|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$221.35
|
|
|
Service Code
|
NDC 69097040707
|
| Hospital Charge Code |
30070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.90 |
| Max. Negotiated Rate |
$199.22 |
| Rate for Payer: Aetna American Axle |
$143.88
|
| Rate for Payer: Aetna Commercial |
$188.15
|
| Rate for Payer: Aetna Medicare |
$110.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.88
|
| Rate for Payer: BCBS Complete |
$88.54
|
| Rate for Payer: Cash Price |
$177.08
|
| Rate for Payer: Cofinity Commercial |
$154.94
|
| Rate for Payer: Cofinity Commercial |
$190.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$154.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.08
|
| Rate for Payer: Healthscope Commercial |
$199.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.15
|
| Rate for Payer: PHP Commercial |
$188.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.88
|
| Rate for Payer: Priority Health SBD |
$139.45
|
| Rate for Payer: UMR Bronson Commercial |
$81.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.01
|
|
|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$372.40
|
|
|
Service Code
|
NDC 00904632361
|
| Hospital Charge Code |
30070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$137.79 |
| Max. Negotiated Rate |
$335.16 |
| Rate for Payer: Aetna American Axle |
$242.06
|
| Rate for Payer: Aetna Commercial |
$316.54
|
| Rate for Payer: Aetna Medicare |
$186.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.06
|
| Rate for Payer: BCBS Complete |
$148.96
|
| Rate for Payer: Cash Price |
$297.92
|
| Rate for Payer: Cofinity Commercial |
$260.68
|
| Rate for Payer: Cofinity Commercial |
$320.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$260.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.92
|
| Rate for Payer: Healthscope Commercial |
$335.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.54
|
| Rate for Payer: PHP Commercial |
$316.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.06
|
| Rate for Payer: Priority Health SBD |
$234.61
|
| Rate for Payer: UMR Bronson Commercial |
$137.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.30
|
|
|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$4.12
|
|
|
Service Code
|
NDC 51079017001
|
| Hospital Charge Code |
30070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.52 |
| Max. Negotiated Rate |
$3.71 |
| Rate for Payer: Aetna American Axle |
$2.68
|
| Rate for Payer: Aetna Commercial |
$3.50
|
| Rate for Payer: Aetna Medicare |
$2.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.68
|
| Rate for Payer: BCBS Complete |
$1.65
|
| Rate for Payer: Cash Price |
$3.30
|
| Rate for Payer: Cofinity Commercial |
$2.88
|
| Rate for Payer: Cofinity Commercial |
$3.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.30
|
| Rate for Payer: Healthscope Commercial |
$3.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.50
|
| Rate for Payer: PHP Commercial |
$3.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.68
|
| Rate for Payer: Priority Health SBD |
$2.60
|
| Rate for Payer: UMR Bronson Commercial |
$1.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.09
|
|
|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$131.60
|
|
|
Service Code
|
NDC 70436018301
|
| Hospital Charge Code |
30070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.69 |
| Max. Negotiated Rate |
$118.44 |
| Rate for Payer: Aetna American Axle |
$85.54
|
| Rate for Payer: Aetna Commercial |
$111.86
|
| Rate for Payer: Aetna Medicare |
$65.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.54
|
| Rate for Payer: BCBS Complete |
$52.64
|
| Rate for Payer: Cash Price |
$105.28
|
| Rate for Payer: Cofinity Commercial |
$113.18
|
| Rate for Payer: Cofinity Commercial |
$92.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.28
|
| Rate for Payer: Healthscope Commercial |
$118.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.86
|
| Rate for Payer: PHP Commercial |
$111.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.54
|
| Rate for Payer: Priority Health SBD |
$82.91
|
| Rate for Payer: UMR Bronson Commercial |
$48.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.70
|
|
|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$372.40
|
|
|
Service Code
|
NDC 00904632361
|
| Hospital Charge Code |
30070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$163.86 |
| Max. Negotiated Rate |
$335.16 |
| Rate for Payer: Aetna American Axle |
$242.06
|
| Rate for Payer: Aetna Commercial |
$316.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.06
|
| Rate for Payer: Cash Price |
$297.92
|
| Rate for Payer: Cofinity Commercial |
$260.68
|
| Rate for Payer: Cofinity Commercial |
$320.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$260.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.92
|
| Rate for Payer: Healthscope Commercial |
$335.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.54
|
| Rate for Payer: PHP Commercial |
$316.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.06
|
| Rate for Payer: Priority Health SBD |
$234.61
|
| Rate for Payer: UMR Bronson Commercial |
$163.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.30
|
|
|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$301.11
|
|
|
Service Code
|
NDC 00378459677
|
| Hospital Charge Code |
30070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$111.41 |
| Max. Negotiated Rate |
$271.00 |
| Rate for Payer: Aetna American Axle |
$195.72
|
| Rate for Payer: Aetna Commercial |
$255.94
|
| Rate for Payer: Aetna Medicare |
$150.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.72
