|
METOPROLOL TARTRATE 12.5 MG CUSTOM TAB
|
Facility
|
OP
|
$164.50
|
|
|
Service Code
|
NDC 0990000038
|
| Hospital Charge Code |
500250
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$29.00 |
| Max. Negotiated Rate |
$148.05 |
| Rate for Payer: Aetna Commercial |
$139.82
|
| Rate for Payer: Aetna Medicare |
$42.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.41
|
| Rate for Payer: BCBS Complete |
$30.45
|
| Rate for Payer: BCBS MAPPO |
$41.12
|
| Rate for Payer: BCBS Trust/PPO |
$135.24
|
| Rate for Payer: BCN Commercial |
$135.24
|
| Rate for Payer: BCN Medicare Advantage |
$41.12
|
| Rate for Payer: Cash Price |
$131.60
|
| Rate for Payer: Cofinity Commercial |
$141.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.12
|
| Rate for Payer: Healthscope Commercial |
$148.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.38
|
| Rate for Payer: Mclaren Medicaid |
$29.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.18
|
| Rate for Payer: Meridian Medicaid |
$30.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.82
|
| Rate for Payer: Nomi Health Commercial |
$134.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.38
|
| Rate for Payer: PACE Senior Care Partners |
$39.07
|
| Rate for Payer: PACE SWMI |
$41.12
|
| Rate for Payer: PHP Commercial |
$139.82
|
| Rate for Payer: PHP Medicare Advantage |
$41.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$143.12
|
| Rate for Payer: Priority Health Medicare |
$41.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.49
|
| Rate for Payer: Railroad Medicare Medicare |
$41.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.76
|
| Rate for Payer: UHC Core |
$137.36
|
| Rate for Payer: UHC Exchange |
$41.12
|
| Rate for Payer: UHC Medicaid |
$29.00
|
| Rate for Payer: UHC Medicare Advantage |
$41.12
|
| Rate for Payer: UHCCP Medicaid |
$29.00
|
| Rate for Payer: VA VA |
$41.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.38
|
|
|
METOPROLOL TARTRATE 12.5 MG CUSTOM TAB
|
Facility
|
IP
|
$164.50
|
|
|
Service Code
|
NDC 0990000038
|
| Hospital Charge Code |
500250
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$114.49 |
| Max. Negotiated Rate |
$148.05 |
| Rate for Payer: Aetna Commercial |
$139.82
|
| Rate for Payer: BCBS Trust/PPO |
$135.86
|
| Rate for Payer: BCN Commercial |
$135.86
|
| Rate for Payer: Cash Price |
$131.60
|
| Rate for Payer: Cofinity Commercial |
$141.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.60
|
| Rate for Payer: Healthscope Commercial |
$148.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.82
|
| Rate for Payer: Nomi Health Commercial |
$134.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.38
|
| Rate for Payer: PHP Commercial |
$139.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$143.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.76
|
| Rate for Payer: UHC Core |
$137.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.38
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
IP
|
$2.03
|
|
|
Service Code
|
NDC 51079025501
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.41 |
| Max. Negotiated Rate |
$1.83 |
| Rate for Payer: Aetna Commercial |
$1.73
|
| Rate for Payer: BCBS Trust/PPO |
$1.68
|
| Rate for Payer: BCN Commercial |
$1.68
|
| Rate for Payer: Cash Price |
$1.62
|
| Rate for Payer: Cofinity Commercial |
$1.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.62
|
| Rate for Payer: Healthscope Commercial |
$1.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.73
|
| Rate for Payer: Nomi Health Commercial |
$1.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.52
|
| Rate for Payer: PHP Commercial |
$1.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.79
|
| Rate for Payer: UHC Core |
$1.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.52
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
IP
|
$223.25
|
|
|
Service Code
|
NDC 62584026501
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$155.38 |
| Max. Negotiated Rate |
$200.93 |
| Rate for Payer: Aetna Commercial |
$189.76
|
| Rate for Payer: BCBS Trust/PPO |
$184.38
|
| Rate for Payer: BCN Commercial |
$184.38
|
| Rate for Payer: Cash Price |
$178.60
|
| Rate for Payer: Cofinity Commercial |
$192.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.60
|
| Rate for Payer: Healthscope Commercial |
$200.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.76
|
| Rate for Payer: Nomi Health Commercial |
$183.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.44
|
| Rate for Payer: PHP Commercial |
$189.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$194.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.46
|
| Rate for Payer: UHC Core |
$186.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.44
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
IP
|
$2.24
|
|
|
Service Code
|
NDC 62584026511
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$2.02 |
