|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$225.60
|
|
|
Service Code
|
NDC 62584026611
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$53.58 |
| Max. Negotiated Rate |
$203.04 |
| Rate for Payer: Aetna Commercial |
$191.76
|
| Rate for Payer: Aetna Medicare |
$58.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.50
|
| Rate for Payer: BCBS Complete |
$90.24
|
| Rate for Payer: BCBS MAPPO |
$56.40
|
| Rate for Payer: BCBS Trust/PPO |
$185.47
|
| Rate for Payer: BCN Commercial |
$175.40
|
| Rate for Payer: BCN Medicare Advantage |
$56.40
|
| Rate for Payer: Cash Price |
$180.48
|
| Rate for Payer: Cofinity Commercial |
$194.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.40
|
| Rate for Payer: Healthscope Commercial |
$203.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.76
|
| Rate for Payer: Nomi Health Commercial |
$184.99
|
| Rate for Payer: PACE Senior Care Partners |
$53.58
|
| Rate for Payer: PACE SWMI |
$56.40
|
| Rate for Payer: PHP Commercial |
$191.76
|
| Rate for Payer: PHP Medicare Advantage |
$56.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.64
|
| Rate for Payer: Priority Health HMO/PPO |
$196.27
|
| Rate for Payer: Priority Health Medicare |
$56.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.15
|
| Rate for Payer: Railroad Medicare Medicare |
$56.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.53
|
| Rate for Payer: UHC Core |
$188.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.40
|
| Rate for Payer: UHC Exchange |
$56.40
|
| Rate for Payer: UHC Medicare Advantage |
$56.40
|
| Rate for Payer: VA VA |
$56.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.20
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$225.60
|
|
|
Service Code
|
NDC 62584026601
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$53.58 |
| Max. Negotiated Rate |
$203.04 |
| Rate for Payer: Aetna Commercial |
$191.76
|
| Rate for Payer: Aetna Medicare |
$58.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.50
|
| Rate for Payer: BCBS Complete |
$90.24
|
| Rate for Payer: BCBS MAPPO |
$56.40
|
| Rate for Payer: BCBS Trust/PPO |
$185.47
|
| Rate for Payer: BCN Commercial |
$175.40
|
| Rate for Payer: BCN Medicare Advantage |
$56.40
|
| Rate for Payer: Cash Price |
$180.48
|
| Rate for Payer: Cofinity Commercial |
$194.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.40
|
| Rate for Payer: Healthscope Commercial |
$203.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.76
|
| Rate for Payer: Nomi Health Commercial |
$184.99
|
| Rate for Payer: PACE Senior Care Partners |
$53.58
|
| Rate for Payer: PACE SWMI |
$56.40
|
| Rate for Payer: PHP Commercial |
$191.76
|
| Rate for Payer: PHP Medicare Advantage |
$56.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.64
|
| Rate for Payer: Priority Health HMO/PPO |
$196.27
|
| Rate for Payer: Priority Health Medicare |
$56.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.15
|
| Rate for Payer: Railroad Medicare Medicare |
$56.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.53
|
| Rate for Payer: UHC Core |
$188.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.40
|
| Rate for Payer: UHC Exchange |
$56.40
|
| Rate for Payer: UHC Medicare Advantage |
$56.40
|
| Rate for Payer: VA VA |
$56.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.20
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$1.77
|
|
|
Service Code
|
NDC 51079080101
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.15 |
| Max. Negotiated Rate |
$1.59 |
| Rate for Payer: Aetna Commercial |
$1.50
|
| Rate for Payer: BCBS Trust/PPO |
$1.44
|
| Rate for Payer: BCN Commercial |
$1.37
|
| Rate for Payer: Cash Price |
$1.42
|
| Rate for Payer: Cofinity Commercial |
$1.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.42
|
| Rate for Payer: Healthscope Commercial |
$1.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.50
|
| Rate for Payer: Nomi Health Commercial |
$1.45
|
| Rate for Payer: PHP Commercial |
$1.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.56
|
| Rate for Payer: UHC Core |
$1.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.33
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$164.50
|
|
|
Service Code
|
NDC 00904711861
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.07 |
| 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 |
$65.80
|
| Rate for Payer: BCBS MAPPO |
$41.12
|
| Rate for Payer: BCBS Trust/PPO |
$135.24
|
| Rate for Payer: BCN Commercial |
$127.90
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.82
