|
METOLAZONE 5 MG TABLET
|
Facility
|
IP
|
$250.08
|
|
|
Service Code
|
NDC 00185005501
|
| Hospital Charge Code |
10588
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$110.04 |
| Max. Negotiated Rate |
$225.07 |
| Rate for Payer: Aetna American Axle |
$162.55
|
| Rate for Payer: Aetna Commercial |
$212.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.55
|
| Rate for Payer: Cash Price |
$200.06
|
| Rate for Payer: Cofinity Advantage |
$175.06
|
| Rate for Payer: Cofinity Commercial |
$215.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.06
|
| Rate for Payer: Healthscope Commercial |
$225.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.56
|
| Rate for Payer: PHP Commercial |
$212.57
|
| Rate for Payer: Priority Health SBD |
$157.55
|
| Rate for Payer: UMR Bronson Commercial |
$110.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.56
|
|
|
METOLAZONE 5 MG TABLET
|
Facility
|
IP
|
$895.40
|
|
|
Service Code
|
NDC 00904713961
|
| Hospital Charge Code |
10588
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$393.98 |
| Max. Negotiated Rate |
$805.86 |
| Rate for Payer: Aetna American Axle |
$582.01
|
| Rate for Payer: Aetna Commercial |
$761.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$582.01
|
| Rate for Payer: Cash Price |
$716.32
|
| Rate for Payer: Cofinity Advantage |
$626.78
|
| Rate for Payer: Cofinity Commercial |
$770.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$716.32
|
| Rate for Payer: Healthscope Commercial |
$805.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$626.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$671.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$761.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$671.55
|
| Rate for Payer: PHP Commercial |
$761.09
|
| Rate for Payer: Priority Health SBD |
$564.10
|
| Rate for Payer: UMR Bronson Commercial |
$393.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$671.55
|
|
|
METOLAZONE 5 MG TABLET
|
Facility
|
IP
|
$1,200.28
|
|
|
Service Code
|
NDC 51079002420
|
| Hospital Charge Code |
10588
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$528.12 |
| Max. Negotiated Rate |
$1,080.25 |
| Rate for Payer: Aetna American Axle |
$780.18
|
| Rate for Payer: Aetna Commercial |
$1,020.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$780.18
|
| Rate for Payer: Cash Price |
$960.22
|
| Rate for Payer: Cofinity Advantage |
$840.20
|
| Rate for Payer: Cofinity Commercial |
$1,032.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$960.22
|
| Rate for Payer: Healthscope Commercial |
$1,080.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$840.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$900.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,020.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$900.21
|
| Rate for Payer: PHP Commercial |
$1,020.24
|
| Rate for Payer: Priority Health SBD |
$756.18
|
| Rate for Payer: UMR Bronson Commercial |
$528.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$900.21
|
|
|
METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$392.45
|
|
|
Service Code
|
NDC 24979003901
|
| Hospital Charge Code |
30071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$172.68 |
| Max. Negotiated Rate |
$353.20 |
| Rate for Payer: Aetna American Axle |
$255.09
|
| Rate for Payer: Aetna Commercial |
$333.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.09
|
| Rate for Payer: Cash Price |
$313.96
|
| Rate for Payer: Cofinity Advantage |
$274.71
|
| Rate for Payer: Cofinity Commercial |
$337.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.96
|
| Rate for Payer: Healthscope Commercial |
$353.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$274.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$294.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$294.34
|
| Rate for Payer: PHP Commercial |
$333.58
|
| Rate for Payer: Priority Health SBD |
$247.24
|
| Rate for Payer: UMR Bronson Commercial |
$172.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$294.34
|
|
|
METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$333.45
|
|
|
Service Code
|
NDC 45963067711
|
| Hospital Charge Code |
30071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$146.72 |
| Max. Negotiated Rate |
$300.11 |
| Rate for Payer: Aetna American Axle |
$216.74
|
| Rate for Payer: Aetna Commercial |