| Rate for Payer: Aetna Commercial |
$1.90
|
| Rate for Payer: BCBS Trust/PPO |
$1.85
|
| Rate for Payer: BCN Commercial |
$1.85
|
| Rate for Payer: Cash Price |
$1.79
|
| Rate for Payer: Cofinity Commercial |
$1.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.79
|
| Rate for Payer: Healthscope Commercial |
$2.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.90
|
| Rate for Payer: Nomi Health Commercial |
$1.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.68
|
| Rate for Payer: PHP Commercial |
$1.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.97
|
| Rate for Payer: UHC Core |
$1.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.68
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
OP
|
$2.24
|
|
|
Service Code
|
NDC 62584026511
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$2.02 |
| Rate for Payer: Aetna Commercial |
$1.90
|
| Rate for Payer: Aetna Medicare |
$0.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.70
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS MAPPO |
$0.56
|
| Rate for Payer: BCBS Trust/PPO |
$1.84
|
| Rate for Payer: BCN Commercial |
$1.84
|
| Rate for Payer: BCN Medicare Advantage |
$0.56
|
| Rate for Payer: Cash Price |
$1.79
|
| Rate for Payer: Cofinity Commercial |
$1.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.56
|
| Rate for Payer: Healthscope Commercial |
$2.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.68
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.59
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.90
|
| Rate for Payer: Nomi Health Commercial |
$1.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.68
|
| Rate for Payer: PACE Senior Care Partners |
$0.53
|
| Rate for Payer: PACE SWMI |
$0.56
|
| Rate for Payer: PHP Commercial |
$1.90
|
| Rate for Payer: PHP Medicare Advantage |
$0.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.95
|
| Rate for Payer: Priority Health Medicare |
$0.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.56
|
| Rate for Payer: Railroad Medicare Medicare |
$0.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.97
|
| Rate for Payer: UHC Core |
$1.87
|
| Rate for Payer: UHC Exchange |
$0.56
|
| Rate for Payer: UHC Medicaid |
$0.39
|
| Rate for Payer: UHC Medicare Advantage |
$0.56
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: VA VA |
$0.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.68
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
OP
|
$2.03
|
|
|
Service Code
|
NDC 51079025501
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.36 |
| Max. Negotiated Rate |
$1.83 |
| Rate for Payer: Aetna Commercial |
$1.73
|
| Rate for Payer: Aetna Medicare |
$0.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.63
|
| Rate for Payer: BCBS Complete |
$0.38
|
| Rate for Payer: BCBS MAPPO |
$0.51
|
| Rate for Payer: BCBS Trust/PPO |
$1.67
|
| Rate for Payer: BCN Commercial |
$1.67
|
| Rate for Payer: BCN Medicare Advantage |
$0.51
|
| Rate for Payer: Cash Price |
$1.62
|
| Rate for Payer: Cofinity Commercial |
$1.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.51
|
| Rate for Payer: Healthscope Commercial |
$1.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.52
|
| Rate for Payer: Mclaren Medicaid |
$0.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.53
|
| Rate for Payer: Meridian Medicaid |
$0.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.73
|
| Rate for Payer: Nomi Health Commercial |
$1.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.52
|
| Rate for Payer: PACE Senior Care Partners |
$0.48
|
| Rate for Payer: PACE SWMI |
$0.51
|
| Rate for Payer: PHP Commercial |
$1.73
|
| Rate for Payer: PHP Medicare Advantage |
$0.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.77
|
| Rate for Payer: Priority Health Medicare |
$0.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.41
|
| Rate for Payer: Railroad Medicare Medicare |
$0.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.79
|
| Rate for Payer: UHC Core |
$1.70
|
| Rate for Payer: UHC Exchange |
$0.51
|
| Rate for Payer: UHC Medicaid |
$0.36
|
| Rate for Payer: UHC Medicare Advantage |
$0.51
|
| Rate for Payer: UHCCP Medicaid |
$0.36
|
| Rate for Payer: VA VA |
$0.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.52
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
NDC 62332011231
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$32.71 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Aetna Commercial |
$39.95
|
| Rate for Payer: BCBS Trust/PPO |
$38.82
|
| Rate for Payer: BCN Commercial |
$38.82
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$40.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.60
|
| Rate for Payer: Healthscope Commercial |
$42.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.95
|
| Rate for Payer: Nomi Health Commercial |
$38.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.25
|
