|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
IP
|
$2.03
|
|
|
Service Code
|
NDC 51079025501
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.89 |
| Max. Negotiated Rate |
$1.83 |
| Rate for Payer: Aetna American Axle |
$1.32
|
| Rate for Payer: Aetna Commercial |
$1.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.32
|
| Rate for Payer: Cash Price |
$1.62
|
| Rate for Payer: Cofinity Advantage |
$1.42
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$1.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.52
|
| Rate for Payer: PHP Commercial |
$1.73
|
| Rate for Payer: Priority Health SBD |
$1.28
|
| Rate for Payer: UMR Bronson Commercial |
$0.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.52
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
OP
|
$2.03
|
|
|
Service Code
|
NDC 51079025501
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$1.83 |
| Rate for Payer: Aetna American Axle |
$1.32
|
| Rate for Payer: Aetna Commercial |
$1.73
|
| Rate for Payer: Aetna Medicare |
$1.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.32
|
| Rate for Payer: BCBS Complete |
$0.81
|
| Rate for Payer: Cash Price |
$1.62
|
| Rate for Payer: Cofinity Advantage |
$1.42
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$1.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.52
|
| Rate for Payer: PHP Commercial |
$1.73
|
| Rate for Payer: Priority Health SBD |
$1.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.32
|
| Rate for Payer: UHC Core |
$1.06
|
| Rate for Payer: UHC Exchange |
$0.80
|
| Rate for Payer: UMR Bronson Commercial |
$0.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.52
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
OP
|
$105.75
|
|
|
Service Code
|
NDC 00378001801
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.13 |
| Max. Negotiated Rate |
$95.17 |
| Rate for Payer: Aetna American Axle |
$68.74
|
| Rate for Payer: Aetna Commercial |
$89.89
|
| Rate for Payer: Aetna Medicare |
$52.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.74
|
| Rate for Payer: BCBS Complete |
$42.30
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cofinity Advantage |
$74.03
|
| Rate for Payer: Cofinity Commercial |
$90.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.60
|
| Rate for Payer: Healthscope Commercial |
$95.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.31
|
| Rate for Payer: PHP Commercial |
$89.89
|
| Rate for Payer: Priority Health SBD |
$66.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.74
|
| Rate for Payer: UHC Core |
$55.10
|
| Rate for Payer: UHC Exchange |
$41.56
|
| Rate for Payer: UMR Bronson Commercial |
$39.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.31
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$2.12
|
|
|
Service Code
|
NDC 62584026611
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.78 |
| Max. Negotiated Rate |
$1.91 |
| Rate for Payer: Aetna American Axle |
$1.38
|
| Rate for Payer: Aetna Commercial |
$1.80
|
| Rate for Payer: Aetna Medicare |
$1.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.38
|
| Rate for Payer: BCBS Complete |
$0.85
|
| Rate for Payer: Cash Price |
$1.70
|
| Rate for Payer: Cofinity Advantage |
$1.48
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$1.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.59
|
| Rate for Payer: PHP Commercial |
$1.80
|
| Rate for Payer: Priority Health SBD |
$1.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.38
|
| Rate for Payer: UHC Core |
$1.10
|
| Rate for Payer: UHC Exchange |
$0.83
|
| Rate for Payer: UMR Bronson Commercial |
$0.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.59
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$72.85
|
|
|
Service Code
|
NDC 63304058001
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$32.05 |
| Max. Negotiated Rate |
$65.56 |
| Rate for Payer: Aetna American Axle |
$47.35
|
| Rate for Payer: Aetna Commercial |
$61.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.35
|
| Rate for Payer: Cash Price |
$58.28
|
| Rate for Payer: Cofinity Advantage |
$50.99
|
| Rate for Payer: Cofinity Commercial |
$62.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.28
|
| Rate for Payer: Healthscope Commercial |
