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NDC 1199401716

PERFLUTREN LIPID MICROSPHERES RT 0.65 MG/ML IV SUSP

Reported by 6 hospitals in the network under the other methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a payer-specific billing methodology not covered by the standard categories.

National pricing summary

Low

$209

Average

$330

Median

$271

High

$676

Hospitals reporting this code

#HospitalLocation
1Catholic Health Initiatives ColoradoColorado Springs, CO$47$142$209$680$124
2Catholic Health Initiatives ColoradoFrisco, CO$62$676$676$711—
3Catholic Health Initiatives ColoradoPueblo, CO$213$311$325$680$128
4Catholic Health Initiatives ColoradoDurango, CO$209$196$230$696$67
5Catholic Health Initiatives ColoradoWest Jordan, UT$100$299$299$773$145
6Catholic Health Initiatives ColoradoCanon City, CO$116$163$243$696$220

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