIDE SAW BLADE SUP-270000000 CDM 270 RC outpatient 369.2 361.82 All Payors / Plans All Payors / Plans 369.2 other 369.2 369.2 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIPE SURGICAL INSTRUMENT VISIWIPE L2 7/8 IN X W2 7/8 IN CLEAN SUP-270000000 CDM 270 RC outpatient 3.13 3.07 All Payors / Plans All Payors / Plans 3.13 other 3.13 3.13 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE FIXATION KIRSCHNER 150MM 2MM SS NS TROCAR POINT SUP-270010022 CDM 270 RC outpatient 16.91 16.57 All Payors / Plans All Payors / Plans 16.91 other 16.91 16.91 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE FIXATION KIRSCHNER COCR FLUTE L150MM OD 1.6MM DRILL TIP SUP-270000000 CDM 270 RC outpatient 91.98 90.14 All Payors / Plans All Payors / Plans 91.98 other 91.98 91.98 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE FIXATION KIRSCHNER EVOS L 225MM OD 2 MM TROCAR TIP SUP-270000000 CDM 270 RC outpatient 932.4 913.75 All Payors / Plans All Payors / Plans 932.4 other 932.4 932.4 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE FIXATION KIRSCHNER STAINLESS STEEL L 150MM OD 1.6MM TROCAR POINT STERILE SUP-270000000 CDM 270 RC outpatient 43.35 42.48 All Payors / Plans All Payors / Plans 43.35 other 43.35 43.35 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE FIXATION KIRSCHNER STAINLESS STEEL L 150MM OD 2MM TROCAR POINT STERILE SUP-270000000 CDM 270 RC outpatient 53.55 52.48 All Payors / Plans All Payors / Plans 53.55 other 53.55 53.55 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE FIXATION L 100 MM OD 1.4 MM TROCAR TIP SUP-270000000 CDM 270 RC outpatient 69.3 67.91 All Payors / Plans All Payors / Plans 69.3 other 69.3 69.3 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE PROTRACK PIGTAIL 0.025 IN DIAMETER 230 CM OVERALL LENGTH SUP-481000000 CDM 270 RC outpatient 493.5 483.63 All Payors / Plans All Payors / Plans 493.5 other 493.5 493.5 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE STERNAL SINGLE SUP-270000000 CDM 270 RC outpatient 5.6 5.49 All Payors / Plans All Payors / Plans 5.6 other 5.6 5.6 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WIRE SUTURE DOUBLEWIRE 6 BE-3 1/2 CIRCLE BALL L54 MM STERNOTOMY SUP-270000000 CDM 270 RC outpatient 184.17 180.49 All Payors / Plans All Payors / Plans 184.17 other 184.17 184.17 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WRAP THERAPEUTIC ACTIVEWRAP PLUSH LARGE XL OD16+ IN LEG KNEE THERMAL SUPPORT GEL PACK POST OPERATIVE NONSTERILE LATEX FREE SUP-270000000 CDM 270 RC outpatient 36.43 35.7 All Payors / Plans All Payors / Plans 36.43 other 36.43 36.43 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WRENCH PACEMAKER 2 BIDRECTIONAL TORQUE STERILE SUP-270000000 CDM 270 RC outpatient 105 102.9 All Payors / Plans All Payors / Plans 105 other 105 105 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers facility WRENCH SURGICAL HEXAGON LEAD SUP-270000000 CDM 270 RC outpatient 47.25 46.31 All Payors / Plans All Payors / Plans 47.25 other 47.25 47.25 Alternative Rate Setting Method Hospitals in Maryland do not negotiate rates with payers