|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14.88
|
|
|
Service Code
|
HCPCS J0616
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.37 |
| Max. Negotiated Rate |
$13.39 |
| Rate for Payer: Aetna Commercial |
$12.65
|
| Rate for Payer: Aetna Commercial |
$11.47
|
| Rate for Payer: Aetna Commercial |
$11.05
|
| Rate for Payer: Aetna Commercial |
$11.90
|
| Rate for Payer: Aetna Commercial |
$12.11
|
| Rate for Payer: Aetna Commercial |
$20.65
|
| Rate for Payer: Aetna Commercial |
$13.71
|
| Rate for Payer: Aetna Commercial |
$12.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.67
|
| Rate for Payer: Cash Price |
$10.79
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.90
|
| Rate for Payer: Cash Price |
$12.11
|
| Rate for Payer: Cash Price |
$19.43
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cofinity Advantage |
$9.10
|
| Rate for Payer: Cofinity Advantage |
$9.44
|
| Rate for Payer: Cofinity Advantage |
$9.80
|
| Rate for Payer: Cofinity Advantage |
$9.97
|
| Rate for Payer: Cofinity Advantage |
$10.42
|
| Rate for Payer: Cofinity Advantage |
$10.60
|
| Rate for Payer: Cofinity Advantage |
$11.29
|
| Rate for Payer: Cofinity Advantage |
$17.00
|
| Rate for Payer: Cofinity Commercial |
$12.26
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$11.60
|
| Rate for Payer: Cofinity Commercial |
$13.87
|
| Rate for Payer: Cofinity Commercial |
$20.89
|
| Rate for Payer: Cofinity Commercial |
$12.04
|
| Rate for Payer: Cofinity Commercial |
$13.02
|
| Rate for Payer: Cofinity Commercial |
$12.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$11.70
|
| Rate for Payer: Healthscope Commercial |
$12.14
|
| Rate for Payer: Healthscope Commercial |
$13.63
|
| Rate for Payer: Healthscope Commercial |
$12.82
|
| Rate for Payer: Healthscope Commercial |
$14.52
|
| Rate for Payer: Healthscope Commercial |
$21.86
|
| Rate for Payer: Healthscope Commercial |
$13.39
|
| Rate for Payer: Healthscope Commercial |
$12.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.12
|
| Rate for Payer: PHP Commercial |
$12.87
|
| Rate for Payer: PHP Commercial |
$12.65
|
| Rate for Payer: PHP Commercial |
$20.65
|
| Rate for Payer: PHP Commercial |
$13.71
|
| Rate for Payer: PHP Commercial |
$12.11
|
| Rate for Payer: PHP Commercial |
$11.47
|
| Rate for Payer: PHP Commercial |
$11.90
|
| Rate for Payer: PHP Commercial |
$11.05
|
| Rate for Payer: Priority Health SBD |
$15.30
|
| Rate for Payer: Priority Health SBD |
$8.19
|
| Rate for Payer: Priority Health SBD |
$8.82
|
| Rate for Payer: Priority Health SBD |
$9.37
|
| Rate for Payer: Priority Health SBD |
$10.16
|
| Rate for Payer: Priority Health SBD |
$9.54
|
| Rate for Payer: Priority Health SBD |
$8.50
|
| Rate for Payer: Priority Health SBD |
$8.98
|
|
|
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$55.94
|
|
|
Service Code
|
HCPCS J1836
|
| Hospital Charge Code |
5018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$50.35 |
| Rate for Payer: Aetna Commercial |
$47.55
|
| Rate for Payer: Aetna Commercial |
$49.50
|
| Rate for Payer: Aetna Commercial |
$74.29
|
| Rate for Payer: Aetna Commercial |
$43.38
|
| Rate for Payer: Aetna Commercial |
$50.52
|
| Rate for Payer: Aetna Commercial |
$62.41
|
| Rate for Payer: Aetna Medicare |
$25.52
|
| Rate for Payer: Aetna Medicare |
$27.97
|
| Rate for Payer: Aetna Medicare |
$29.11
|
| Rate for Payer: Aetna Medicare |
$36.71
|
| Rate for Payer: Aetna Medicare |
$43.70
|
| Rate for Payer: Aetna Medicare |
$29.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.85
|
| Rate for Payer: BCBS Complete |
$23.29
|
| Rate for Payer: BCBS Complete |
$34.96
|
| Rate for Payer: BCBS Complete |
$29.37
|
| Rate for Payer: BCBS Complete |
$22.38
|
| Rate for Payer: BCBS Complete |
$20.42
|
| Rate for Payer: BCBS Complete |
$23.78
|
| Rate for Payer: BCBS Trust/PPO |
$0.05
|
| Rate for Payer: BCBS Trust/PPO |
$0.05
|
| Rate for Payer: BCBS Trust/PPO |
$0.05
|
| Rate for Payer: BCBS Trust/PPO |
$0.05
|
| Rate for Payer: BCBS Trust/PPO |
$0.05
|
| Rate for Payer: BCBS Trust/PPO |
$0.05
|
| Rate for Payer: BCN Commercial |
$0.05
|
| Rate for Payer: BCN Commercial |
