|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14.88
|
|
|
Service Code
|
NDC 72266012225
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.95 |
| Max. Negotiated Rate |
$13.39 |
| Rate for Payer: Aetna Commercial |
$12.65
|
| Rate for Payer: Aetna Medicare |
$7.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.67
|
| Rate for Payer: BCBS Complete |
$5.95
|
| Rate for Payer: Cash Price |
$11.90
|
| Rate for Payer: Cofinity Commercial |
$10.42
|
| Rate for Payer: Cofinity Commercial |
$12.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.90
|
| Rate for Payer: Healthscope Commercial |
$13.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.65
|
| Rate for Payer: PHP Commercial |
$12.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.67
|
| Rate for Payer: Priority Health SBD |
$9.37
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14.88
|
|
|
Service Code
|
NDC 72266012225
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.37 |
| Max. Negotiated Rate |
$13.39 |
| Rate for Payer: Aetna Commercial |
$12.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.67
|
| Rate for Payer: Cash Price |
$11.90
|
| Rate for Payer: Cofinity Commercial |
$10.42
|
| Rate for Payer: Cofinity Commercial |
$12.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.90
|
| Rate for Payer: Healthscope Commercial |
$13.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.65
|
| Rate for Payer: PHP Commercial |
$12.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.67
|
| Rate for Payer: Priority Health SBD |
$9.37
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$16.13
|
|
|
Service Code
|
NDC 72611074010
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Aetna Commercial |
$13.71
|
| Rate for Payer: Aetna Medicare |
$8.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.48
|
| Rate for Payer: BCBS Complete |
$6.45
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cofinity Commercial |
$11.29
|
| Rate for Payer: Cofinity Commercial |
$13.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$14.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.71
|
| Rate for Payer: PHP Commercial |
$13.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.48
|
| Rate for Payer: Priority Health SBD |
$10.16
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$16.13
|
|
|
Service Code
|
NDC 72611074001
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.16 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Aetna Commercial |
$13.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.48
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cofinity Commercial |
$11.29
|
| Rate for Payer: Cofinity Commercial |
$13.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$14.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.71
|
| Rate for Payer: PHP Commercial |
$13.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.48
|
| Rate for Payer: Priority Health SBD |
$10.16
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$13.05
|
|
|
Service Code
|
NDC 72266012201
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$11.74 |
| Rate for Payer: Aetna Commercial |
$11.09
|
| Rate for Payer: Aetna Medicare |
$6.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.48
|
| Rate for Payer: BCBS Complete |
$5.22
|
| Rate for Payer: Cash Price |
$10.44
|
| Rate for Payer: Cofinity Commercial |
$11.22
|
| Rate for Payer: Cofinity Commercial |
$9.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.44
|
| Rate for Payer: Healthscope Commercial |
$11.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.09
|
| Rate for Payer: PHP Commercial |
$11.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.48
|
| Rate for Payer: Priority Health SBD |
$8.22
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$24.29
|
|
|
Service Code
|
NDC 70860030005
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.72 |
| Max. Negotiated Rate |
$21.86 |
| Rate for Payer: Aetna Commercial |
$20.65
|
| Rate for Payer: Aetna Medicare |
$12.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.79
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: Cash Price |
$19.43
|
| Rate for Payer: Cofinity Commercial |
$17.00
|
| Rate for Payer: Cofinity Commercial |
$20.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.43
|
| Rate for Payer: Healthscope Commercial |
$21.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.65
|
| Rate for Payer: PHP Commercial |
$20.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.79
|
| Rate for Payer: Priority Health SBD |
$15.30
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14.00
|
|
|
Service Code
|
NDC 00143966001
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$12.60 |
| Rate for Payer: Aetna Commercial |
$11.90
|
| Rate for Payer: Aetna Medicare |
$7.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.10
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$12.04
|
| Rate for Payer: Cofinity Commercial |
$9.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.20
|
| Rate for Payer: Healthscope Commercial |
$12.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.90
|
| Rate for Payer: PHP Commercial |
$11.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health SBD |
$8.82
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14.00
|
|
|
Service Code
|
NDC 00143966010
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$12.60 |
| Rate for Payer: Aetna Commercial |