$65.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.64
|
| Rate for Payer: PHP Commercial |
$61.92
|
| Rate for Payer: Priority Health SBD |
$45.90
|
| Rate for Payer: UMR Bronson Commercial |
$32.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.64
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$1.86
|
|
|
Service Code
|
NDC 51079080101
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.69 |
| Max. Negotiated Rate |
$1.67 |
| Rate for Payer: Aetna American Axle |
$1.21
|
| Rate for Payer: Aetna Commercial |
$1.58
|
| Rate for Payer: Aetna Medicare |
$0.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.21
|
| Rate for Payer: BCBS Complete |
$0.74
|
| Rate for Payer: Cash Price |
$1.49
|
| Rate for Payer: Cofinity Advantage |
$1.30
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$1.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.40
|
| Rate for Payer: PHP Commercial |
$1.58
|
| Rate for Payer: Priority Health SBD |
$1.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.21
|
| Rate for Payer: UHC Core |
$0.97
|
| Rate for Payer: UHC Exchange |
$0.73
|
| Rate for Payer: UMR Bronson Commercial |
$0.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.40
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$1.86
|
|
|
Service Code
|
NDC 51079080101
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$1.67 |
| Rate for Payer: Aetna American Axle |
$1.21
|
| Rate for Payer: Aetna Commercial |
$1.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.21
|
| Rate for Payer: Cash Price |
$1.49
|
| Rate for Payer: Cofinity Advantage |
$1.30
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$1.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.40
|
| Rate for Payer: PHP Commercial |
$1.58
|
| Rate for Payer: Priority Health SBD |
$1.17
|
| Rate for Payer: UMR Bronson Commercial |
$0.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.40
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$185.65
|
|
|
Service Code
|
NDC 51079080120
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$68.69 |
| Max. Negotiated Rate |
$167.09 |
| Rate for Payer: Aetna American Axle |
$120.67
|
| Rate for Payer: Aetna Commercial |
$157.80
|
| Rate for Payer: Aetna Medicare |
$92.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.67
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: Cash Price |
$148.52
|
| Rate for Payer: Cofinity Advantage |
$129.96
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$129.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$148.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.24
|
| Rate for Payer: PHP Commercial |
$157.80
|
| Rate for Payer: Priority Health SBD |
$116.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.67
|
| Rate for Payer: UHC Core |
$96.72
|
| Rate for Payer: UHC Exchange |
$72.96
|
| Rate for Payer: UMR Bronson Commercial |
$68.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.24
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$72.85
|
|
|
Service Code
|
NDC 63304058001
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$26.95 |
| Max. Negotiated Rate |
$65.56 |
| Rate for Payer: Aetna American Axle |
$47.35
|
| Rate for Payer: Aetna Commercial |
$61.92
|
| Rate for Payer: Aetna Medicare |
$36.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.35
|
| Rate for Payer: BCBS Complete |
$29.14
|
| Rate for Payer: Cash Price |
$58.28
|
| Rate for Payer: Cofinity Advantage |
$50.99
|
| Rate for Payer: Cofinity Commercial |
$62.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.28
|
| Rate for Payer: Healthscope Commercial |
$65.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.64
|
| Rate for Payer: PHP Commercial |
$61.92
|
| Rate for Payer: Priority Health SBD |
$45.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.35
|
| Rate for Payer: UHC Core |
$37.95
|
| Rate for Payer: UHC Exchange |
$28.63
|
| Rate for Payer: UMR Bronson Commercial |
$26.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.64
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$185.65
|
|
|
Service Code
|
NDC 51079080120
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.69 |
| Max. Negotiated Rate |
$167.09 |
| Rate for Payer: Aetna American Axle |