$0.05
|
| Rate for Payer: BCN Commercial |
$0.05
|
| Rate for Payer: BCN Commercial |
$0.05
|
| Rate for Payer: BCN Commercial |
$0.05
|
| Rate for Payer: BCN Commercial |
$0.05
|
| Rate for Payer: Cash Price |
$58.74
|
| Rate for Payer: Cash Price |
$47.55
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$40.83
|
| Rate for Payer: Cash Price |
$40.83
|
| Rate for Payer: Cash Price |
$44.75
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$69.92
|
| Rate for Payer: Cash Price |
$58.74
|
| Rate for Payer: Cash Price |
$69.92
|
| Rate for Payer: Cash Price |
$47.55
|
| Rate for Payer: Cash Price |
$44.75
|
| Rate for Payer: Cofinity Advantage |
$35.73
|
| Rate for Payer: Cofinity Advantage |
$51.39
|
| Rate for Payer: Cofinity Advantage |
$41.61
|
| Rate for Payer: Cofinity Advantage |
$61.18
|
| Rate for Payer: Cofinity Advantage |
$40.76
|
| Rate for Payer: Cofinity Advantage |
$39.16
|
| Rate for Payer: Cofinity Commercial |
$50.08
|
| Rate for Payer: Cofinity Commercial |
$48.11
|
| Rate for Payer: Cofinity Commercial |
$43.89
|
| Rate for Payer: Cofinity Commercial |
$75.16
|
| Rate for Payer: Cofinity Commercial |
$51.12
|
| Rate for Payer: Cofinity Commercial |
$63.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.74
|
| Rate for Payer: Healthscope Commercial |
$78.66
|
| Rate for Payer: Healthscope Commercial |
$66.08
|
| Rate for Payer: Healthscope Commercial |
$53.50
|
| Rate for Payer: Healthscope Commercial |
$52.41
|
| Rate for Payer: Healthscope Commercial |
$50.35
|
| Rate for Payer: Healthscope Commercial |
$45.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.55
|
| Rate for Payer: PHP Commercial |
$50.52
|
| Rate for Payer: PHP Commercial |
$47.55
|
| Rate for Payer: PHP Commercial |
$49.50
|
| Rate for Payer: PHP Commercial |
$43.38
|
| Rate for Payer: PHP Commercial |
$74.29
|
| Rate for Payer: PHP Commercial |
$62.41
|
| Rate for Payer: Priority Health SBD |
$46.25
|
| Rate for Payer: Priority Health SBD |
$35.24
|
| Rate for Payer: Priority Health SBD |
$55.06
|
| Rate for Payer: Priority Health SBD |
$37.45
|
| Rate for Payer: Priority Health SBD |
$36.68
|
| Rate for Payer: Priority Health SBD |
$32.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
|
|
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$59.44
|
|
|
Service Code
|
HCPCS J1836
|
| Hospital Charge Code |
5018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$37.45 |
| Max. Negotiated Rate |
$53.50 |
| Rate for Payer: Aetna Commercial |
$50.52
|
| Rate for Payer: Aetna Commercial |
$49.50
|
| Rate for Payer: Aetna Commercial |
$43.38
|
| Rate for Payer: Aetna Commercial |
$62.41
|
| Rate for Payer: Aetna Commercial |
$74.29
|
| Rate for Payer: Aetna Commercial |
$47.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.36
|
| Rate for Payer: Cash Price |
$40.83
|
| Rate for Payer: Cash Price |
$44.75
|
| Rate for Payer: Cash Price |
$58.74
|
| Rate for Payer: Cash Price |
$69.92
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$47.55
|
| Rate for Payer: Cofinity Advantage |
$51.39
|
| Rate for Payer: Cofinity Advantage |
$40.76
|
| Rate for Payer: Cofinity Advantage |
$41.61
|
| Rate for Payer: Cofinity Advantage |
$39.16
|
| Rate for Payer: Cofinity Advantage |
$35.73
|
| Rate for Payer: Cofinity Advantage |
$61.18
|
| Rate for Payer: Cofinity Commercial |
$75.16
|
| Rate for Payer: Cofinity Commercial |
$50.08
|
| Rate for Payer: Cofinity Commercial |
$48.11
|
| Rate for Payer: Cofinity Commercial |
$43.89
|
| Rate for Payer: Cofinity Commercial |
$63.14
|
| Rate for Payer: Cofinity Commercial |
$51.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.92
|
| Rate for Payer: Healthscope Commercial |
$53.50
|
| Rate for Payer: Healthscope Commercial |
$78.66
|
| Rate for Payer: Healthscope Commercial |
$66.08
|
| Rate for Payer: Healthscope Commercial |
$50.35
|
| Rate for Payer: Healthscope Commercial |
$52.41
|
| Rate for Payer: Healthscope Commercial |
$45.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.55
|
| 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 |
$62.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.55
|
| Rate for Payer: PHP Commercial |