| Rate for Payer: PHP Commercial |
$39.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.36
|
| Rate for Payer: UHC Core |
$39.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.25
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
NDC 62332011231
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$8.29 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Aetna Commercial |
$39.95
|
| Rate for Payer: Aetna Medicare |
$12.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.69
|
| Rate for Payer: BCBS Complete |
$8.70
|
| Rate for Payer: BCBS MAPPO |
$11.75
|
| Rate for Payer: BCBS Trust/PPO |
$38.64
|
| Rate for Payer: BCN Commercial |
$38.64
|
| Rate for Payer: BCN Medicare Advantage |
$11.75
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$40.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.75
|
| Rate for Payer: Healthscope Commercial |
$42.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.25
|
| Rate for Payer: Mclaren Medicaid |
$8.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.34
|
| Rate for Payer: Meridian Medicaid |
$8.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.95
|
| Rate for Payer: Nomi Health Commercial |
$38.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.25
|
| Rate for Payer: PACE Senior Care Partners |
$11.16
|
| Rate for Payer: PACE SWMI |
$11.75
|
| Rate for Payer: PHP Commercial |
$39.95
|
| Rate for Payer: PHP Medicare Advantage |
$11.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.89
|
| Rate for Payer: Priority Health Medicare |
$11.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.71
|
| Rate for Payer: Railroad Medicare Medicare |
$11.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.36
|
| Rate for Payer: UHC Core |
$39.24
|
| Rate for Payer: UHC Exchange |
$11.75
|
| Rate for Payer: UHC Medicaid |
$8.29
|
| Rate for Payer: UHC Medicare Advantage |
$11.75
|
| Rate for Payer: UHCCP Medicaid |
$8.29
|
| Rate for Payer: VA VA |
$11.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.25
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
OP
|
$223.25
|
|
|
Service Code
|
NDC 62584026501
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.36 |
| Max. Negotiated Rate |
$200.93 |
| Rate for Payer: Aetna Commercial |
$189.76
|
| Rate for Payer: Aetna Medicare |
$58.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.77
|
| Rate for Payer: BCBS Complete |
$41.32
|
| Rate for Payer: BCBS MAPPO |
$55.81
|
| Rate for Payer: BCBS Trust/PPO |
$183.53
|
| Rate for Payer: BCN Commercial |
$183.53
|
| Rate for Payer: BCN Medicare Advantage |
$55.81
|
| Rate for Payer: Cash Price |
$178.60
|
| Rate for Payer: Cofinity Commercial |
$192.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.81
|
| Rate for Payer: Healthscope Commercial |
$200.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.44
|
| Rate for Payer: Mclaren Medicaid |
$39.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.60
|
| Rate for Payer: Meridian Medicaid |
$41.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.76
|
| Rate for Payer: Nomi Health Commercial |
$183.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.44
|
| Rate for Payer: PACE Senior Care Partners |
$53.02
|
| Rate for Payer: PACE SWMI |
$55.81
|
| Rate for Payer: PHP Commercial |
$189.76
|
| Rate for Payer: PHP Medicare Advantage |
$55.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$194.23
|
| Rate for Payer: Priority Health Medicare |
$56.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.38
|
| Rate for Payer: Railroad Medicare Medicare |
$55.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.46
|
| Rate for Payer: UHC Core |
$186.41
|
| Rate for Payer: UHC Exchange |
$55.81
|
| Rate for Payer: UHC Medicaid |
$39.36
|
| Rate for Payer: UHC Medicare Advantage |
$55.81
|
| Rate for Payer: UHCCP Medicaid |
$39.36
|
| Rate for Payer: VA VA |
$55.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.44
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
OP
|
$202.10
|
|
|
Service Code
|
NDC 51079025520
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$35.63 |
| Max. Negotiated Rate |
$181.89 |
| Rate for Payer: Aetna Commercial |
$171.78
|
| Rate for Payer: Aetna Medicare |
$52.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.16
|
| Rate for Payer: BCBS Complete |
$37.41
|
| Rate for Payer: BCBS MAPPO |
$50.52
|
| Rate for Payer: BCBS Trust/PPO |
$166.15
|
| Rate for Payer: BCN Commercial |
$166.15
|
| Rate for Payer: BCN Medicare Advantage |
$50.52
|
| Rate for Payer: Cash Price |
$161.68
|
| Rate for Payer: Cofinity Commercial |
$173.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.52
|
| Rate for Payer: Healthscope Commercial |
$181.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.57
|
| Rate for Payer: Mclaren Medicaid |
$35.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.05
|
| Rate for Payer: Meridian Medicaid |