$120.67
|
| Rate for Payer: Aetna Commercial |
$157.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.67
|
| Rate for Payer: Cash Price |
$148.52
|
| Rate for Payer: Cofinity Advantage |
$129.96
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$129.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.24
|
| Rate for Payer: PHP Commercial |
$157.80
|
| Rate for Payer: Priority Health SBD |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$81.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.24
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$2.12
|
|
|
Service Code
|
NDC 62584026611
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$1.91 |
| Rate for Payer: Aetna American Axle |
$1.38
|
| Rate for Payer: Aetna Commercial |
$1.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.38
|
| Rate for Payer: Cash Price |
$1.70
|
| Rate for Payer: Cofinity Advantage |
$1.48
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$1.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.59
|
| Rate for Payer: PHP Commercial |
$1.80
|
| Rate for Payer: Priority Health SBD |
$1.34
|
| Rate for Payer: UMR Bronson Commercial |
$0.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.59
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$16.13
|
|
|
Service Code
|
HCPCS J0616
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Aetna American Axle |
$10.48
|
| Rate for Payer: Aetna American Axle |
$9.84
|
| Rate for Payer: Aetna American Axle |
$9.26
|
| Rate for Payer: Aetna American Axle |
$7.64
|
| Rate for Payer: Aetna American Axle |
$9.10
|
| Rate for Payer: Aetna American Axle |
$8.77
|
| Rate for Payer: Aetna Commercial |
$13.71
|
| Rate for Payer: Aetna Commercial |
$11.90
|
| Rate for Payer: Aetna Commercial |
$12.11
|
| Rate for Payer: Aetna Commercial |
$11.47
|
| Rate for Payer: Aetna Commercial |
$12.87
|
| Rate for Payer: Aetna Commercial |
$9.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.64
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cash Price |
$12.11
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$10.79
|
| Rate for Payer: Cofinity Advantage |
$9.97
|
| Rate for Payer: Cofinity Advantage |
$9.44
|
| Rate for Payer: Cofinity Advantage |
$8.22
|
| Rate for Payer: Cofinity Advantage |
$10.60
|
| Rate for Payer: Cofinity Advantage |
$9.80
|
| Rate for Payer: Cofinity Advantage |
$11.29
|
| Rate for Payer: Cofinity Commercial |
$11.60
|
| Rate for Payer: Cofinity Commercial |
$12.26
|
| Rate for Payer: Cofinity Commercial |
$13.02
|
| Rate for Payer: Cofinity Commercial |
$10.11
|
| Rate for Payer: Cofinity Commercial |
$12.04
|
| Rate for Payer: Cofinity Commercial |
$13.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$13.63
|
| Rate for Payer: Healthscope Commercial |
$10.57
|
| Rate for Payer: Healthscope Commercial |
$12.82
|
| Rate for Payer: Healthscope Commercial |
$12.14
|
| Rate for Payer: Healthscope Commercial |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$14.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.50
|
| Rate for Payer: PHP Commercial |
$11.90
|
| Rate for Payer: PHP Commercial |
$13.71
|
| Rate for Payer: PHP Commercial |
$12.87
|
| Rate for Payer: PHP Commercial |
$12.11
|
| Rate for Payer: PHP Commercial |
$9.99
|
| Rate for Payer: PHP Commercial |
$11.47
|
| Rate for Payer: Priority Health SBD |
$9.54
|
| Rate for Payer: Priority Health SBD |
$8.50
|
| Rate for Payer: Priority Health SBD |
$7.40
|
| Rate for Payer: Priority Health SBD |
$8.82
|
| Rate for Payer: Priority Health SBD |
$8.98
|
| Rate for Payer: Priority Health SBD |
$10.16
|
| Rate for Payer: UMR Bronson Commercial |
$6.66
|
| Rate for Payer: UMR Bronson Commercial |
$6.16
|
| Rate for Payer: UMR Bronson Commercial |
$6.27
|
| Rate for Payer: UMR Bronson Commercial |
$5.94
|
| Rate for Payer: UMR Bronson Commercial |
$7.10
|
| Rate for Payer: UMR Bronson Commercial |
$5.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.50
|
|
|
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 |
$0.20 |
| Max. Negotiated Rate |
$12.14 |
| Rate for Payer: Aetna American Axle |
$8.77
|
| Rate for Payer: Aetna American Axle |
$9.26
|
| Rate for Payer: Aetna American Axle |
$9.84