$74.29
|
| Rate for Payer: PHP Commercial |
$43.38
|
| Rate for Payer: PHP Commercial |
$47.55
|
| Rate for Payer: PHP Commercial |
$50.52
|
| Rate for Payer: PHP Commercial |
$49.50
|
| Rate for Payer: PHP Commercial |
$62.41
|
| Rate for Payer: Priority Health SBD |
$36.68
|
| Rate for Payer: Priority Health SBD |
$37.45
|
| Rate for Payer: Priority Health SBD |
$46.25
|
| Rate for Payer: Priority Health SBD |
$55.06
|
| Rate for Payer: Priority Health SBD |
$35.24
|
| Rate for Payer: Priority Health SBD |
$32.16
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
OP
|
$337.25
|
|
|
Service Code
|
NDC 29300022701
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$132.54 |
| Max. Negotiated Rate |
$303.52 |
| Rate for Payer: Aetna Commercial |
$286.66
|
| Rate for Payer: Aetna Medicare |
$168.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.21
|
| Rate for Payer: BCBS Complete |
$134.90
|
| Rate for Payer: Cash Price |
$269.80
|
| Rate for Payer: Cofinity Advantage |
$236.07
|
| Rate for Payer: Cofinity Commercial |
$290.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.80
|
| Rate for Payer: Healthscope Commercial |
$303.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.94
|
| Rate for Payer: PHP Commercial |
$286.66
|
| Rate for Payer: Priority Health SBD |
$212.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.21
|
| Rate for Payer: UHC Core |
$175.71
|
| Rate for Payer: UHC Exchange |
$132.54
|
|
|
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 Advantage |
$315.21
|
| Rate for Payer: Cofinity Commercial |
$387.26
|
| 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: Opus (Opus Packaging Group) HMA |
$337.73
|
| Rate for Payer: PHP Commercial |
$382.75
|
| Rate for Payer: Priority Health SBD |
$283.69
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
IP
|
$242.88
|
|
|
Service Code
|
NDC 00904712661
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$153.01 |
| Max. Negotiated Rate |
$218.59 |
| Rate for Payer: Aetna Commercial |
$206.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.87
|
| Rate for Payer: Cash Price |
$194.30
|
| Rate for Payer: Cofinity Advantage |
$170.02
|
| Rate for Payer: Cofinity Commercial |
$208.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.30
|
| Rate for Payer: Healthscope Commercial |
$218.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.16
|
| Rate for Payer: PHP Commercial |
$206.45
|
| Rate for Payer: Priority Health SBD |
$153.01
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
OP
|
$2.68
|
|
|
Service Code
|
NDC 60687055011
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$2.41 |
| Rate for Payer: Aetna Commercial |
$2.28
|
| Rate for Payer: Aetna Medicare |
$1.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.74
|
| Rate for Payer: BCBS Complete |
$1.07
|
| Rate for Payer: Cash Price |
$2.14
|
| Rate for Payer: Cofinity Advantage |
$1.88
|
| Rate for Payer: Cofinity Commercial |
$2.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.14
|
| Rate for Payer: Healthscope Commercial |
$2.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.01
|
| Rate for Payer: PHP Commercial |
$2.28
|
| Rate for Payer: Priority Health SBD |
$1.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.74
|
| Rate for Payer: UHC Core |
$1.40
|
| Rate for Payer: UHC Exchange |
$1.05
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
OP
|
$267.36
|
|
|
Service Code
|
NDC 60687055001
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$105.07 |
| Max. Negotiated Rate |
$240.62 |
| Rate for Payer: Aetna Commercial |
$227.26
|
| Rate for Payer: Aetna Medicare |
$133.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.78
|
| Rate for Payer: BCBS Complete |
$106.94
|
| Rate for Payer: Cash Price |
$213.89
|
| Rate for Payer: Cofinity Advantage |
$187.15
|
| Rate for Payer: Cofinity Commercial |
$229.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.89
|
| Rate for Payer: Healthscope Commercial |
$240.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$213.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.52
|
| Rate for Payer: PHP Commercial |
$227.26
|