$283.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.74
|
| Rate for Payer: Cash Price |
$266.76
|
| Rate for Payer: Cofinity Advantage |
$233.41
|
| Rate for Payer: Cofinity Commercial |
$286.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.76
|
| Rate for Payer: Healthscope Commercial |
$300.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$250.09
|
| Rate for Payer: PHP Commercial |
$283.43
|
| Rate for Payer: Priority Health SBD |
$210.07
|
| Rate for Payer: UMR Bronson Commercial |
$146.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.09
|
|
|
METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$328.70
|
|
|
Service Code
|
NDC 00527260237
|
| Hospital Charge Code |
30071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$144.63 |
| Max. Negotiated Rate |
$295.83 |
| Rate for Payer: Aetna American Axle |
$213.66
|
| Rate for Payer: Aetna Commercial |
$279.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.66
|
| Rate for Payer: Cash Price |
$262.96
|
| Rate for Payer: Cofinity Advantage |
$230.09
|
| Rate for Payer: Cofinity Commercial |
$282.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.96
|
| Rate for Payer: Healthscope Commercial |
$295.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$230.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.53
|
| Rate for Payer: PHP Commercial |
$279.39
|
| Rate for Payer: Priority Health SBD |
$207.08
|
| Rate for Payer: UMR Bronson Commercial |
$144.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.53
|
|
|
METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$392.45
|
|
|
Service Code
|
NDC 24979003901
|
| Hospital Charge Code |
30071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$145.21 |
| Max. Negotiated Rate |
$353.20 |
| Rate for Payer: Aetna American Axle |
$255.09
|
| Rate for Payer: Aetna Commercial |
$333.58
|
| Rate for Payer: Aetna Medicare |
$196.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.09
|
| Rate for Payer: BCBS Complete |
$156.98
|
| Rate for Payer: Cash Price |
$313.96
|
| Rate for Payer: Cofinity Advantage |
$274.71
|
| Rate for Payer: Cofinity Commercial |
$337.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.96
|
| Rate for Payer: Healthscope Commercial |
$353.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$274.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$294.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$313.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$294.34
|
| Rate for Payer: PHP Commercial |
$333.58
|
| Rate for Payer: Priority Health SBD |
$247.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.09
|
| Rate for Payer: UHC Core |
$204.47
|
| Rate for Payer: UHC Exchange |
$154.23
|
| Rate for Payer: UMR Bronson Commercial |
$145.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$294.34
|
|
|
METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$323.00
|
|
|
Service Code
|
NDC 55111046801
|
| Hospital Charge Code |
30071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.51 |
| Max. Negotiated Rate |
$290.70 |
| Rate for Payer: Aetna American Axle |
$209.95
|
| Rate for Payer: Aetna Commercial |
$274.55
|
| Rate for Payer: Aetna Medicare |
$161.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.95
|
| Rate for Payer: BCBS Complete |
$129.20
|
| Rate for Payer: Cash Price |
$258.40
|
| Rate for Payer: Cofinity Advantage |
$226.10
|
| Rate for Payer: Cofinity Commercial |
$277.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.40
|
| Rate for Payer: Healthscope Commercial |
$290.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$226.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$242.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$258.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$242.25
|
| Rate for Payer: PHP Commercial |
$274.55
|
| Rate for Payer: Priority Health SBD |
$203.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.95
|
| Rate for Payer: UHC Core |
$168.28
|
| Rate for Payer: UHC Exchange |
$126.94
|
| Rate for Payer: UMR Bronson Commercial |
$119.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$242.25
|
|
|
METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$343.68
|
|
|
Service Code
|
NDC 00904632461
|
| Hospital Charge Code |
30071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$151.22 |
| Max. Negotiated Rate |
$309.31 |
| Rate for Payer: Aetna American Axle |
$223.39
|