|
| Rate for Payer: Nomi Health Commercial |
$134.89
|
| 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 Cigna Priority Health |
$106.92
|
| Rate for Payer: Priority Health HMO/PPO |
$143.12
|
| Rate for Payer: Priority Health Medicare |
$41.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.22
|
| 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 Dual Complete DSNP |
$41.12
|
| Rate for Payer: UHC Exchange |
$41.12
|
| Rate for Payer: UHC Medicare Advantage |
$41.12
|
| 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
|
$225.60
|
|
|
Service Code
|
NDC 62584026601
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$146.64 |
| Max. Negotiated Rate |
$203.04 |
| Rate for Payer: Aetna Commercial |
$191.76
|
| Rate for Payer: BCBS Trust/PPO |
$184.16
|
| Rate for Payer: BCN Commercial |
$174.34
|
| Rate for Payer: Cash Price |
$180.48
|
| Rate for Payer: Cofinity Commercial |
$194.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.48
|
| Rate for Payer: Healthscope Commercial |
$203.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.76
|
| Rate for Payer: Nomi Health Commercial |
$184.99
|
| Rate for Payer: PHP Commercial |
$191.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.64
|
| Rate for Payer: Priority Health HMO/PPO |
$196.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.53
|
| Rate for Payer: UHC Core |
$188.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.20
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$176.25
|
|
|
Service Code
|
NDC 51079080120
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$41.86 |
| Max. Negotiated Rate |
$158.62 |
| Rate for Payer: Aetna Commercial |
$149.81
|
| Rate for Payer: Aetna Medicare |
$45.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.08
|
| Rate for Payer: BCBS Complete |
$70.50
|
| Rate for Payer: BCBS MAPPO |
$44.06
|
| Rate for Payer: BCBS Trust/PPO |
$144.90
|
| Rate for Payer: BCN Commercial |
$137.03
|
| Rate for Payer: BCN Medicare Advantage |
$44.06
|
| Rate for Payer: Cash Price |
$141.00
|
| Rate for Payer: Cofinity Commercial |
$151.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.06
|
| Rate for Payer: Healthscope Commercial |
$158.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.81
|
| Rate for Payer: Nomi Health Commercial |
$144.53
|
| Rate for Payer: PACE Senior Care Partners |
$41.86
|
| Rate for Payer: PACE SWMI |
$44.06
|
| Rate for Payer: PHP Commercial |
$149.81
|
| Rate for Payer: PHP Medicare Advantage |
$44.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.56
|
| Rate for Payer: Priority Health HMO/PPO |
$153.34
|
| Rate for Payer: Priority Health Medicare |
$44.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.09
|
| Rate for Payer: Railroad Medicare Medicare |
$44.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.10
|
| Rate for Payer: UHC Core |
$147.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.06
|
| Rate for Payer: UHC Exchange |
$44.06
|
| Rate for Payer: UHC Medicare Advantage |
$44.06
|
| Rate for Payer: VA VA |
$44.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.19
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$225.60
|
|
|
Service Code
|
NDC 62584026611
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$146.64 |
| Max. Negotiated Rate |
$203.04 |
| Rate for Payer: Aetna Commercial |
$191.76
|
| Rate for Payer: BCBS Trust/PPO |
$184.16
|
| Rate for Payer: BCN Commercial |
$174.34
|
| Rate for Payer: Cash Price |
$180.48
|
| Rate for Payer: Cofinity Commercial |
$194.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.48
|
| Rate for Payer: Healthscope Commercial |
$203.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.76
|
| Rate for Payer: Nomi Health Commercial |
$184.99
|
| Rate for Payer: PHP Commercial |
$191.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.64
|
| Rate for Payer: Priority Health HMO/PPO |
$196.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.53
|
| Rate for Payer: UHC Core |
$188.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.20
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$1.77
|
|
|
Service Code
|
NDC 51079080101
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.42 |
| Max. Negotiated Rate |
$1.59 |
| Rate for Payer: Aetna Commercial |
$1.50
|
| Rate for Payer: Aetna Medicare |
$0.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.55
|
| Rate for Payer: BCBS Complete |
$0.71
|
| Rate for Payer: BCBS MAPPO |
$0.44
|
| Rate for Payer: BCBS Trust/PPO |
$1.46
|
| Rate for Payer: BCN Commercial |