| Rate for Payer: Priority Health SBD |
$168.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.78
|
| Rate for Payer: UHC Core |
$139.29
|
| Rate for Payer: UHC Exchange |
$105.07
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
OP
|
$450.30
|
|
|
Service Code
|
NDC 23155065201
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$176.97 |
| 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 Advantage |
$315.21
|
| Rate for Payer: Cofinity Commercial |
$387.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.24
|
| Rate for Payer: Healthscope Commercial |
$405.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$360.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$337.73
|
| Rate for Payer: PHP Commercial |
$382.75
|
| Rate for Payer: Priority Health SBD |
$283.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.69
|
| Rate for Payer: UHC Core |
$234.61
|
| Rate for Payer: UHC Exchange |
$176.97
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
IP
|
$2.68
|
|
|
Service Code
|
NDC 60687055011
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$2.41 |
| Rate for Payer: Aetna Commercial |
$2.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.74
|
| Rate for Payer: Cash Price |
$2.14
|
| Rate for Payer: Cofinity Advantage |
$1.88
|
| Rate for Payer: Cofinity Commercial |
$2.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.14
|
| Rate for Payer: Healthscope Commercial |
$2.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.01
|
| Rate for Payer: PHP Commercial |
$2.28
|
| Rate for Payer: Priority Health SBD |
$1.69
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
IP
|
$4.62
|
|
|
Service Code
|
NDC 50268053511
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$4.16 |
| Rate for Payer: Aetna Commercial |
$3.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.00
|
| Rate for Payer: Cash Price |
$3.70
|
| Rate for Payer: Cofinity Advantage |
$3.23
|
| Rate for Payer: Cofinity Commercial |
$3.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.70
|
| Rate for Payer: Healthscope Commercial |
$4.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.46
|
| Rate for Payer: PHP Commercial |
$3.93
|
| Rate for Payer: Priority Health SBD |
$2.91
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
IP
|
$337.25
|
|
|
Service Code
|
NDC 29300022701
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$212.47 |
| Max. Negotiated Rate |
$303.52 |
| Rate for Payer: Aetna Commercial |
$286.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.21
|
| Rate for Payer: Cash Price |
$269.80
|
| Rate for Payer: Cofinity Advantage |
$236.07
|
| Rate for Payer: Cofinity Commercial |
$290.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.80
|
| Rate for Payer: Healthscope Commercial |
$303.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.94
|
| Rate for Payer: PHP Commercial |
$286.66
|
| Rate for Payer: Priority Health SBD |
$212.47
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
IP
|
$4.45
|
|
|
Service Code
|
NDC 42292000101
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$4.00 |
| Rate for Payer: Aetna Commercial |
$3.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.89
|
| Rate for Payer: Cash Price |
$3.56
|
| Rate for Payer: Cofinity Advantage |
$3.12
|
| Rate for Payer: Cofinity Commercial |
$3.83
|
| 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: Opus (Opus Packaging Group) HMA |
$3.34
|
| Rate for Payer: PHP Commercial |
$3.78
|
| Rate for Payer: Priority Health SBD |
$2.80
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
OP
|
$242.88
|
|
|
Service Code
|
NDC 00904712661
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$95.45 |
| Max. Negotiated Rate |
$218.59 |
| Rate for Payer: Aetna Commercial |
$206.45
|
| Rate for Payer: Aetna Medicare |
$121.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.87
|
| Rate for Payer: BCBS Complete |
$97.15
|
| Rate for Payer: Cash Price |
$194.30
|
| Rate for Payer: Cofinity Advantage |
$170.02
|
| Rate for Payer: Cofinity Commercial |
$208.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.30
|
| Rate for Payer: Healthscope Commercial |