| Rate for Payer: Aetna Commercial |
$292.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.39
|
| Rate for Payer: Cash Price |
$274.94
|
| Rate for Payer: Cofinity Advantage |
$240.58
|
| Rate for Payer: Cofinity Commercial |
$295.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.94
|
| Rate for Payer: Healthscope Commercial |
$309.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$240.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$292.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.76
|
| Rate for Payer: PHP Commercial |
$292.13
|
| Rate for Payer: Priority Health SBD |
$216.52
|
| Rate for Payer: UMR Bronson Commercial |
$151.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.76
|
|
|
METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$343.68
|
|
|
Service Code
|
NDC 00904632461
|
| Hospital Charge Code |
30071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$127.16 |
| Max. Negotiated Rate |
$309.31 |
| Rate for Payer: Aetna American Axle |
$223.39
|
| Rate for Payer: Aetna Commercial |
$292.13
|
| Rate for Payer: Aetna Medicare |
$171.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.39
|
| Rate for Payer: BCBS Complete |
$137.47
|
| Rate for Payer: Cash Price |
$274.94
|
| Rate for Payer: Cofinity Advantage |
$240.58
|
| Rate for Payer: Cofinity Commercial |
$295.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.94
|
| Rate for Payer: Healthscope Commercial |
$309.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$240.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$292.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.76
|
| Rate for Payer: PHP Commercial |
$292.13
|
| Rate for Payer: Priority Health SBD |
$216.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.39
|
| Rate for Payer: UHC Core |
$179.06
|
| Rate for Payer: UHC Exchange |
$135.07
|
| Rate for Payer: UMR Bronson Commercial |
$127.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.76
|
|
|
METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$328.70
|
|
|
Service Code
|
NDC 00527260237
|
| Hospital Charge Code |
30071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$121.62 |
| Max. Negotiated Rate |
$295.83 |
| Rate for Payer: Aetna American Axle |
$213.66
|
| Rate for Payer: Aetna Commercial |
$279.39
|
| Rate for Payer: Aetna Medicare |
$164.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.66
|
| Rate for Payer: BCBS Complete |
$131.48
|
| Rate for Payer: Cash Price |
$262.96
|
| Rate for Payer: Cofinity Advantage |
$230.09
|
| Rate for Payer: Cofinity Commercial |
$282.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.96
|
| Rate for Payer: Healthscope Commercial |
$295.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$230.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$262.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.53
|
| Rate for Payer: PHP Commercial |
$279.39
|
| Rate for Payer: Priority Health SBD |
$207.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.66
|
| Rate for Payer: UHC Core |
$171.25
|
| Rate for Payer: UHC Exchange |
$129.18
|
| Rate for Payer: UMR Bronson Commercial |
$121.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.53
|
|
|
METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$323.00
|
|
|
Service Code
|
NDC 55111046801
|
| Hospital Charge Code |
30071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$142.12 |
| Max. Negotiated Rate |
$290.70 |
| Rate for Payer: Aetna American Axle |
$209.95
|
| Rate for Payer: Aetna Commercial |
$274.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.95
|
| Rate for Payer: Cash Price |
$258.40
|
| Rate for Payer: Cofinity Advantage |
$226.10
|
| Rate for Payer: Cofinity Commercial |
$277.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.40
|
| Rate for Payer: Healthscope Commercial |
$290.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$226.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$242.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$242.25
|
| Rate for Payer: PHP Commercial |
$274.55
|
| Rate for Payer: Priority Health SBD |
$203.49
|
| Rate for Payer: UMR Bronson Commercial |
$142.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$242.25
|
|
|
METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$333.45
|
|
|
Service Code
|
NDC 45963067711
|
| Hospital Charge Code |
30071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$123.38 |