$1.38
|
| Rate for Payer: BCN Medicare Advantage |
$0.44
|
| Rate for Payer: Cash Price |
$1.42
|
| Rate for Payer: Cofinity Commercial |
$1.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.44
|
| Rate for Payer: Healthscope Commercial |
$1.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.50
|
| Rate for Payer: Nomi Health Commercial |
$1.45
|
| Rate for Payer: PACE Senior Care Partners |
$0.42
|
| Rate for Payer: PACE SWMI |
$0.44
|
| Rate for Payer: PHP Commercial |
$1.50
|
| Rate for Payer: PHP Medicare Advantage |
$0.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1.54
|
| Rate for Payer: Priority Health Medicare |
$0.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.19
|
| Rate for Payer: Railroad Medicare Medicare |
$0.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.56
|
| Rate for Payer: UHC Core |
$1.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.44
|
| Rate for Payer: UHC Exchange |
$0.44
|
| Rate for Payer: UHC Medicare Advantage |
$0.44
|
| Rate for Payer: VA VA |
$0.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.33
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$176.25
|
|
|
Service Code
|
NDC 51079080120
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$114.56 |
| Max. Negotiated Rate |
$158.62 |
| Rate for Payer: Aetna Commercial |
$149.81
|
| Rate for Payer: BCBS Trust/PPO |
$143.87
|
| Rate for Payer: BCN Commercial |
$136.21
|
| Rate for Payer: Cash Price |
$141.00
|
| Rate for Payer: Cofinity Commercial |
$151.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.00
|
| Rate for Payer: Healthscope Commercial |
$158.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.81
|
| Rate for Payer: Nomi Health Commercial |
$144.53
|
| Rate for Payer: PHP Commercial |
$149.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.56
|
| Rate for Payer: Priority Health HMO/PPO |
$153.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.10
|
| Rate for Payer: UHC Core |
$147.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.19
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$164.50
|
|
|
Service Code
|
NDC 00904711861
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$106.92 |
| Max. Negotiated Rate |
$148.05 |
| Rate for Payer: Aetna Commercial |
$139.82
|
| Rate for Payer: BCBS Trust/PPO |
$134.28
|
| Rate for Payer: BCN Commercial |
$127.13
|
| 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: PHP Commercial |
$139.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.92
|
| Rate for Payer: Priority Health HMO/PPO |
$143.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.22
|
| 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 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14.13
|
|
|
Service Code
|
NDC 00409201610
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$12.72 |
| Rate for Payer: Aetna Commercial |
$12.01
|
| Rate for Payer: Aetna Medicare |
$3.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.42
|
| Rate for Payer: BCBS Complete |
$5.65
|
| Rate for Payer: BCBS MAPPO |
$3.53
|
| Rate for Payer: BCBS Trust/PPO |
$11.62
|
| Rate for Payer: BCN Commercial |
$10.99
|
| Rate for Payer: BCN Medicare Advantage |
$3.53
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cofinity Commercial |
$12.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.53
|
| Rate for Payer: Healthscope Commercial |
$12.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.01
|
| Rate for Payer: Nomi Health Commercial |
$11.59
|
| Rate for Payer: PACE Senior Care Partners |
$3.36
|
| Rate for Payer: PACE SWMI |
$3.53
|
| Rate for Payer: PHP Commercial |
$12.01
|
| Rate for Payer: PHP Medicare Advantage |
$3.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.18
|
| Rate for Payer: Priority Health HMO/PPO |
$12.29
|
| Rate for Payer: Priority Health Medicare |
$3.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.47
|
| Rate for Payer: Railroad Medicare Medicare |
$3.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.43
|
| Rate for Payer: UHC Core |
$11.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.53
|
| Rate for Payer: UHC Exchange |
$3.53
|
| Rate for Payer: UHC Medicare Advantage |
$3.53
|
| Rate for Payer: VA VA |
$3.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.60
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14.13
|
|
|
Service Code
|
NDC 00409177805
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.18 |
| Max. Negotiated Rate |
$12.72 |
| Rate for Payer: Aetna Commercial |
$12.01
|
| Rate for Payer: BCBS Trust/PPO |
$11.53
|