|
| Rate for Payer: Aetna American Axle |
$7.64
|
| Rate for Payer: Aetna American Axle |
$10.48
|
| Rate for Payer: Aetna American Axle |
$9.10
|
| Rate for Payer: Aetna Commercial |
$13.71
|
| Rate for Payer: Aetna Commercial |
$12.87
|
| Rate for Payer: Aetna Commercial |
$11.90
|
| Rate for Payer: Aetna Commercial |
$9.99
|
| Rate for Payer: Aetna Commercial |
$12.11
|
| Rate for Payer: Aetna Commercial |
$11.47
|
| Rate for Payer: Aetna Medicare |
$5.88
|
| Rate for Payer: Aetna Medicare |
$6.75
|
| Rate for Payer: Aetna Medicare |
$7.00
|
| Rate for Payer: Aetna Medicare |
$8.06
|
| Rate for Payer: Aetna Medicare |
$7.57
|
| Rate for Payer: Aetna Medicare |
$7.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.26
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Complete |
$5.40
|
| Rate for Payer: BCBS Complete |
$4.70
|
| Rate for Payer: BCBS Complete |
$5.70
|
| Rate for Payer: BCBS Complete |
$6.06
|
| Rate for Payer: BCBS Complete |
$6.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.38
|
| Rate for Payer: BCBS Trust/PPO |
$0.38
|
| Rate for Payer: BCBS Trust/PPO |
$0.38
|
| Rate for Payer: BCBS Trust/PPO |
$0.38
|
| Rate for Payer: BCBS Trust/PPO |
$0.38
|
| Rate for Payer: BCBS Trust/PPO |
$0.38
|
| Rate for Payer: BCN Commercial |
$0.38
|
| Rate for Payer: BCN Commercial |
$0.38
|
| Rate for Payer: BCN Commercial |
$0.38
|
| Rate for Payer: BCN Commercial |
$0.38
|
| Rate for Payer: BCN Commercial |
$0.38
|
| Rate for Payer: BCN Commercial |
$0.38
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$10.79
|
| Rate for Payer: Cash Price |
$10.79
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cash Price |
$12.11
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cash Price |
$12.11
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cofinity Advantage |
$9.97
|
| Rate for Payer: Cofinity Advantage |
$9.80
|
| Rate for Payer: Cofinity Advantage |
$11.29
|
| Rate for Payer: Cofinity Advantage |
$8.22
|
| Rate for Payer: Cofinity Advantage |
$9.44
|
| Rate for Payer: Cofinity Advantage |
$10.60
|
| Rate for Payer: Cofinity Commercial |
$13.02
|
| Rate for Payer: Cofinity Commercial |
$10.11
|
| Rate for Payer: Cofinity Commercial |
$11.60
|
| Rate for Payer: Cofinity Commercial |
$12.04
|
| 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 |
$9.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.11
|
| Rate for Payer: Healthscope Commercial |
$10.57
|
| Rate for Payer: Healthscope Commercial |
$13.63
|
| Rate for Payer: Healthscope Commercial |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$12.82
|
| Rate for Payer: Healthscope Commercial |
$14.52
|
| Rate for Payer: Healthscope Commercial |
$12.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.10
|
| 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 |
$8.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.50
|
| Rate for Payer: PHP Commercial |
$11.47
|
| Rate for Payer: PHP Commercial |
$11.90
|
| Rate for Payer: PHP Commercial |
$12.11
|
| Rate for Payer: PHP Commercial |
$9.99
|
| Rate for Payer: PHP Commercial |
$12.87
|
| Rate for Payer: PHP Commercial |
$13.71
|
| Rate for Payer: Priority Health SBD |
$8.98
|
| Rate for Payer: Priority Health SBD |
$7.40
|
| Rate for Payer: Priority Health SBD |
$8.50
|
| Rate for Payer: Priority Health SBD |
$10.16
|
| Rate for Payer: Priority Health SBD |
$8.82
|
| Rate for Payer: Priority Health SBD |
$9.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.20
|
| Rate for Payer: UHC Core |
$0.20
|
| Rate for Payer: UHC Core |
$0.20
|
| Rate for Payer: UHC Core |
$0.20
|
| Rate for Payer: UHC Core |
$0.20
|
| Rate for Payer: UHC Core |
$0.20
|
| Rate for Payer: UHC Core |
$0.20
|
| Rate for Payer: UHC Exchange |
$0.20
|
| Rate for Payer: UHC Exchange |
$0.20
|
| Rate for Payer: UHC Exchange |
$0.20
|
| Rate for Payer: UHC Exchange |
$0.20
|
| Rate for Payer: UHC Exchange |
$0.20
|
| Rate for Payer: UHC Exchange |
$0.20
|
| Rate for Payer: UMR Bronson Commercial |
$5.27
|
| Rate for Payer: UMR Bronson Commercial |
$5.60
|
| Rate for Payer: UMR Bronson Commercial |
$4.99
|
| Rate for Payer: UMR Bronson Commercial |
$4.35
|
| Rate for Payer: UMR Bronson Commercial |
$5.97
|