| Max. Negotiated Rate |
$300.11 |
| Rate for Payer: Aetna American Axle |
$216.74
|
| Rate for Payer: Aetna Commercial |
$283.43
|
| Rate for Payer: Aetna Medicare |
$166.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.74
|
| Rate for Payer: BCBS Complete |
$133.38
|
| Rate for Payer: Cash Price |
$266.76
|
| Rate for Payer: Cofinity Advantage |
$233.41
|
| Rate for Payer: Cofinity Commercial |
$286.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.76
|
| Rate for Payer: Healthscope Commercial |
$300.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$266.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$250.09
|
| Rate for Payer: PHP Commercial |
$283.43
|
| Rate for Payer: Priority Health SBD |
$210.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.74
|
| Rate for Payer: UHC Core |
$173.73
|
| Rate for Payer: UHC Exchange |
$131.05
|
| Rate for Payer: UMR Bronson Commercial |
$123.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.09
|
|
|
METOPROLOL SUCCINATE ER 12.5 MG CUSTOM TAB
|
Facility
|
OP
|
$240.48
|
|
|
Service Code
|
NDC 09900000013
|
| Hospital Charge Code |
150704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$88.98 |
| Max. Negotiated Rate |
$216.43 |
| Rate for Payer: Aetna American Axle |
$156.31
|
| Rate for Payer: Aetna Commercial |
$204.41
|
| Rate for Payer: Aetna Medicare |
$120.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.31
|
| Rate for Payer: BCBS Complete |
$96.19
|
| Rate for Payer: Cash Price |
$192.38
|
| Rate for Payer: Cofinity Advantage |
$168.34
|
| Rate for Payer: Cofinity Commercial |
$206.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.38
|
| Rate for Payer: Healthscope Commercial |
$216.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$192.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.36
|
| Rate for Payer: PHP Commercial |
$204.41
|
| Rate for Payer: Priority Health SBD |
$151.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.31
|
| Rate for Payer: UHC Core |
$125.29
|
| Rate for Payer: UHC Exchange |
$94.51
|
| Rate for Payer: UMR Bronson Commercial |
$88.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.36
|
|
|
METOPROLOL SUCCINATE ER 12.5 MG CUSTOM TAB
|
Facility
|
IP
|
$240.48
|
|
|
Service Code
|
NDC 09900000013
|
| Hospital Charge Code |
150704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$105.81 |
| Max. Negotiated Rate |
$216.43 |
| Rate for Payer: Aetna American Axle |
$156.31
|
| Rate for Payer: Aetna Commercial |
$204.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.31
|
| Rate for Payer: Cash Price |
$192.38
|
| Rate for Payer: Cofinity Advantage |
$168.34
|
| Rate for Payer: Cofinity Commercial |
$206.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.38
|
| Rate for Payer: Healthscope Commercial |
$216.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.36
|
| Rate for Payer: PHP Commercial |
$204.41
|
| Rate for Payer: Priority Health SBD |
$151.50
|
| Rate for Payer: UMR Bronson Commercial |
$105.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.36
|
|
|
METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$414.20
|
|
|
Service Code
|
NDC 51079016920
|
| Hospital Charge Code |
29858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$182.25 |
| Max. Negotiated Rate |
$372.78 |
| Rate for Payer: Aetna American Axle |
$269.23
|
| Rate for Payer: Aetna Commercial |
$352.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.23
|
| Rate for Payer: Cash Price |
$331.36
|
| Rate for Payer: Cofinity Advantage |
$289.94
|
| Rate for Payer: Cofinity Commercial |
$356.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.36
|
| Rate for Payer: Healthscope Commercial |
$372.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$289.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$310.65
|
| Rate for Payer: PHP Commercial |
$352.07
|
| Rate for Payer: Priority Health SBD |
$260.95
|
| Rate for Payer: UMR Bronson Commercial |
$182.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.65
|
|
|
METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$4.15
|
|
|
Service Code
|
NDC 51079016901
|
| Hospital Charge Code |
29858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.83 |
| Max. Negotiated Rate |
$3.73 |
| Rate for Payer: Aetna American Axle |
$2.70
|
| Rate for Payer: Aetna Commercial |
$3.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.70
|