$37.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.78
|
| Rate for Payer: Nomi Health Commercial |
$165.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.57
|
| Rate for Payer: PACE Senior Care Partners |
$48.00
|
| Rate for Payer: PACE SWMI |
$50.52
|
| Rate for Payer: PHP Commercial |
$171.78
|
| Rate for Payer: PHP Medicare Advantage |
$50.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$175.83
|
| Rate for Payer: Priority Health Medicare |
$51.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.66
|
| Rate for Payer: Railroad Medicare Medicare |
$50.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.85
|
| Rate for Payer: UHC Core |
$168.75
|
| Rate for Payer: UHC Exchange |
$50.52
|
| Rate for Payer: UHC Medicaid |
$35.63
|
| Rate for Payer: UHC Medicare Advantage |
$50.52
|
| Rate for Payer: UHCCP Medicaid |
$35.63
|
| Rate for Payer: VA VA |
$50.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.57
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
IP
|
$202.10
|
|
|
Service Code
|
NDC 51079025520
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$140.66 |
| Max. Negotiated Rate |
$181.89 |
| Rate for Payer: Aetna Commercial |
$171.78
|
| Rate for Payer: BCBS Trust/PPO |
$166.91
|
| Rate for Payer: BCN Commercial |
$166.91
|
| Rate for Payer: Cash Price |
$161.68
|
| Rate for Payer: Cofinity Commercial |
$173.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.68
|
| Rate for Payer: Healthscope Commercial |
$181.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.78
|
| Rate for Payer: Nomi Health Commercial |
$165.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.57
|
| Rate for Payer: PHP Commercial |
$171.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$175.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.85
|
| Rate for Payer: UHC Core |
$168.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.57
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$185.65
|
|
|
Service Code
|
NDC 51079080120
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$32.73 |
| Max. Negotiated Rate |
$167.09 |
| Rate for Payer: Aetna Commercial |
$157.80
|
| Rate for Payer: Aetna Medicare |
$48.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.02
|
| Rate for Payer: BCBS Complete |
$34.36
|
| Rate for Payer: BCBS MAPPO |
$46.41
|
| Rate for Payer: BCBS Trust/PPO |
$152.62
|
| Rate for Payer: BCN Commercial |
$152.62
|
| Rate for Payer: BCN Medicare Advantage |
$46.41
|
| Rate for Payer: Cash Price |
$148.52
|
| Rate for Payer: Cofinity Commercial |
$159.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.41
|
| Rate for Payer: Healthscope Commercial |
$167.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.24
|
| Rate for Payer: Mclaren Medicaid |
$32.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.73
|
| Rate for Payer: Meridian Medicaid |
$34.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.80
|
| Rate for Payer: Nomi Health Commercial |
$152.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.24
|
| Rate for Payer: PACE Senior Care Partners |
$44.09
|
| Rate for Payer: PACE SWMI |
$46.41
|
| Rate for Payer: PHP Commercial |
$157.80
|
| Rate for Payer: PHP Medicare Advantage |
$46.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$161.52
|
| Rate for Payer: Priority Health Medicare |
$46.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.21
|
| Rate for Payer: Railroad Medicare Medicare |
$46.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.37
|
| Rate for Payer: UHC Core |
$155.02
|
| Rate for Payer: UHC Exchange |
$46.41
|
| Rate for Payer: UHC Medicaid |
$32.73
|
| Rate for Payer: UHC Medicare Advantage |
$46.41
|
| Rate for Payer: UHCCP Medicaid |
$32.73
|
| Rate for Payer: VA VA |
$46.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.24
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$164.50
|
|
|
Service Code
|
NDC 00904711861
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$29.00 |
| Max. Negotiated Rate |
$148.05 |
| Rate for Payer: Aetna Commercial |
$139.82
|
| Rate for Payer: Aetna Medicare |
$42.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.41
|
| Rate for Payer: BCBS Complete |
$30.45
|
| Rate for Payer: BCBS MAPPO |
$41.12
|
| Rate for Payer: BCBS Trust/PPO |
$135.24
|
| Rate for Payer: BCN Commercial |
$135.24
|
| Rate for Payer: BCN Medicare Advantage |
$41.12
|
| Rate for Payer: Cash Price |
$131.60
|
| Rate for Payer: Cofinity Commercial |
$141.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.12
|
| Rate for Payer: Healthscope Commercial |
$148.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.38
|
| Rate for Payer: Mclaren Medicaid |
$29.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.18
|
| Rate for Payer: Meridian Medicaid |
$30.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.82
|
| Rate for Payer: Nomi Health Commercial |
$134.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.38