$11.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.10
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$12.04
|
| Rate for Payer: Cofinity Commercial |
$9.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.20
|
| Rate for Payer: Healthscope Commercial |
$12.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.90
|
| Rate for Payer: PHP Commercial |
$11.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health SBD |
$8.82
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$16.75
|
|
|
Service Code
|
NDC 36000003310
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.70 |
| Max. Negotiated Rate |
$15.07 |
| Rate for Payer: Aetna Commercial |
$14.24
|
| Rate for Payer: Aetna Medicare |
$8.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.89
|
| Rate for Payer: BCBS Complete |
$6.70
|
| Rate for Payer: Cash Price |
$13.40
|
| Rate for Payer: Cofinity Commercial |
$11.72
|
| Rate for Payer: Cofinity Commercial |
$14.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.40
|
| Rate for Payer: Healthscope Commercial |
$15.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.24
|
| Rate for Payer: PHP Commercial |
$14.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.89
|
| Rate for Payer: Priority Health SBD |
$10.55
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
NDC 47781058720
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$11.70 |
| Rate for Payer: Aetna Commercial |
$11.05
|
| Rate for Payer: Aetna Medicare |
$6.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.45
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$9.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$11.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.05
|
| Rate for Payer: PHP Commercial |
$11.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.45
|
| Rate for Payer: Priority Health SBD |
$8.19
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.94
|
|
|
Service Code
|
NDC 63323066005
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.98 |
| Max. Negotiated Rate |
$17.95 |
| Rate for Payer: Aetna Commercial |
$16.95
|
| Rate for Payer: Aetna Medicare |
$9.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.96
|
| Rate for Payer: BCBS Complete |
$7.98
|
| Rate for Payer: Cash Price |
$15.95
|
| Rate for Payer: Cofinity Commercial |
$13.96
|
| Rate for Payer: Cofinity Commercial |
$17.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.95
|
| Rate for Payer: Healthscope Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.95
|
| Rate for Payer: PHP Commercial |
$16.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.96
|
| Rate for Payer: Priority Health SBD |
$12.56
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14.00
|
|
|
Service Code
|
NDC 00143966001
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$12.60 |
| Rate for Payer: Aetna Commercial |
$11.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.10
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$12.04
|
| Rate for Payer: Cofinity Commercial |
$9.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.20
|
| Rate for Payer: Healthscope Commercial |
$12.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.90
|
| Rate for Payer: PHP Commercial |
$11.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health SBD |
$8.82
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$13.00
|
|
|
Service Code
|
NDC 47781058717
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$11.70 |
| Rate for Payer: Aetna Commercial |
$11.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.45
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$9.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$11.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.05
|
| Rate for Payer: PHP Commercial |
$11.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.45
|
| Rate for Payer: Priority Health SBD |
$8.19
|
|
|
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$67.19
|
|
|
Service Code
|
HCPCS J1836
|
| Hospital Charge Code |
5018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$26.88 |
| Max. Negotiated Rate |
$60.47 |
| Rate for Payer: Aetna Commercial |
$57.11
|
| Rate for Payer: Aetna Commercial |
$53.49
|
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna Commercial |
$43.38
|
| Rate for Payer: Aetna Commercial |
$49.50
|
| Rate for Payer: Aetna Medicare |
$31.46
|
| Rate for Payer: Aetna Medicare |
$34.96
|
| Rate for Payer: Aetna Medicare |
$33.59
|
| Rate for Payer: Aetna Medicare |
$29.11
|
| Rate for Payer: Aetna Medicare |
$25.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.18
|
| Rate for Payer: BCBS Complete |
$23.29
|
| Rate for Payer: BCBS Complete |
$26.88
|
| Rate for Payer: BCBS Complete |
$25.17
|
| Rate for Payer: BCBS Complete |
$20.42
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: Cash Price |
$40.83
|
| Rate for Payer: Cash Price |
$50.34
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cofinity Commercial |
$57.78
|
| Rate for Payer: Cofinity Commercial |
$35.73
|
| Rate for Payer: Cofinity Commercial |
$43.89
|
| Rate for Payer: Cofinity Commercial |
$40.76
|
| Rate for Payer: Cofinity Commercial |
$50.08
|
| Rate for Payer: Cofinity Commercial |
$44.05
|
| Rate for Payer: Cofinity Commercial |
$54.12
|
| Rate for Payer: Cofinity Commercial |
$47.03
|
| Rate for Payer: Cofinity Commercial |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.58
|