| Rate for Payer: Cash Price |
$3.32
|
| Rate for Payer: Cofinity Advantage |
$2.90
|
| Rate for Payer: Cofinity Commercial |
$3.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.32
|
| Rate for Payer: Healthscope Commercial |
$3.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.11
|
| Rate for Payer: PHP Commercial |
$3.53
|
| Rate for Payer: Priority Health SBD |
$2.61
|
| Rate for Payer: UMR Bronson Commercial |
$1.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.11
|
|
|
METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$304.32
|
|
|
Service Code
|
NDC 60687039001
|
| Hospital Charge Code |
29858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$112.60 |
| Max. Negotiated Rate |
$273.89 |
| Rate for Payer: Aetna American Axle |
$197.81
|
| Rate for Payer: Aetna Commercial |
$258.67
|
| Rate for Payer: Aetna Medicare |
$152.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.81
|
| Rate for Payer: BCBS Complete |
$121.73
|
| Rate for Payer: Cash Price |
$243.46
|
| Rate for Payer: Cofinity Advantage |
$213.02
|
| Rate for Payer: Cofinity Commercial |
$261.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.46
|
| Rate for Payer: Healthscope Commercial |
$273.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$243.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.24
|
| Rate for Payer: PHP Commercial |
$258.67
|
| Rate for Payer: Priority Health SBD |
$191.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.81
|
| Rate for Payer: UHC Core |
$158.55
|
| Rate for Payer: UHC Exchange |
$119.60
|
| Rate for Payer: UMR Bronson Commercial |
$112.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.24
|
|
|
METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$3.05
|
|
|
Service Code
|
NDC 60687039011
|
| Hospital Charge Code |
29858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.34 |
| Max. Negotiated Rate |
$2.75 |
| Rate for Payer: Aetna American Axle |
$1.98
|
| Rate for Payer: Aetna Commercial |
$2.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.98
|
| Rate for Payer: Cash Price |
$2.44
|
| Rate for Payer: Cofinity Advantage |
$2.13
|
| Rate for Payer: Cofinity Commercial |
$2.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.44
|
| Rate for Payer: Healthscope Commercial |
$2.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.29
|
| Rate for Payer: PHP Commercial |
$2.59
|
| Rate for Payer: Priority Health SBD |
$1.92
|
| Rate for Payer: UMR Bronson Commercial |
$1.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.29
|
|
|
METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$136.30
|
|
|
Service Code
|
NDC 72516003001
|
| Hospital Charge Code |
29858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$59.97 |
| Max. Negotiated Rate |
$122.67 |
| Rate for Payer: Aetna American Axle |
$88.59
|
| Rate for Payer: Aetna Commercial |
$115.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.59
|
| Rate for Payer: Cash Price |
$109.04
|
| Rate for Payer: Cofinity Advantage |
$95.41
|
| Rate for Payer: Cofinity Commercial |
$117.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.04
|
| Rate for Payer: Healthscope Commercial |
$122.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.22
|
| Rate for Payer: PHP Commercial |
$115.86
|
| Rate for Payer: Priority Health SBD |
$85.87
|
| Rate for Payer: UMR Bronson Commercial |
$59.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.22
|
|
|
METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$304.32
|
|
|
Service Code
|
NDC 60687039001
|
| Hospital Charge Code |
29858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$133.90 |
| Max. Negotiated Rate |
$273.89 |
| Rate for Payer: Aetna American Axle |
$197.81
|
| Rate for Payer: Aetna Commercial |
$258.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.81
|
| Rate for Payer: Cash Price |
$243.46
|
| Rate for Payer: Cofinity Advantage |
$213.02
|
| Rate for Payer: Cofinity Commercial |
$261.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.46
|
| Rate for Payer: Healthscope Commercial |
$273.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.24
|
| Rate for Payer: PHP Commercial |
$258.67
|
| Rate for Payer: Priority Health SBD |
$191.72
|
| Rate for Payer: UMR Bronson Commercial |
$133.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.24
|
|
|
METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$326.65
|
|
|
Service Code
|