| Rate for Payer: BCN Commercial |
$10.92
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cofinity Commercial |
$12.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.30
|
| Rate for Payer: Healthscope Commercial |
$12.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.01
|
| Rate for Payer: Nomi Health Commercial |
$11.59
|
| Rate for Payer: PHP Commercial |
$12.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.18
|
| Rate for Payer: Priority Health HMO/PPO |
$12.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.43
|
| Rate for Payer: UHC Core |
$11.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.60
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14.13
|
|
|
Service Code
|
NDC 00409201610
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.18 |
| Max. Negotiated Rate |
$12.72 |
| Rate for Payer: Aetna Commercial |
$12.01
|
| Rate for Payer: BCBS Trust/PPO |
$11.53
|
| Rate for Payer: BCN Commercial |
$10.92
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cofinity Commercial |
$12.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.30
|
| Rate for Payer: Healthscope Commercial |
$12.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.01
|
| Rate for Payer: Nomi Health Commercial |
$11.59
|
| Rate for Payer: PHP Commercial |
$12.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.18
|
| Rate for Payer: Priority Health HMO/PPO |
$12.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.43
|
| Rate for Payer: UHC Core |
$11.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.60
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$16.13
|
|
|
Service Code
|
NDC 72611074001
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Aetna Commercial |
$13.71
|
| Rate for Payer: Aetna Medicare |
$4.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.04
|
| Rate for Payer: BCBS Complete |
$6.45
|
| Rate for Payer: BCBS MAPPO |
$4.03
|
| Rate for Payer: BCBS Trust/PPO |
$13.26
|
| Rate for Payer: BCN Commercial |
$12.54
|
| Rate for Payer: BCN Medicare Advantage |
$4.03
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cofinity Commercial |
$13.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.03
|
| Rate for Payer: Healthscope Commercial |
$14.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.71
|
| Rate for Payer: Nomi Health Commercial |
$13.23
|
| Rate for Payer: PACE Senior Care Partners |
$3.83
|
| Rate for Payer: PACE SWMI |
$4.03
|
| Rate for Payer: PHP Commercial |
$13.71
|
| Rate for Payer: PHP Medicare Advantage |
$4.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.48
|
| Rate for Payer: Priority Health HMO/PPO |
$14.03
|
| Rate for Payer: Priority Health Medicare |
$4.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.81
|
| Rate for Payer: Railroad Medicare Medicare |
$4.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.19
|
| Rate for Payer: UHC Core |
$13.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.03
|
| Rate for Payer: UHC Exchange |
$4.03
|
| Rate for Payer: UHC Medicare Advantage |
$4.03
|
| Rate for Payer: VA VA |
$4.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.10
|
|
|
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 |
$3.98 |
| Max. Negotiated Rate |
$15.07 |
| Rate for Payer: Aetna Commercial |
$14.24
|
| Rate for Payer: Aetna Medicare |
$4.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.23
|
| Rate for Payer: BCBS Complete |
$6.70
|
| Rate for Payer: BCBS MAPPO |
$4.19
|
| Rate for Payer: BCBS Trust/PPO |
$13.77
|
| Rate for Payer: BCN Commercial |
$13.02
|
| Rate for Payer: BCN Medicare Advantage |
$4.19
|
| Rate for Payer: Cash Price |
$13.40
|
| Rate for Payer: Cofinity Commercial |
$14.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.19
|
| Rate for Payer: Healthscope Commercial |
$15.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.24
|
| Rate for Payer: Nomi Health Commercial |
$13.73
|
| Rate for Payer: PACE Senior Care Partners |
$3.98
|
| Rate for Payer: PACE SWMI |
$4.19
|
| Rate for Payer: PHP Commercial |
$14.24
|
| Rate for Payer: PHP Medicare Advantage |
$4.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.89
|
| Rate for Payer: Priority Health HMO/PPO |
$14.57
|
| Rate for Payer: Priority Health Medicare |
$4.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.22
|
| Rate for Payer: Railroad Medicare Medicare |
$4.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.74
|
| Rate for Payer: UHC Core |
$13.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.19
|
| Rate for Payer: UHC Exchange |
$4.19
|