|
| Rate for Payer: PACE Senior Care Partners |
$39.07
|
| Rate for Payer: PACE SWMI |
$41.12
|
| Rate for Payer: PHP Commercial |
$139.82
|
| Rate for Payer: PHP Medicare Advantage |
$41.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$143.12
|
| Rate for Payer: Priority Health Medicare |
$41.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.49
|
| Rate for Payer: Railroad Medicare Medicare |
$41.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.76
|
| Rate for Payer: UHC Core |
$137.36
|
| Rate for Payer: UHC Exchange |
$41.12
|
| Rate for Payer: UHC Medicaid |
$29.00
|
| Rate for Payer: UHC Medicare Advantage |
$41.12
|
| Rate for Payer: UHCCP Medicaid |
$29.00
|
| Rate for Payer: VA VA |
$41.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.38
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$164.50
|
|
|
Service Code
|
NDC 00904711861
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$114.49 |
| Max. Negotiated Rate |
$148.05 |
| Rate for Payer: Aetna Commercial |
$139.82
|
| Rate for Payer: BCBS Trust/PPO |
$135.86
|
| Rate for Payer: BCN Commercial |
$135.86
|
| Rate for Payer: Cash Price |
$131.60
|
| Rate for Payer: Cofinity Commercial |
$141.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.60
|
| Rate for Payer: Healthscope Commercial |
$148.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.82
|
| Rate for Payer: Nomi Health Commercial |
$134.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.38
|
| Rate for Payer: PHP Commercial |
$139.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$143.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.76
|
| Rate for Payer: UHC Core |
$137.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.38
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$1.86
|
|
|
Service Code
|
NDC 51079080101
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.67 |
| Rate for Payer: Aetna Commercial |
$1.58
|
| Rate for Payer: BCBS Trust/PPO |
$1.54
|
| Rate for Payer: BCN Commercial |
$1.54
|
| Rate for Payer: Cash Price |
$1.49
|
| Rate for Payer: Cofinity Commercial |
$1.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.49
|
| Rate for Payer: Healthscope Commercial |
$1.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.58
|
| Rate for Payer: Nomi Health Commercial |
$1.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.40
|
| Rate for Payer: PHP Commercial |
$1.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.64
|
| Rate for Payer: UHC Core |
$1.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.40
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$2.12
|
|
|
Service Code
|
NDC 62584026611
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.48 |
| Max. Negotiated Rate |
$1.91 |
| Rate for Payer: Aetna Commercial |
$1.80
|
| Rate for Payer: BCBS Trust/PPO |
$1.75
|
| Rate for Payer: BCN Commercial |
$1.75
|
| Rate for Payer: Cash Price |
$1.70
|
| Rate for Payer: Cofinity Commercial |
$1.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.70
|
| Rate for Payer: Healthscope Commercial |
$1.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.80
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.59
|
| Rate for Payer: PHP Commercial |
$1.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.87
|
| Rate for Payer: UHC Core |
$1.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.59
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$2.12
|
|
|
Service Code
|
NDC 62584026611
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.37 |
| Max. Negotiated Rate |
$1.91 |
| Rate for Payer: Aetna Commercial |
$1.80
|
| Rate for Payer: Aetna Medicare |
$0.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.66
|
| Rate for Payer: BCBS Complete |
$0.39
|
| Rate for Payer: BCBS MAPPO |
$0.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.74
|
| Rate for Payer: BCN Commercial |
$1.74
|
| Rate for Payer: BCN Medicare Advantage |
$0.53
|
| Rate for Payer: Cash Price |
$1.70
|
| Rate for Payer: Cofinity Commercial |
$1.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.53
|
| Rate for Payer: Healthscope Commercial |
$1.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.59
|
| Rate for Payer: Mclaren Medicaid |
$0.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.56
|
| Rate for Payer: Meridian Medicaid |
$0.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.80
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.59
|
| Rate for Payer: PACE Senior Care Partners |
$0.50
|
| Rate for Payer: PACE SWMI |
$0.53
|
| Rate for Payer: PHP Commercial |
$1.80
|
| Rate for Payer: PHP Medicare Advantage |
$0.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.84
|
| Rate for Payer: Priority Health Medicare |
$0.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.48
|
| Rate for Payer: Railroad Medicare Medicare |
$0.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.87
|
| Rate for Payer: UHC Core |