|
| Rate for Payer: BCBS Complete |
$120.44
|
| Rate for Payer: Cash Price |
$240.89
|
| Rate for Payer: Cofinity Commercial |
$210.78
|
| Rate for Payer: Cofinity Commercial |
$258.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$210.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.89
|
| Rate for Payer: Healthscope Commercial |
$271.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$210.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.94
|
| Rate for Payer: PHP Commercial |
$255.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.72
|
| Rate for Payer: Priority Health SBD |
$189.70
|
| Rate for Payer: UMR Bronson Commercial |
$111.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.83
|
|
|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$215.65
|
|
|
Service Code
|
NDC 55111046701
|
| Hospital Charge Code |
30070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$79.79 |
| Max. Negotiated Rate |
$194.08 |
| Rate for Payer: Aetna American Axle |
$140.17
|
| Rate for Payer: Aetna Commercial |
$183.30
|
| Rate for Payer: Aetna Medicare |
$107.82
|
| 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 Commercial |
$150.96
|
| Rate for Payer: Cofinity Commercial |
$185.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$150.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.52
|
| Rate for Payer: Healthscope Commercial |
$194.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$150.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.30
|
| Rate for Payer: PHP Commercial |
$183.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.17
|
| Rate for Payer: Priority Health SBD |
$135.86
|
| Rate for Payer: UMR Bronson Commercial |
$79.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.74
|
|
|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$221.35
|
|
|
Service Code
|
NDC 69097040707
|
| Hospital Charge Code |
30070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$97.39 |
| Max. Negotiated Rate |
$199.22 |
| Rate for Payer: Aetna American Axle |
$143.88
|
| Rate for Payer: Aetna Commercial |
$188.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.88
|
| Rate for Payer: Cash Price |
$177.08
|
| Rate for Payer: Cofinity Commercial |
$154.94
|
| Rate for Payer: Cofinity Commercial |
$190.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$154.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.08
|
| Rate for Payer: Healthscope Commercial |
$199.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.15
|
| Rate for Payer: PHP Commercial |
$188.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.88
|
| Rate for Payer: Priority Health SBD |
$139.45
|
| Rate for Payer: UMR Bronson Commercial |
$97.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.01
|
|
|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$131.60
|
|
|
Service Code
|
NDC 70436018301
|
| Hospital Charge Code |
30070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$57.90 |
| Max. Negotiated Rate |
$118.44 |
| Rate for Payer: Aetna American Axle |
$85.54
|
| Rate for Payer: Aetna Commercial |
$111.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.54
|
| Rate for Payer: Cash Price |
$105.28
|
| Rate for Payer: Cofinity Commercial |
$113.18
|
| Rate for Payer: Cofinity Commercial |
$92.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.28
|
| Rate for Payer: Healthscope Commercial |
$118.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.86
|
| Rate for Payer: PHP Commercial |
$111.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.54
|
| Rate for Payer: Priority Health SBD |
$82.91
|
| Rate for Payer: UMR Bronson Commercial |
$57.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.70
|
|
|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$215.65
|
|
|
Service Code
|
NDC 55111046701
|
| Hospital Charge Code |
30070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$94.89 |
| Max. Negotiated Rate |
$194.08 |
| Rate for Payer: Aetna American Axle |
$140.17
|
| Rate for Payer: Aetna Commercial |
$183.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.17
|
| Rate for Payer: Cash Price |
$172.52
|
| Rate for Payer: Cofinity Commercial |
$150.96
|
| Rate for Payer: Cofinity Commercial |
$185.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$150.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.52
|
| Rate for Payer: Healthscope Commercial |
$194.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$150.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.30
|
| Rate for Payer: PHP Commercial |
$183.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.17
|
| Rate for Payer: Priority Health SBD |
$135.86
|
| Rate for Payer: UMR Bronson Commercial |
$94.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.74
|
|
|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$411.35
|
|
|
Service Code
|
NDC 51079017020
|
| Hospital Charge Code |
30070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$152.20 |
| Max. Negotiated Rate |
$370.22 |
| Rate for Payer: Aetna American Axle |
$267.38
|
| Rate for Payer: Aetna Commercial |
$349.65
|
| Rate for Payer: Aetna Medicare |
$205.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.38
|
| Rate for Payer: BCBS Complete |
$164.54
|
| Rate for Payer: Cash Price |
$329.08
|
| Rate for Payer: Cofinity Commercial |
$287.94
|
| Rate for Payer: Cofinity Commercial |
$353.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$287.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.08
|
| Rate for Payer: Healthscope Commercial |