| Rate for Payer: Healthscope Commercial |
$52.41
|
| Rate for Payer: Healthscope Commercial |
$45.94
|
| Rate for Payer: Healthscope Commercial |
$60.47
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Healthscope Commercial |
$56.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: PHP Commercial |
$53.49
|
| Rate for Payer: PHP Commercial |
$49.50
|
| Rate for Payer: PHP Commercial |
$43.38
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.90
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: Priority Health SBD |
$32.16
|
| Rate for Payer: Priority Health SBD |
$36.68
|
| Rate for Payer: Priority Health SBD |
$42.33
|
| Rate for Payer: Priority Health SBD |
$39.65
|
|
|
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$51.04
|
|
|
Service Code
|
HCPCS J1836
|
| Hospital Charge Code |
5018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$32.16 |
| Max. Negotiated Rate |
$45.94 |
| Rate for Payer: Aetna Commercial |
$43.38
|
| Rate for Payer: Aetna Commercial |
$49.50
|
| Rate for Payer: Aetna Commercial |
$57.11
|
| Rate for Payer: Aetna Commercial |
$53.49
|
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.67
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$40.83
|
| Rate for Payer: Cash Price |
$50.34
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$40.76
|
| Rate for Payer: Cofinity Commercial |
$35.73
|
| Rate for Payer: Cofinity Commercial |
$43.89
|
| Rate for Payer: Cofinity Commercial |
$54.12
|
| Rate for Payer: Cofinity Commercial |
$50.08
|
| Rate for Payer: Cofinity Commercial |
$44.05
|
| Rate for Payer: Cofinity Commercial |
$57.78
|
| Rate for Payer: Cofinity Commercial |
$47.03
|
| Rate for Payer: Cofinity Commercial |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Healthscope Commercial |
$45.94
|
| Rate for Payer: Healthscope Commercial |
$52.41
|
| Rate for Payer: Healthscope Commercial |
$56.64
|
| Rate for Payer: Healthscope Commercial |
$60.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: PHP Commercial |
$43.38
|
| Rate for Payer: PHP Commercial |
$49.50
|
| Rate for Payer: PHP Commercial |
$53.49
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.45
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: Priority Health SBD |
$36.68
|
| Rate for Payer: Priority Health SBD |
$39.65
|
| Rate for Payer: Priority Health SBD |
$32.16
|
| Rate for Payer: Priority Health SBD |
$42.33
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
OP
|
$444.60
|
|
|
Service Code
|
NDC 42292000120
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$177.84 |
| Max. Negotiated Rate |
$400.14 |
| Rate for Payer: Aetna Commercial |
$377.91
|
| Rate for Payer: Aetna Medicare |
$222.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.99
|
| Rate for Payer: BCBS Complete |
$177.84
|
| Rate for Payer: Cash Price |
$355.68
|
| Rate for Payer: Cofinity Commercial |
$311.22
|
| Rate for Payer: Cofinity Commercial |
$382.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$311.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$355.68
|
| Rate for Payer: Healthscope Commercial |
$400.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$377.91
|
| Rate for Payer: PHP Commercial |
$377.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$288.99
|
| Rate for Payer: Priority Health SBD |
$280.10
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
OP
|
$214.23
|
|
|
Service Code
|
NDC 50268053515
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$85.69 |
| Max. Negotiated Rate |
$192.81 |
| Rate for Payer: Aetna Commercial |
$182.10
|
| Rate for Payer: Aetna Medicare |
$107.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.25
|
| Rate for Payer: BCBS Complete |
$85.69
|
| Rate for Payer: Cash Price |
$171.38
|
| Rate for Payer: Cofinity Commercial |
$149.96
|
| Rate for Payer: Cofinity Commercial |
$184.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.38
|
| Rate for Payer: Healthscope Commercial |
$192.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.10
|
| Rate for Payer: PHP Commercial |
$182.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.25
|
| Rate for Payer: Priority Health SBD |
$134.96
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
OP
|
$249.60
|
|
|
Service Code
|
NDC 60687055001
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.84 |
| Max. Negotiated Rate |
$224.64 |
| Rate for Payer: Aetna Commercial |
$212.16
|
| Rate for Payer: Aetna Medicare |
$124.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.24
|
| Rate for Payer: BCBS Complete |
$99.84
|
| Rate for Payer: Cash Price |
$199.68
|
| Rate for Payer: Cofinity Commercial |
$174.72
|
| Rate for Payer: Cofinity Commercial |
$214.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.68
|
| Rate for Payer: Healthscope Commercial |
$224.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.16
|
| Rate for Payer: PHP Commercial |
$212.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.24
|
| Rate for Payer: Priority Health SBD |
$157.25
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
OP
|
$450.30
|
|
|
Service Code
|
NDC 23155065201
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$180.12 |
| Max. Negotiated Rate |
$405.27 |
| Rate for Payer: Aetna Commercial |
$382.75
|
| Rate for Payer: Aetna Medicare |
$225.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.69
|
| Rate for Payer: BCBS Complete |
$180.12
|
| Rate for Payer: Cash Price |
$360.24
|