$218.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$194.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.16
|
| Rate for Payer: PHP Commercial |
$206.45
|
| Rate for Payer: Priority Health SBD |
$153.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.87
|
| Rate for Payer: UHC Core |
$126.54
|
| Rate for Payer: UHC Exchange |
$95.45
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
OP
|
$230.85
|
|
|
Service Code
|
NDC 50268053515
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$90.72 |
| Max. Negotiated Rate |
$207.76 |
| Rate for Payer: Aetna Commercial |
$196.22
|
| Rate for Payer: Aetna Medicare |
$115.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.05
|
| Rate for Payer: BCBS Complete |
$92.34
|
| Rate for Payer: Cash Price |
$184.68
|
| Rate for Payer: Cofinity Advantage |
$161.59
|
| Rate for Payer: Cofinity Commercial |
$198.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.68
|
| Rate for Payer: Healthscope Commercial |
$207.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$184.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.14
|
| Rate for Payer: PHP Commercial |
$196.22
|
| Rate for Payer: Priority Health SBD |
$145.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.05
|
| Rate for Payer: UHC Core |
$120.27
|
| Rate for Payer: UHC Exchange |
$90.72
|
|
|
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 Advantage |
$311.22
|
| Rate for Payer: Cofinity Commercial |
$382.36
|
| 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: Opus (Opus Packaging Group) HMA |
$333.45
|
| Rate for Payer: PHP Commercial |
$377.91
|
| Rate for Payer: Priority Health SBD |
$280.10
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
IP
|
$450.30
|
|
|
Service Code
|
NDC 50111033401
|
| 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 Advantage |
$315.21
|
| Rate for Payer: Cofinity Commercial |
$387.26
|
| 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: Opus (Opus Packaging Group) HMA |
$337.73
|
| Rate for Payer: PHP Commercial |
$382.75
|
| Rate for Payer: Priority Health SBD |
$283.69
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
OP
|
$444.60
|
|
|
Service Code
|
NDC 42292000120
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$174.73 |
| 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 Advantage |
$311.22
|
| Rate for Payer: Cofinity Commercial |
$382.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$355.68
|
| Rate for Payer: Healthscope Commercial |
$400.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$355.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$377.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$333.45
|
| Rate for Payer: PHP Commercial |
$377.91
|
| Rate for Payer: Priority Health SBD |
$280.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.99
|
| Rate for Payer: UHC Core |
$231.64
|
| Rate for Payer: UHC Exchange |
$174.73
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
OP
|
$4.45
|
|
|
Service Code
|
NDC 42292000101
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.75 |
| 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 Advantage |
$3.12
|
| Rate for Payer: Cofinity Commercial |
$3.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.56
|
| Rate for Payer: Healthscope Commercial |
$4.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.34
|
| Rate for Payer: PHP Commercial |
$3.78
|
| Rate for Payer: Priority Health SBD |
$2.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.89
|
| Rate for Payer: UHC Core |
$2.32
|
| Rate for Payer: UHC Exchange |
$1.75
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
IP
|
$230.85
|
|
|
Service Code
|
NDC 50268053515
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$145.44 |
| Max. Negotiated Rate |
$207.76 |
| Rate for Payer: Aetna Commercial |
$196.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.05
|
| Rate for Payer: Cash Price |
$184.68
|
| Rate for Payer: Cofinity Advantage |
$161.59
|
| Rate for Payer: Cofinity Commercial |
$198.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.68
|
| Rate for Payer: Healthscope Commercial |
$207.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.14
|