$1.77
|
| Rate for Payer: UHC Exchange |
$0.53
|
| Rate for Payer: UHC Medicaid |
$0.37
|
| Rate for Payer: UHC Medicare Advantage |
$0.53
|
| Rate for Payer: UHCCP Medicaid |
$0.37
|
| Rate for Payer: VA VA |
$0.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.59
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$185.65
|
|
|
Service Code
|
NDC 51079080120
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$129.21 |
| Max. Negotiated Rate |
$167.09 |
| Rate for Payer: Aetna Commercial |
$157.80
|
| Rate for Payer: BCBS Trust/PPO |
$153.33
|
| Rate for Payer: BCN Commercial |
$153.33
|
| Rate for Payer: Cash Price |
$148.52
|
| Rate for Payer: Cofinity Commercial |
$159.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.52
|
| Rate for Payer: Healthscope Commercial |
$167.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.80
|
| Rate for Payer: Nomi Health Commercial |
$152.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.24
|
| Rate for Payer: PHP Commercial |
$157.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$161.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.37
|
| Rate for Payer: UHC Core |
$155.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.24
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$211.50
|
|
|
Service Code
|
NDC 62584026601
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$147.20 |
| Max. Negotiated Rate |
$190.35 |
| Rate for Payer: Aetna Commercial |
$179.78
|
| Rate for Payer: BCBS Trust/PPO |
$174.68
|
| Rate for Payer: BCN Commercial |
$174.68
|
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Cofinity Commercial |
$181.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.20
|
| Rate for Payer: Healthscope Commercial |
$190.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.78
|
| Rate for Payer: Nomi Health Commercial |
$173.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$158.62
|
| Rate for Payer: PHP Commercial |
$179.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$184.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.12
|
| Rate for Payer: UHC Core |
$176.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.62
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$211.50
|
|
|
Service Code
|
NDC 62584026601
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$37.29 |
| Max. Negotiated Rate |
$190.35 |
| Rate for Payer: Aetna Commercial |
$179.78
|
| Rate for Payer: Aetna Medicare |
$54.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.09
|
| Rate for Payer: BCBS Complete |
$39.15
|
| Rate for Payer: BCBS MAPPO |
$52.88
|
| Rate for Payer: BCBS Trust/PPO |
$173.87
|
| Rate for Payer: BCN Commercial |
$173.87
|
| Rate for Payer: BCN Medicare Advantage |
$52.88
|
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Cofinity Commercial |
$181.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.88
|
| Rate for Payer: Healthscope Commercial |
$190.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.62
|
| Rate for Payer: Mclaren Medicaid |
$37.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.52
|
| Rate for Payer: Meridian Medicaid |
$39.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.78
|
| Rate for Payer: Nomi Health Commercial |
$173.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$158.62
|
| Rate for Payer: PACE Senior Care Partners |
$50.23
|
| Rate for Payer: PACE SWMI |
$52.88
|
| Rate for Payer: PHP Commercial |
$179.78
|
| Rate for Payer: PHP Medicare Advantage |
$52.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$184.00
|
| Rate for Payer: Priority Health Medicare |
$53.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.20
|
| Rate for Payer: Railroad Medicare Medicare |
$52.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.12
|
| Rate for Payer: UHC Core |
$176.60
|
| Rate for Payer: UHC Exchange |
$52.88
|
| Rate for Payer: UHC Medicaid |
$37.29
|
| Rate for Payer: UHC Medicare Advantage |
$52.88
|
| Rate for Payer: UHCCP Medicaid |
$37.29
|
| Rate for Payer: VA VA |
$52.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.62
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$1.86
|
|
|
Service Code
|
NDC 51079080101
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$1.67 |
| Rate for Payer: Aetna Commercial |
$1.58
|
| Rate for Payer: Aetna Medicare |
$0.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.58
|
| Rate for Payer: BCBS Complete |
$0.34
|
| Rate for Payer: BCBS MAPPO |
$0.47
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Medicare Advantage |
$0.47
|
| Rate for Payer: Cash Price |
$1.49
|
| Rate for Payer: Cofinity Commercial |
$1.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.47
|
| Rate for Payer: Healthscope Commercial |
$1.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.40
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.49
|
| Rate for Payer: Meridian Medicaid |
$0.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.58