| Rate for Payer: UMR Bronson Commercial |
$5.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.12
|
|
|
METRONIDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL
|
Facility
|
OP
|
$118.83
|
|
|
Service Code
|
NDC 00245086070
|
| Hospital Charge Code |
10592
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.97 |
| Max. Negotiated Rate |
$106.95 |
| Rate for Payer: Aetna American Axle |
$77.24
|
| Rate for Payer: Aetna Commercial |
$101.01
|
| Rate for Payer: Aetna Medicare |
$59.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.24
|
| Rate for Payer: BCBS Complete |
$47.53
|
| Rate for Payer: Cash Price |
$95.06
|
| Rate for Payer: Cofinity Advantage |
$83.18
|
| Rate for Payer: Cofinity Commercial |
$102.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.06
|
| Rate for Payer: Healthscope Commercial |
$106.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.12
|
| Rate for Payer: PHP Commercial |
$101.01
|
| Rate for Payer: Priority Health SBD |
$74.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.24
|
| Rate for Payer: UHC Core |
$61.91
|
| Rate for Payer: UHC Exchange |
$46.70
|
| Rate for Payer: UMR Bronson Commercial |
$43.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.12
|
|
|
METRONIDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL
|
Facility
|
OP
|
$65.17
|
|
|
Service Code
|
NDC 45802013970
|
| Hospital Charge Code |
10592
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$24.11 |
| Max. Negotiated Rate |
$58.65 |
| Rate for Payer: Aetna American Axle |
$42.36
|
| Rate for Payer: Aetna Commercial |
$55.39
|
| Rate for Payer: Aetna Medicare |
$32.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.36
|
| Rate for Payer: BCBS Complete |
$26.07
|
| Rate for Payer: Cash Price |
$52.14
|
| Rate for Payer: Cofinity Advantage |
$45.62
|
| Rate for Payer: Cofinity Commercial |
$56.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.14
|
| Rate for Payer: Healthscope Commercial |
$58.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.88
|
| Rate for Payer: PHP Commercial |
$55.39
|
| Rate for Payer: Priority Health SBD |
$41.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.36
|
| Rate for Payer: UHC Core |
$33.95
|
| Rate for Payer: UHC Exchange |
$25.61
|
| Rate for Payer: UMR Bronson Commercial |
$24.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.88
|
|
|
METRONIDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL
|
Facility
|
IP
|
$65.17
|
|
|
Service Code
|
NDC 45802013970
|
| Hospital Charge Code |
10592
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$28.67 |
| Max. Negotiated Rate |
$58.65 |
| Rate for Payer: Aetna American Axle |
$42.36
|
| Rate for Payer: Aetna Commercial |
$55.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.36
|
| Rate for Payer: Cash Price |
$52.14
|
| Rate for Payer: Cofinity Advantage |
$45.62
|
| Rate for Payer: Cofinity Commercial |
$56.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.14
|
| Rate for Payer: Healthscope Commercial |
$58.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.88
|
| Rate for Payer: PHP Commercial |
$55.39
|
| Rate for Payer: Priority Health SBD |
$41.06
|
| Rate for Payer: UMR Bronson Commercial |
$28.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.88
|
|
|
METRONIDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL
|
Facility
|
IP
|
$118.83
|
|
|
Service Code
|
NDC 00245086070
|
| Hospital Charge Code |
10592
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.29 |
| Max. Negotiated Rate |
$106.95 |
| Rate for Payer: Aetna American Axle |
$77.24
|
| Rate for Payer: Aetna Commercial |
$101.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.24
|
| Rate for Payer: Cash Price |
$95.06
|
| Rate for Payer: Cofinity Advantage |
$83.18
|
| Rate for Payer: Cofinity Commercial |
$102.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.06
|
| Rate for Payer: Healthscope Commercial |
$106.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.12
|
| Rate for Payer: PHP Commercial |
$101.01
|
| Rate for Payer: Priority Health SBD |
$74.86
|
| Rate for Payer: UMR Bronson Commercial |
$52.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.12
|
|
|
METRONIDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL
|
Facility
|
IP
|
$65.17
|
|
|
Service Code
|
NDC 73473030370
|
| Hospital Charge Code |
10592
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$28.67 |
| Max. Negotiated Rate |
$58.65 |
| Rate for Payer: Aetna American Axle |
$42.36
|
| Rate for Payer: Aetna Commercial |
$55.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.36
|
| Rate for Payer: Cash Price |
$52.14
|
| Rate for Payer: Cofinity Advantage |
$45.62
|
| Rate for Payer: Cofinity Commercial |
$56.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.14
|
| Rate for Payer: Healthscope Commercial |
$58.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.88
|
| Rate for Payer: PHP Commercial |
$55.39
|
| Rate for Payer: Priority Health SBD |
$41.06
|
| Rate for Payer: UMR Bronson Commercial |
$28.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.88
|
|
|
METRONIDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL
|
Facility
|
OP
|
$65.17
|
|
|
Service Code
|
NDC 73473030370
|
| Hospital Charge Code |
10592
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$24.11 |
| Max. Negotiated Rate |
$58.65 |
| Rate for Payer: Aetna American Axle |
$42.36
|
| Rate for Payer: Aetna Commercial |
$55.39
|
| Rate for Payer: Aetna Medicare |
$32.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.36
|
| Rate for Payer: BCBS Complete |
$26.07
|
| Rate for Payer: Cash Price |
$52.14
|
| Rate for Payer: Cofinity Advantage |
$45.62
|
| Rate for Payer: Cofinity Commercial |
$56.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.14
|
| Rate for Payer: Healthscope Commercial |
$58.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.88
|
| Rate for Payer: PHP Commercial |
$55.39
|
| Rate for Payer: Priority Health SBD |
$41.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.36
|
| Rate for Payer: UHC Core |
$33.95
|
| Rate for Payer: UHC Exchange |
$25.61
|
| Rate for Payer: UMR Bronson Commercial |
$24.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.88
|
|
|
METRONIDAZOLE 0.75 % TOPICAL CREAM
|
Facility
|
IP
|
$124.27
|
|
|
Service Code
|
NDC 00168032346
|
| Hospital Charge Code |
19805
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$54.68 |
| Max. Negotiated Rate |
$111.84 |
| Rate for Payer: Aetna American Axle |
$80.78
|
| Rate for Payer: Aetna Commercial |
$105.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.78
|
| Rate for Payer: Cash Price |
$99.42
|
| Rate for Payer: Cofinity Advantage |
$86.99
|
| Rate for Payer: Cofinity Commercial |
$106.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.42
|
| Rate for Payer: Healthscope Commercial |
$111.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.20
|
| Rate for Payer: PHP Commercial |
$105.63
|
| Rate for Payer: Priority Health SBD |
$78.29
|
| Rate for Payer: UMR Bronson Commercial |
$54.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.20
|
|
|
METRONIDAZOLE 0.75 % TOPICAL CREAM
|
Facility
|
OP
|
$124.27
|
|
|
Service Code
|
NDC 00168032346
|
| Hospital Charge Code |
19805
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$45.98 |
| Max. Negotiated Rate |
$111.84 |
| Rate for Payer: Aetna American Axle |
$80.78
|
| Rate for Payer: Aetna Commercial |
$105.63
|
| Rate for Payer: Aetna Medicare |
$62.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.78
|
| Rate for Payer: BCBS Complete |
$49.71
|
| Rate for Payer: Cash Price |
$99.42
|
| Rate for Payer: Cofinity Advantage |
$86.99
|
| Rate for Payer: Cofinity Commercial |
$106.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.42
|
| Rate for Payer: Healthscope Commercial |
$111.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.20
|
| Rate for Payer: PHP Commercial |
$105.63
|
| Rate for Payer: Priority Health SBD |
$78.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$64.74
|
| Rate for Payer: UHC Exchange |
$48.84
|
| Rate for Payer: UMR Bronson Commercial |
$45.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.20
|
|
|
METRONIDAZOLE 1 % TOPICAL GEL
|
Facility
|
OP
|
$505.47
|
|
|
Service Code
|
NDC 00781708035
|
| Hospital Charge Code |
41899
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$187.02 |
| Max. Negotiated Rate |
$454.92 |
| Rate for Payer: Aetna American Axle |
$328.56
|
| Rate for Payer: Aetna Commercial |