| Rate for Payer: UHC Medicare Advantage |
$4.19
|
| Rate for Payer: VA VA |
$4.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.56
|
|
|
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 |
$3.83 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Aetna Commercial |
$13.71
|
| Rate for Payer: Aetna Medicare |
$4.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.04
|
| Rate for Payer: BCBS Complete |
$6.45
|
| Rate for Payer: BCBS MAPPO |
$4.03
|
| Rate for Payer: BCBS Trust/PPO |
$13.26
|
| Rate for Payer: BCN Commercial |
$12.54
|
| Rate for Payer: BCN Medicare Advantage |
$4.03
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cofinity Commercial |
$13.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.03
|
| Rate for Payer: Healthscope Commercial |
$14.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.71
|
| Rate for Payer: Nomi Health Commercial |
$13.23
|
| Rate for Payer: PACE Senior Care Partners |
$3.83
|
| Rate for Payer: PACE SWMI |
$4.03
|
| Rate for Payer: PHP Commercial |
$13.71
|
| Rate for Payer: PHP Medicare Advantage |
$4.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.48
|
| Rate for Payer: Priority Health HMO/PPO |
$14.03
|
| Rate for Payer: Priority Health Medicare |
$4.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.81
|
| Rate for Payer: Railroad Medicare Medicare |
$4.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.19
|
| Rate for Payer: UHC Core |
$13.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.03
|
| Rate for Payer: UHC Exchange |
$4.03
|
| Rate for Payer: UHC Medicare Advantage |
$4.03
|
| Rate for Payer: VA VA |
$4.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.10
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$16.75
|
|
|
Service Code
|
NDC 36000003310
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.89 |
| Max. Negotiated Rate |
$15.07 |
| Rate for Payer: Aetna Commercial |
$14.24
|
| Rate for Payer: BCBS Trust/PPO |
$13.67
|
| Rate for Payer: BCN Commercial |
$12.94
|
| Rate for Payer: Cash Price |
$13.40
|
| Rate for Payer: Cofinity Commercial |
$14.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.40
|
| Rate for Payer: Healthscope Commercial |
$15.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.24
|
| Rate for Payer: Nomi Health Commercial |
$13.73
|
| Rate for Payer: PHP Commercial |
$14.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.89
|
| Rate for Payer: Priority Health HMO/PPO |
$14.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.74
|
| Rate for Payer: UHC Core |
$13.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.56
|
|
|
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 |
$10.48 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Aetna Commercial |
$13.71
|
| Rate for Payer: BCBS Trust/PPO |
$13.17
|
| Rate for Payer: BCN Commercial |
$12.47
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cofinity Commercial |
$13.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$14.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.71
|
| Rate for Payer: Nomi Health Commercial |
$13.23
|
| Rate for Payer: PHP Commercial |
$13.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.48
|
| Rate for Payer: Priority Health HMO/PPO |
$14.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.19
|
| Rate for Payer: UHC Core |
$13.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.10
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$16.13
|
|
|
Service Code
|
NDC 72611074010
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.48 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Aetna Commercial |
$13.71
|
| Rate for Payer: BCBS Trust/PPO |
$13.17
|
| Rate for Payer: BCN Commercial |
$12.47
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cofinity Commercial |
$13.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$14.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.71
|
| Rate for Payer: Nomi Health Commercial |
$13.23
|
| Rate for Payer: PHP Commercial |
$13.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.48
|
| Rate for Payer: Priority Health HMO/PPO |
$14.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.19
|
| Rate for Payer: UHC Core |
$13.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.10
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14.13
|
|
|
Service Code
|
NDC 00409177805
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$12.72 |
| Rate for Payer: Aetna Commercial |
$12.01
|
| Rate for Payer: Aetna Medicare |
$3.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.42