$370.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$287.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$308.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.65
|
| Rate for Payer: PHP Commercial |
$349.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.38
|
| Rate for Payer: Priority Health SBD |
$259.15
|
| Rate for Payer: UMR Bronson Commercial |
$152.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$308.51
|
|
|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$4.12
|
|
|
Service Code
|
NDC 51079017001
|
| Hospital Charge Code |
30070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$3.71 |
| Rate for Payer: Aetna American Axle |
$2.68
|
| Rate for Payer: Aetna Commercial |
$3.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.68
|
| Rate for Payer: Cash Price |
$3.30
|
| Rate for Payer: Cofinity Commercial |
$2.88
|
| Rate for Payer: Cofinity Commercial |
$3.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.30
|
| Rate for Payer: Healthscope Commercial |
$3.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.50
|
| Rate for Payer: PHP Commercial |
$3.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.68
|
| Rate for Payer: Priority Health SBD |
$2.60
|
| Rate for Payer: UMR Bronson Commercial |
$1.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.09
|
|
|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$301.11
|
|
|
Service Code
|
NDC 00378459677
|
| Hospital Charge Code |
30070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$132.49 |
| Max. Negotiated Rate |
$271.00 |
| Rate for Payer: Cofinity Commercial |
$210.78
|
| Rate for Payer: Cofinity Commercial |
$258.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$210.78
|
| Rate for Payer: Aetna American Axle |
$195.72
|
| Rate for Payer: Aetna Commercial |
$255.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.72
|
| Rate for Payer: Cash Price |
$240.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.89
|
| Rate for Payer: Healthscope Commercial |
$271.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$210.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.94
|
| Rate for Payer: PHP Commercial |
$255.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.72
|
| Rate for Payer: Priority Health SBD |
$189.70
|
| Rate for Payer: UMR Bronson Commercial |
$132.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.83
|
|
|
METOPROLOL TARTRATE 12.5 MG CUSTOM TAB
|
Facility
|
OP
|
$164.50
|
|
|
Service Code
|
NDC 00990000038
|
| Hospital Charge Code |
500250
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$60.86 |
| Max. Negotiated Rate |
$148.05 |
| Rate for Payer: Aetna American Axle |
$106.92
|
| Rate for Payer: Aetna Commercial |
$139.82
|
| Rate for Payer: Aetna Medicare |
$82.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.92
|
| Rate for Payer: BCBS Complete |
$65.80
|
| Rate for Payer: Cash Price |
$131.60
|
| Rate for Payer: Cofinity Commercial |
$115.15
|
| Rate for Payer: Cofinity Commercial |
$141.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$115.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.60
|
| Rate for Payer: Healthscope Commercial |
$148.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.82
|
| Rate for Payer: PHP Commercial |
$139.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.92
|
| Rate for Payer: Priority Health SBD |
$103.64
|
| Rate for Payer: UMR Bronson Commercial |
$60.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.38
|
|
|
METOPROLOL TARTRATE 12.5 MG CUSTOM TAB
|
Facility
|
IP
|
$164.50
|
|
|
Service Code
|
NDC 00990000038
|
| Hospital Charge Code |
500250
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$72.38 |
| Max. Negotiated Rate |
$148.05 |
| Rate for Payer: Aetna American Axle |
$106.92
|
| Rate for Payer: Aetna Commercial |
$139.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.92
|
| Rate for Payer: Cash Price |
$131.60
|
| Rate for Payer: Cofinity Commercial |
$115.15
|
| Rate for Payer: Cofinity Commercial |
$141.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$115.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.60
|
| Rate for Payer: Healthscope Commercial |
$148.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.82
|
| Rate for Payer: PHP Commercial |
$139.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.92
|
| Rate for Payer: Priority Health SBD |
$103.64
|
| Rate for Payer: UMR Bronson Commercial |
$72.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.38
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
IP
|
$105.75
|
|
|
Service Code
|
NDC 00378001801
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$46.53 |
| Max. Negotiated Rate |
$95.18 |
| Rate for Payer: Aetna American Axle |
$68.74
|
| Rate for Payer: Aetna Commercial |
$89.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.74
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cofinity Commercial |
$74.02
|
| Rate for Payer: Cofinity Commercial |
$90.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.60
|
| Rate for Payer: Healthscope Commercial |
$95.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.89
|
| Rate for Payer: PHP Commercial |
$89.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.74
|
| Rate for Payer: Priority Health SBD |
$66.62
|
| Rate for Payer: UMR Bronson Commercial |
$46.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.31
|
|
|
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 |
$95.18 |
| 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 Commercial |
$74.02
|
| Rate for Payer: Cofinity Commercial |
$90.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.60
|
| Rate for Payer: Healthscope Commercial |