|
| Rate for Payer: Nomi Health Commercial |
$1.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.40
|
| Rate for Payer: PACE Senior Care Partners |
$0.44
|
| Rate for Payer: PACE SWMI |
$0.47
|
| Rate for Payer: PHP Commercial |
$1.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.62
|
| Rate for Payer: Priority Health Medicare |
$0.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.29
|
| Rate for Payer: Railroad Medicare Medicare |
$0.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.64
|
| Rate for Payer: UHC Core |
$1.55
|
| Rate for Payer: UHC Exchange |
$0.47
|
| Rate for Payer: UHC Medicaid |
$0.33
|
| Rate for Payer: UHC Medicare Advantage |
$0.47
|
| Rate for Payer: UHCCP Medicaid |
$0.33
|
| Rate for Payer: VA VA |
$0.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.40
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14.25
|
|
|
Service Code
|
HCPCS J0616
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$12.82 |
| Rate for Payer: Aetna Commercial |
$12.11
|
| Rate for Payer: Aetna Commercial |
$12.01
|
| Rate for Payer: Aetna Commercial |
$11.47
|
| Rate for Payer: Aetna Commercial |
$13.71
|
| Rate for Payer: BCBS Trust/PPO |
$11.77
|
| Rate for Payer: BCBS Trust/PPO |
$13.32
|
| Rate for Payer: BCBS Trust/PPO |
$11.67
|
| Rate for Payer: BCBS Trust/PPO |
$11.14
|
| Rate for Payer: BCN Commercial |
$11.77
|
| Rate for Payer: BCN Commercial |
$11.14
|
| Rate for Payer: BCN Commercial |
$13.32
|
| Rate for Payer: BCN Commercial |
$11.67
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cash Price |
$10.79
|
| Rate for Payer: Cofinity Commercial |
$11.60
|
| Rate for Payer: Cofinity Commercial |
$13.87
|
| Rate for Payer: Cofinity Commercial |
$12.26
|
| Rate for Payer: Cofinity Commercial |
$12.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$14.52
|
| Rate for Payer: Healthscope Commercial |
$12.72
|
| Rate for Payer: Healthscope Commercial |
$12.82
|
| Rate for Payer: Healthscope Commercial |
$12.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.71
|
| Rate for Payer: Nomi Health Commercial |
$11.06
|
| Rate for Payer: Nomi Health Commercial |
$11.59
|
| Rate for Payer: Nomi Health Commercial |
$13.23
|
| Rate for Payer: Nomi Health Commercial |
$11.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.10
|
| Rate for Payer: PHP Commercial |
$13.71
|
| Rate for Payer: PHP Commercial |
$11.47
|
| Rate for Payer: PHP Commercial |
$12.01
|
| Rate for Payer: PHP Commercial |
$12.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.54
|
| Rate for Payer: UHC Core |
$11.90
|
| Rate for Payer: UHC Core |
$13.47
|
| Rate for Payer: UHC Core |
$11.80
|
| Rate for Payer: UHC Core |
$11.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.69
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$13.49
|
|
|
Service Code
|
HCPCS J0616
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.38 |
| Max. Negotiated Rate |
$12.14 |
| Rate for Payer: Aetna Commercial |
$11.47
|
| Rate for Payer: Aetna Commercial |
$12.11
|
| Rate for Payer: Aetna Commercial |
$13.71
|
| Rate for Payer: Aetna Commercial |
$12.01
|
| Rate for Payer: Aetna Medicare |
$3.67
|
| Rate for Payer: Aetna Medicare |
$3.51
|
| Rate for Payer: Aetna Medicare |
$3.71
|
| Rate for Payer: Aetna Medicare |
$4.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.22
|
| Rate for Payer: BCBS Complete |
$2.99
|
| Rate for Payer: BCBS Complete |
$2.62
|
| Rate for Payer: BCBS Complete |
$2.50
|
| Rate for Payer: BCBS Complete |
$2.64
|
| Rate for Payer: BCBS MAPPO |
$3.37
|
| Rate for Payer: BCBS MAPPO |
$3.53
|
| Rate for Payer: BCBS MAPPO |
$4.03
|
| Rate for Payer: BCBS MAPPO |
$3.56
|
| Rate for Payer: BCBS Trust/PPO |
$11.71
|
| Rate for Payer: BCBS Trust/PPO |
$11.09
|
| Rate for Payer: BCBS Trust/PPO |
$13.26
|
| Rate for Payer: BCBS Trust/PPO |
$11.62
|
| Rate for Payer: BCN Commercial |
$11.71
|
| Rate for Payer: BCN Commercial |
$13.26
|
| Rate for Payer: BCN Commercial |
$11.62
|
| Rate for Payer: BCN Commercial |
$11.09
|
| Rate for Payer: BCN Medicare Advantage |
$3.56
|
| Rate for Payer: BCN Medicare Advantage |
$3.53
|
| Rate for Payer: BCN Medicare Advantage |
$4.03
|
| Rate for Payer: BCN Medicare Advantage |
$3.37
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cash Price |
$10.79
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cofinity Commercial |
$12.15
|
| Rate for Payer: Cofinity Commercial |
$11.60
|
| Rate for Payer: Cofinity Commercial |
$12.26
|
| Rate for Payer: Cofinity Commercial |
$13.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.56
|
| Rate for Payer: Healthscope Commercial |
$12.14
|
| Rate for Payer: Healthscope Commercial |
$14.52
|
| Rate for Payer: Healthscope Commercial |
$12.82
|
| Rate for Payer: Healthscope Commercial |
$12.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.12
|
| Rate for Payer: Mclaren Medicaid |