|
| Rate for Payer: BCBS Complete |
$5.65
|
| Rate for Payer: BCBS MAPPO |
$3.53
|
| Rate for Payer: BCBS Trust/PPO |
$11.62
|
| Rate for Payer: BCN Commercial |
$10.99
|
| Rate for Payer: BCN Medicare Advantage |
$3.53
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cofinity Commercial |
$12.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.53
|
| Rate for Payer: Healthscope Commercial |
$12.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.01
|
| Rate for Payer: Nomi Health Commercial |
$11.59
|
| Rate for Payer: PACE Senior Care Partners |
$3.36
|
| Rate for Payer: PACE SWMI |
$3.53
|
| Rate for Payer: PHP Commercial |
$12.01
|
| Rate for Payer: PHP Medicare Advantage |
$3.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.18
|
| Rate for Payer: Priority Health HMO/PPO |
$12.29
|
| Rate for Payer: Priority Health Medicare |
$3.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.47
|
| Rate for Payer: Railroad Medicare Medicare |
$3.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.43
|
| Rate for Payer: UHC Core |
$11.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.53
|
| Rate for Payer: UHC Exchange |
$3.53
|
| Rate for Payer: UHC Medicare Advantage |
$3.53
|
| Rate for Payer: VA VA |
$3.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.60
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14.13
|
|
|
Service Code
|
NDC 00409201605
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.18 |
| Max. Negotiated Rate |
$12.72 |
| Rate for Payer: Aetna Commercial |
$12.01
|
| Rate for Payer: BCBS Trust/PPO |
$11.53
|
| Rate for Payer: BCN Commercial |
$10.92
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cofinity Commercial |
$12.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.30
|
| Rate for Payer: Healthscope Commercial |
$12.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.01
|
| Rate for Payer: Nomi Health Commercial |
$11.59
|
| Rate for Payer: PHP Commercial |
$12.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.18
|
| Rate for Payer: Priority Health HMO/PPO |
$12.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.43
|
| Rate for Payer: UHC Core |
$11.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.60
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14.13
|
|
|
Service Code
|
NDC 00409177815
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$12.72 |
| Rate for Payer: Aetna Commercial |
$12.01
|
| Rate for Payer: Aetna Medicare |
$3.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.42
|
| Rate for Payer: BCBS Complete |
$5.65
|
| Rate for Payer: BCBS MAPPO |
$3.53
|
| Rate for Payer: BCBS Trust/PPO |
$11.62
|
| Rate for Payer: BCN Commercial |
$10.99
|
| Rate for Payer: BCN Medicare Advantage |
$3.53
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cofinity Commercial |
$12.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.53
|
| Rate for Payer: Healthscope Commercial |
$12.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.01
|
| Rate for Payer: Nomi Health Commercial |
$11.59
|
| Rate for Payer: PACE Senior Care Partners |
$3.36
|
| Rate for Payer: PACE SWMI |
$3.53
|
| Rate for Payer: PHP Commercial |
$12.01
|
| Rate for Payer: PHP Medicare Advantage |
$3.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.18
|
| Rate for Payer: Priority Health HMO/PPO |
$12.29
|
| Rate for Payer: Priority Health Medicare |
$3.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.47
|
| Rate for Payer: Railroad Medicare Medicare |
$3.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.43
|
| Rate for Payer: UHC Core |
$11.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.53
|
| Rate for Payer: UHC Exchange |
$3.53
|
| Rate for Payer: UHC Medicare Advantage |
$3.53
|
| Rate for Payer: VA VA |
$3.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.60
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14.13
|
|
|
Service Code
|
NDC 00409201605
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$12.72 |
| Rate for Payer: Aetna Commercial |
$12.01
|
| Rate for Payer: Aetna Medicare |
$3.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.42
|
| Rate for Payer: BCBS Complete |
$5.65
|
| Rate for Payer: BCBS MAPPO |
$3.53
|
| Rate for Payer: BCBS Trust/PPO |
$11.62
|
| Rate for Payer: BCN Commercial |
$10.99
|
| Rate for Payer: BCN Medicare Advantage |
$3.53
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cofinity Commercial |
$12.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.53
|
| Rate for Payer: Healthscope Commercial |