| Rate for Payer: Cofinity Commercial |
$315.21
|
| Rate for Payer: Cofinity Commercial |
$387.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$315.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.24
|
| Rate for Payer: Healthscope Commercial |
$405.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.75
|
| Rate for Payer: PHP Commercial |
$382.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.69
|
| Rate for Payer: Priority Health SBD |
$283.69
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
OP
|
$449.35
|
|
|
Service Code
|
NDC 00904712661
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$179.74 |
| Max. Negotiated Rate |
$404.42 |
| Rate for Payer: Aetna Commercial |
$381.95
|
| Rate for Payer: Aetna Medicare |
$224.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.08
|
| Rate for Payer: BCBS Complete |
$179.74
|
| Rate for Payer: Cash Price |
$359.48
|
| Rate for Payer: Cofinity Commercial |
$314.55
|
| Rate for Payer: Cofinity Commercial |
$386.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$314.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.48
|
| Rate for Payer: Healthscope Commercial |
$404.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$381.95
|
| Rate for Payer: PHP Commercial |
$381.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.08
|
| Rate for Payer: Priority Health SBD |
$283.09
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
IP
|
$450.30
|
|
|
Service Code
|
NDC 23155065201
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$283.69 |
| Max. Negotiated Rate |
$405.27 |
| Rate for Payer: Aetna Commercial |
$382.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.69
|
| Rate for Payer: Cash Price |
$360.24
|
| Rate for Payer: Cofinity Commercial |
$315.21
|
| Rate for Payer: Cofinity Commercial |
$387.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$315.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.24
|
| Rate for Payer: Healthscope Commercial |
$405.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.75
|
| Rate for Payer: PHP Commercial |
$382.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.69
|
| Rate for Payer: Priority Health SBD |
$283.69
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
IP
|
$444.60
|
|
|
Service Code
|
NDC 42292000120
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$280.10 |
| Max. Negotiated Rate |
$400.14 |
| Rate for Payer: Aetna Commercial |
$377.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.99
|
| Rate for Payer: Cash Price |
$355.68
|
| Rate for Payer: Cofinity Commercial |
$311.22
|
| Rate for Payer: Cofinity Commercial |
$382.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$311.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$355.68
|
| Rate for Payer: Healthscope Commercial |
$400.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$377.91
|
| Rate for Payer: PHP Commercial |
$377.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$288.99
|
| Rate for Payer: Priority Health SBD |
$280.10
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
OP
|
$244.32
|
|
|
Service Code
|
NDC 50111033401
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$97.73 |
| Max. Negotiated Rate |
$219.89 |
| Rate for Payer: Aetna Commercial |
$207.67
|
| Rate for Payer: Aetna Medicare |
$122.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.81
|
| Rate for Payer: BCBS Complete |
$97.73
|
| Rate for Payer: Cash Price |
$195.46
|
| Rate for Payer: Cofinity Commercial |
$171.02
|
| Rate for Payer: Cofinity Commercial |
$210.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.46
|
| Rate for Payer: Healthscope Commercial |
$219.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.67
|
| Rate for Payer: PHP Commercial |
$207.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.81
|
| Rate for Payer: Priority Health SBD |
$153.92
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
IP
|
$244.32
|
|
|
Service Code
|
NDC 50111033401
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$153.92 |
| Max. Negotiated Rate |
$219.89 |
| Rate for Payer: Aetna Commercial |
$207.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.81
|
| Rate for Payer: Cash Price |
$195.46
|
| Rate for Payer: Cofinity Commercial |
$171.02
|
| Rate for Payer: Cofinity Commercial |
$210.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.46
|
| Rate for Payer: Healthscope Commercial |
$219.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.67
|
| Rate for Payer: PHP Commercial |
$207.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.81
|
| Rate for Payer: Priority Health SBD |
$153.92
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
OP
|
$4.45
|
|
|
Service Code
|
NDC 42292000101
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.78 |
| Max. Negotiated Rate |
$4.00 |
| Rate for Payer: Aetna Commercial |
$3.78
|
| Rate for Payer: Aetna Medicare |
$2.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.89
|
| Rate for Payer: BCBS Complete |
$1.78
|
| Rate for Payer: Cash Price |
$3.56
|
| Rate for Payer: Cofinity Commercial |
$3.12
|
| Rate for Payer: Cofinity Commercial |
$3.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.56
|
| Rate for Payer: Healthscope Commercial |
$4.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.78
|
| Rate for Payer: PHP Commercial |
$3.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.89
|
| Rate for Payer: Priority Health SBD |
$2.80
|
|