$429.65
|
| Rate for Payer: Aetna Medicare |
$252.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$328.56
|
| Rate for Payer: BCBS Complete |
$202.19
|
| Rate for Payer: Cash Price |
$404.38
|
| Rate for Payer: Cofinity Advantage |
$353.83
|
| Rate for Payer: Cofinity Commercial |
$434.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.38
|
| Rate for Payer: Healthscope Commercial |
$454.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$353.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$379.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$404.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$379.10
|
| Rate for Payer: PHP Commercial |
$429.65
|
| Rate for Payer: Priority Health SBD |
$318.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.56
|
| Rate for Payer: UHC Core |
$263.35
|
| Rate for Payer: UHC Exchange |
$198.65
|
| Rate for Payer: UMR Bronson Commercial |
$187.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$379.10
|
|
|
METRONIDAZOLE 1 % TOPICAL GEL
|
Facility
|
OP
|
$1,225.35
|
|
|
Service Code
|
NDC 00299382060
|
| Hospital Charge Code |
41899
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$453.38 |
| Max. Negotiated Rate |
$1,102.82 |
| Rate for Payer: Aetna American Axle |
$796.48
|
| Rate for Payer: Aetna Commercial |
$1,041.55
|
| Rate for Payer: Aetna Medicare |
$612.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$796.48
|
| Rate for Payer: BCBS Complete |
$490.14
|
| Rate for Payer: Cash Price |
$980.28
|
| Rate for Payer: Cofinity Advantage |
$857.75
|
| Rate for Payer: Cofinity Commercial |
$1,053.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$980.28
|
| Rate for Payer: Healthscope Commercial |
$1,102.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$857.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$919.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$980.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$919.01
|
| Rate for Payer: PHP Commercial |
$1,041.55
|
| Rate for Payer: Priority Health SBD |
$771.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$796.48
|
| Rate for Payer: UHC Core |
$638.41
|
| Rate for Payer: UHC Exchange |
$481.56
|
| Rate for Payer: UMR Bronson Commercial |
$453.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$919.01
|
|
|
METRONIDAZOLE 1 % TOPICAL GEL
|
Facility
|
IP
|
$1,225.35
|
|
|
Service Code
|
NDC 00299382060
|
| Hospital Charge Code |
41899
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$539.15 |
| Max. Negotiated Rate |
$1,102.82 |
| Rate for Payer: Aetna American Axle |
$796.48
|
| Rate for Payer: Aetna Commercial |
$1,041.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$796.48
|
| Rate for Payer: Cash Price |
$980.28
|
| Rate for Payer: Cofinity Advantage |
$857.75
|
| Rate for Payer: Cofinity Commercial |
$1,053.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$980.28
|
| Rate for Payer: Healthscope Commercial |
$1,102.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$857.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$919.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$919.01
|
| Rate for Payer: PHP Commercial |
$1,041.55
|
| Rate for Payer: Priority Health SBD |
$771.97
|
| Rate for Payer: UMR Bronson Commercial |
$539.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$919.01
|
|
|
METRONIDAZOLE 1 % TOPICAL GEL
|
Facility
|
IP
|
$220.92
|
|
|
Service Code
|
NDC 51672421503
|
| Hospital Charge Code |
41899
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$97.20 |
| Max. Negotiated Rate |
$198.83 |
| Rate for Payer: Aetna American Axle |
$143.60
|
| Rate for Payer: Aetna Commercial |
$187.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.60
|
| Rate for Payer: Cash Price |
$176.74
|
| Rate for Payer: Cofinity Advantage |
$154.64
|
| Rate for Payer: Cofinity Commercial |
$189.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.74
|
| Rate for Payer: Healthscope Commercial |
$198.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.69
|
| Rate for Payer: PHP Commercial |
$187.78
|
| Rate for Payer: Priority Health SBD |
$139.18
|
| Rate for Payer: UMR Bronson Commercial |
$97.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.69
|
|