$2.51
|
| Rate for Payer: Mclaren Medicaid |
$2.49
|
| Rate for Payer: Mclaren Medicaid |
$2.38
|
| Rate for Payer: Mclaren Medicaid |
$2.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.54
|
| Rate for Payer: Meridian Medicaid |
$2.50
|
| Rate for Payer: Meridian Medicaid |
$2.64
|
| Rate for Payer: Meridian Medicaid |
$2.99
|
| Rate for Payer: Meridian Medicaid |
$2.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.71
|
| Rate for Payer: Nomi Health Commercial |
$11.69
|
| Rate for Payer: Nomi Health Commercial |
$11.06
|
| Rate for Payer: Nomi Health Commercial |
$11.59
|
| Rate for Payer: Nomi Health Commercial |
$13.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.12
|
| Rate for Payer: PACE Senior Care Partners |
$3.38
|
| Rate for Payer: PACE Senior Care Partners |
$3.83
|
| Rate for Payer: PACE Senior Care Partners |
$3.20
|
| Rate for Payer: PACE Senior Care Partners |
$3.36
|
| Rate for Payer: PACE SWMI |
$3.37
|
| Rate for Payer: PACE SWMI |
$4.03
|
| Rate for Payer: PACE SWMI |
$3.53
|
| Rate for Payer: PACE SWMI |
$3.56
|
| Rate for Payer: PHP Commercial |
$11.47
|
| Rate for Payer: PHP Commercial |
$12.01
|
| Rate for Payer: PHP Commercial |
$12.11
|
| Rate for Payer: PHP Commercial |
$13.71
|
| Rate for Payer: PHP Medicare Advantage |
$3.37
|
| Rate for Payer: PHP Medicare Advantage |
$4.03
|
| Rate for Payer: PHP Medicare Advantage |
$3.53
|
| Rate for Payer: PHP Medicare Advantage |
$3.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.74
|
| Rate for Payer: Priority Health Medicare |
$3.57
|
| Rate for Payer: Priority Health Medicare |
$3.41
|
| Rate for Payer: Priority Health Medicare |
$3.60
|
| Rate for Payer: Priority Health Medicare |
$4.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.39
|
| Rate for Payer: Railroad Medicare Medicare |
$3.56
|
| Rate for Payer: Railroad Medicare Medicare |
$3.37
|
| Rate for Payer: Railroad Medicare Medicare |
$4.03
|
| Rate for Payer: Railroad Medicare Medicare |
$3.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.19
|
| Rate for Payer: UHC Core |
$11.26
|
| Rate for Payer: UHC Core |
$11.90
|
| Rate for Payer: UHC Core |
$11.80
|
| Rate for Payer: UHC Core |
$13.47
|
| Rate for Payer: UHC Exchange |
$3.56
|
| Rate for Payer: UHC Exchange |
$3.53
|
| Rate for Payer: UHC Exchange |
$4.03
|
| Rate for Payer: UHC Exchange |
$3.37
|
| Rate for Payer: UHC Medicaid |
$2.38
|
| Rate for Payer: UHC Medicaid |
$2.49
|
| Rate for Payer: UHC Medicaid |
$2.51
|
| Rate for Payer: UHC Medicaid |
$2.84
|
| Rate for Payer: UHC Medicare Advantage |
$3.53
|
| Rate for Payer: UHC Medicare Advantage |
$3.37
|
| Rate for Payer: UHC Medicare Advantage |
$4.03
|
| Rate for Payer: UHC Medicare Advantage |
$3.56
|
| Rate for Payer: UHCCP Medicaid |
$2.51
|
| Rate for Payer: UHCCP Medicaid |
$2.84
|
| Rate for Payer: UHCCP Medicaid |
$2.49
|
| Rate for Payer: UHCCP Medicaid |
$2.38
|
| Rate for Payer: VA VA |
$3.37
|
| Rate for Payer: VA VA |
$4.03
|
| Rate for Payer: VA VA |
$3.56
|
| Rate for Payer: VA VA |
$3.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.10
|
|
|
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLORIDE IVPB (PARTIAL PACKAGE)
|
Facility
|
OP
|
$55.94
|
|
|
Service Code
|
HCPCS J1836
|
| Hospital Charge Code |
165987
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$50.35 |
| Rate for Payer: Aetna Commercial |
$47.55
|
| Rate for Payer: Aetna Medicare |
$14.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.48
|
| Rate for Payer: BCBS Complete |
$10.35
|
| Rate for Payer: BCBS MAPPO |
$13.98
|
| Rate for Payer: BCBS Trust/PPO |
$45.99
|
| Rate for Payer: BCN Commercial |
$45.99
|
| Rate for Payer: BCN Medicare Advantage |
$13.98
|
| Rate for Payer: Cash Price |
$44.75
|
| Rate for Payer: Cofinity Commercial |
$48.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.98
|
| Rate for Payer: Healthscope Commercial |
$50.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.95
|
| Rate for Payer: Mclaren Medicaid |
$9.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.68
|
| Rate for Payer: Meridian Medicaid |
$10.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.55
|
| Rate for Payer: Nomi Health Commercial |
$45.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: PACE Senior Care Partners |
$13.29
|
| Rate for Payer: PACE SWMI |
$13.98
|
| Rate for Payer: PHP Commercial |
$47.55
|
| Rate for Payer: PHP Medicare Advantage |
$13.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.67
|
| Rate for Payer: Priority Health Medicare |
$14.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.23
|
| Rate for Payer: UHC Core |
$46.71
|
| Rate for Payer: UHC Exchange |
$13.98
|
| Rate for Payer: UHC Medicaid |
$9.86
|
| Rate for Payer: UHC Medicare Advantage |
$13.98
|
| Rate for Payer: UHCCP Medicaid |
$9.86
|
| Rate for Payer: VA VA |
$13.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.95
|
|