NDC 24979003701
|
| Hospital Charge Code |
29858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$143.73 |
| Max. Negotiated Rate |
$293.99 |
| Rate for Payer: Aetna American Axle |
$212.32
|
| Rate for Payer: Aetna Commercial |
$277.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.32
|
| Rate for Payer: Cash Price |
$261.32
|
| Rate for Payer: Cofinity Advantage |
$228.66
|
| Rate for Payer: Cofinity Commercial |
$280.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.32
|
| Rate for Payer: Healthscope Commercial |
$293.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$228.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$244.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$244.99
|
| Rate for Payer: PHP Commercial |
$277.65
|
| Rate for Payer: Priority Health SBD |
$205.79
|
| Rate for Payer: UMR Bronson Commercial |
$143.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$244.99
|
|
|
METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$215.65
|
|
|
Service Code
|
NDC 55111046601
|
| Hospital Charge Code |
29858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$79.79 |
| Max. Negotiated Rate |
$194.09 |
| Rate for Payer: Aetna American Axle |
$140.17
|
| Rate for Payer: Aetna Commercial |
$183.30
|
| Rate for Payer: Aetna Medicare |
$107.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.17
|
| Rate for Payer: BCBS Complete |
$86.26
|
| Rate for Payer: Cash Price |
$172.52
|
| Rate for Payer: Cofinity Advantage |
$150.96
|
| Rate for Payer: Cofinity Commercial |
$185.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.52
|
| Rate for Payer: Healthscope Commercial |
$194.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$150.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.74
|
| Rate for Payer: PHP Commercial |
$183.30
|
| Rate for Payer: Priority Health SBD |
$135.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.17
|
| Rate for Payer: UHC Core |
$112.35
|
| Rate for Payer: UHC Exchange |
$84.75
|
| Rate for Payer: UMR Bronson Commercial |
$79.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.74
|
|
|
METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$326.65
|
|
|
Service Code
|
NDC 24979003701
|
| Hospital Charge Code |
29858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$120.86 |
| Max. Negotiated Rate |
$293.99 |
| Rate for Payer: Aetna American Axle |
$212.32
|
| Rate for Payer: Aetna Commercial |
$277.65
|
| Rate for Payer: Aetna Medicare |
$163.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.32
|
| Rate for Payer: BCBS Complete |
$130.66
|
| Rate for Payer: Cash Price |
$261.32
|
| Rate for Payer: Cofinity Advantage |
$228.66
|
| Rate for Payer: Cofinity Commercial |
$280.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.32
|
| Rate for Payer: Healthscope Commercial |
$293.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$228.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$244.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$244.99
|
| Rate for Payer: PHP Commercial |
$277.65
|
| Rate for Payer: Priority Health SBD |
$205.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.32
|
| Rate for Payer: UHC Core |
$170.18
|
| Rate for Payer: UHC Exchange |
$128.37
|
| Rate for Payer: UMR Bronson Commercial |
$120.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$244.99
|
|
|
METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$3.05
|
|
|
Service Code
|
NDC 60687039011
|
| Hospital Charge Code |
29858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$2.75 |
| Rate for Payer: Aetna American Axle |
$1.98
|
| Rate for Payer: Aetna Commercial |
$2.59
|
| Rate for Payer: Aetna Medicare |
$1.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.98
|
| Rate for Payer: BCBS Complete |
$1.22
|
| Rate for Payer: Cash Price |
$2.44
|
| Rate for Payer: Cofinity Advantage |
$2.13
|
| Rate for Payer: Cofinity Commercial |
$2.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.44
|
| Rate for Payer: Healthscope Commercial |
$2.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.29
|
| Rate for Payer: PHP Commercial |
$2.59
|
| Rate for Payer: Priority Health SBD |
$1.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.98
|
| Rate for Payer: UHC Core |
$1.59
|
| Rate for Payer: UHC Exchange |
$1.20
|
| Rate for Payer: UMR Bronson Commercial |
$1.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.29
|
|