| Rate for Payer: PHP Commercial |
$196.22
|
| Rate for Payer: Priority Health SBD |
$145.44
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
OP
|
$450.30
|
|
|
Service Code
|
NDC 50111033401
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$176.97 |
| 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 Advantage |
$315.21
|
| Rate for Payer: Cofinity Commercial |
$387.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.24
|
| Rate for Payer: Healthscope Commercial |
$405.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$360.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$337.73
|
| Rate for Payer: PHP Commercial |
$382.75
|
| Rate for Payer: Priority Health SBD |
$283.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.69
|
| Rate for Payer: UHC Core |
$234.61
|
| Rate for Payer: UHC Exchange |
$176.97
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
OP
|
$4.62
|
|
|
Service Code
|
NDC 50268053511
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.82 |
| Max. Negotiated Rate |
$4.16 |
| Rate for Payer: Aetna Commercial |
$3.93
|
| Rate for Payer: Aetna Medicare |
$2.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.00
|
| Rate for Payer: BCBS Complete |
$1.85
|
| Rate for Payer: Cash Price |
$3.70
|
| Rate for Payer: Cofinity Advantage |
$3.23
|
| Rate for Payer: Cofinity Commercial |
$3.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.70
|
| Rate for Payer: Healthscope Commercial |
$4.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.46
|
| Rate for Payer: PHP Commercial |
$3.93
|
| Rate for Payer: Priority Health SBD |
$2.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.00
|
| Rate for Payer: UHC Core |
$2.41
|
| Rate for Payer: UHC Exchange |
$1.82
|
|
|
METRONIDAZOLE 500 MG TABLET
|
Facility
|
IP
|
$267.36
|
|
|
Service Code
|
NDC 60687055001
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$168.44 |
| Max. Negotiated Rate |
$240.62 |
| Rate for Payer: Aetna Commercial |
$227.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.78
|
| Rate for Payer: Cash Price |
$213.89
|
| Rate for Payer: Cofinity Advantage |
$187.15
|
| Rate for Payer: Cofinity Commercial |
$229.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.89
|
| Rate for Payer: Healthscope Commercial |
$240.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.52
|
| Rate for Payer: PHP Commercial |
$227.26
|
| Rate for Payer: Priority Health SBD |
$168.44
|
|
|
MEXILETINE 150 MG CAPSULE
|
Facility
|
IP
|
$577.44
|
|
|
Service Code
|
NDC 00093873901
|
| Hospital Charge Code |
10595
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$363.79 |
| Max. Negotiated Rate |
$519.70 |
| Rate for Payer: Aetna Commercial |
$490.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.34
|
| Rate for Payer: Cash Price |
$461.95
|
| Rate for Payer: Cofinity Advantage |
$404.21
|
| Rate for Payer: Cofinity Commercial |
$496.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.95
|
| Rate for Payer: Healthscope Commercial |
$519.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$433.08
|
| Rate for Payer: PHP Commercial |
$490.82
|
| Rate for Payer: Priority Health SBD |
$363.79
|
|
|
MEXILETINE 150 MG CAPSULE
|
Facility
|
OP
|
$577.44
|
|
|
Service Code
|
NDC 00093873901
|
| Hospital Charge Code |
10595
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$226.93 |
| Max. Negotiated Rate |
$519.70 |
| Rate for Payer: Aetna Commercial |
$490.82
|
| Rate for Payer: Aetna Medicare |
$288.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.34
|
| Rate for Payer: BCBS Complete |
$230.98
|
| Rate for Payer: Cash Price |
$461.95
|
| Rate for Payer: Cofinity Advantage |
$404.21
|
| Rate for Payer: Cofinity Commercial |
$496.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.95
|
| Rate for Payer: Healthscope Commercial |
$519.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$461.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$433.08
|
| Rate for Payer: PHP Commercial |
$490.82
|
| Rate for Payer: Priority Health SBD |
$363.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.34
|
| Rate for Payer: UHC Core |
$300.85
|
| Rate for Payer: UHC Exchange |
$226.93
|
|