$12.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.01
|
| Rate for Payer: Nomi Health Commercial |
$11.59
|
| Rate for Payer: PACE Senior Care Partners |
$3.36
|
| Rate for Payer: PACE SWMI |
$3.53
|
| Rate for Payer: PHP Commercial |
$12.01
|
| Rate for Payer: PHP Medicare Advantage |
$3.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.18
|
| Rate for Payer: Priority Health HMO/PPO |
$12.29
|
| Rate for Payer: Priority Health Medicare |
$3.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.47
|
| Rate for Payer: Railroad Medicare Medicare |
$3.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.43
|
| Rate for Payer: UHC Core |
$11.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.53
|
| Rate for Payer: UHC Exchange |
$3.53
|
| Rate for Payer: UHC Medicare Advantage |
$3.53
|
| Rate for Payer: VA VA |
$3.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.60
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14.13
|
|
|
Service Code
|
NDC 00409177815
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.18 |
| Max. Negotiated Rate |
$12.72 |
| Rate for Payer: Aetna Commercial |
$12.01
|
| Rate for Payer: BCBS Trust/PPO |
$11.53
|
| Rate for Payer: BCN Commercial |
$10.92
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cofinity Commercial |
$12.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.30
|
| Rate for Payer: Healthscope Commercial |
$12.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.01
|
| Rate for Payer: Nomi Health Commercial |
$11.59
|
| Rate for Payer: PHP Commercial |
$12.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.18
|
| Rate for Payer: Priority Health HMO/PPO |
$12.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.43
|
| Rate for Payer: UHC Core |
$11.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.60
|
|
|
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLORIDE IVPB (PARTIAL PACKAGE)
|
Facility
|
OP
|
$67.19
|
|
|
Service Code
|
HCPCS J1836
|
| Hospital Charge Code |
165987
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.96 |
| Max. Negotiated Rate |
$60.47 |
| Rate for Payer: Aetna Commercial |
$57.11
|
| Rate for Payer: Aetna Commercial |
$53.49
|
| Rate for Payer: Aetna Medicare |
$17.47
|
| Rate for Payer: Aetna Medicare |
$16.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.67
|
| Rate for Payer: BCBS Complete |
$25.17
|
| Rate for Payer: BCBS Complete |
$26.88
|
| Rate for Payer: BCBS MAPPO |
$15.73
|
| Rate for Payer: BCBS MAPPO |
$16.80
|
| Rate for Payer: BCBS Trust/PPO |
$55.24
|
| Rate for Payer: BCBS Trust/PPO |
$51.73
|
| Rate for Payer: BCN Commercial |
$52.24
|
| Rate for Payer: BCN Commercial |
$48.93
|
| Rate for Payer: BCN Medicare Advantage |
$16.80
|
| Rate for Payer: BCN Medicare Advantage |
$15.73
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$50.34
|
| Rate for Payer: Cofinity Commercial |
$54.12
|
| Rate for Payer: Cofinity Commercial |
$57.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.80
|
| Rate for Payer: Healthscope Commercial |
$56.64
|
| Rate for Payer: Healthscope Commercial |
$60.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.49
|
| Rate for Payer: Nomi Health Commercial |
$55.10
|
| Rate for Payer: Nomi Health Commercial |
$51.60
|
| Rate for Payer: PACE Senior Care Partners |
$15.96
|
| Rate for Payer: PACE Senior Care Partners |
$14.95
|
| Rate for Payer: PACE SWMI |
$16.80
|
| Rate for Payer: PACE SWMI |
$15.73
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: PHP Commercial |
$53.49
|
| Rate for Payer: PHP Medicare Advantage |
$15.73
|
| Rate for Payer: PHP Medicare Advantage |
$16.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.90
|
| Rate for Payer: Priority Health HMO/PPO |
$54.75
|
| Rate for Payer: Priority Health HMO/PPO |
$58.46
|
| Rate for Payer: Priority Health Medicare |
$16.97
|
| Rate for Payer: Priority Health Medicare |
$15.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.16
|
| Rate for Payer: Railroad Medicare Medicare |
$15.73
|
| Rate for Payer: Railroad Medicare Medicare |
$16.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.13
|
| Rate for Payer: UHC Core |
$56.10
|
| Rate for Payer: UHC Core |
$52.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.73
|
| Rate for Payer: UHC Exchange |
$15.73
|
| Rate for Payer: UHC Exchange |
$16.80
|
| Rate for Payer: UHC Medicare Advantage |
$15.73
|
| Rate for Payer: UHC Medicare Advantage |
$16.80
|
| Rate for Payer: VA VA |
$15.73
|
| Rate for Payer: VA VA |
$16.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.20
|
|