$95.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.89
|
| Rate for Payer: PHP Commercial |
$89.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.74
|
| Rate for Payer: Priority Health SBD |
$66.62
|
| Rate for Payer: UMR Bronson Commercial |
$39.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.31
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
IP
|
$171.55
|
|
|
Service Code
|
NDC 51079025520
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$75.48 |
| Max. Negotiated Rate |
$154.40 |
| Rate for Payer: Aetna American Axle |
$111.51
|
| Rate for Payer: Aetna Commercial |
$145.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.51
|
| Rate for Payer: Cash Price |
$137.24
|
| Rate for Payer: Cofinity Commercial |
$120.08
|
| Rate for Payer: Cofinity Commercial |
$147.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$120.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.24
|
| Rate for Payer: Healthscope Commercial |
$154.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$120.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.82
|
| Rate for Payer: PHP Commercial |
$145.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.51
|
| Rate for Payer: Priority Health SBD |
$108.08
|
| Rate for Payer: UMR Bronson Commercial |
$75.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.66
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
OP
|
$171.55
|
|
|
Service Code
|
NDC 51079025520
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$154.40 |
| Rate for Payer: Aetna American Axle |
$111.51
|
| Rate for Payer: Aetna Commercial |
$145.82
|
| Rate for Payer: Aetna Medicare |
$85.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.51
|
| Rate for Payer: BCBS Complete |
$68.62
|
| Rate for Payer: Cash Price |
$137.24
|
| Rate for Payer: Cofinity Commercial |
$120.08
|
| Rate for Payer: Cofinity Commercial |
$147.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$120.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.24
|
| Rate for Payer: Healthscope Commercial |
$154.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$120.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.82
|
| Rate for Payer: PHP Commercial |
$145.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.51
|
| Rate for Payer: Priority Health SBD |
$108.08
|
| Rate for Payer: UMR Bronson Commercial |
$63.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.66
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
IP
|
$1.72
|
|
|
Service Code
|
NDC 51079025501
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.76 |
| Max. Negotiated Rate |
$1.55 |
| Rate for Payer: Aetna American Axle |
$1.12
|
| Rate for Payer: Aetna Commercial |
$1.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.12
|
| Rate for Payer: Cash Price |
$1.38
|
| Rate for Payer: Cofinity Commercial |
$1.20
|
| Rate for Payer: Cofinity Commercial |
$1.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.38
|
| Rate for Payer: Healthscope Commercial |
$1.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.46
|
| Rate for Payer: PHP Commercial |
$1.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.12
|
| Rate for Payer: Priority Health SBD |
$1.08
|
| Rate for Payer: UMR Bronson Commercial |
$0.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.29
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
OP
|
$1.72
|
|
|
Service Code
|
NDC 51079025501
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$1.55 |
| Rate for Payer: Aetna American Axle |
$1.12
|
| Rate for Payer: Aetna Commercial |
$1.46
|
| Rate for Payer: Aetna Medicare |
$0.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.12
|
| Rate for Payer: BCBS Complete |
$0.69
|
| Rate for Payer: Cash Price |
$1.38
|
| Rate for Payer: Cofinity Commercial |
$1.20
|
| Rate for Payer: Cofinity Commercial |
$1.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.38
|
| Rate for Payer: Healthscope Commercial |
$1.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.46
|
| Rate for Payer: PHP Commercial |
$1.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.12
|
| Rate for Payer: Priority Health SBD |
$1.08
|
| Rate for Payer: UMR Bronson Commercial |
$0.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.29
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$225.60
|
|
|
Service Code
|
NDC 62584026611
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.26 |
| Max. Negotiated Rate |
$203.04 |
| Rate for Payer: Aetna American Axle |
$146.64
|
| Rate for Payer: Aetna Commercial |
$191.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.64
|
| Rate for Payer: Cash Price |
$180.48
|
| Rate for Payer: Cofinity Commercial |
$157.92
|
| Rate for Payer: Cofinity Commercial |
$194.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$157.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.48
|
| Rate for Payer: Healthscope Commercial |
$203.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.76
|
| Rate for Payer: PHP Commercial |
$191.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.64
|
| Rate for Payer: Priority Health SBD |
$142.13
|
| Rate for Payer: UMR Bronson Commercial |
$99.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.20
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$225.60
|
|
|
Service Code
|
NDC 62584026611
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$83.47 |
| Max. Negotiated Rate |
$203.04 |
| Rate for Payer: Aetna American Axle |
$146.64
|
| Rate for Payer: Aetna Commercial |
$191.76
|
| Rate for Payer: Aetna Medicare |
$112.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.64
|
| Rate for Payer: BCBS Complete |
$90.24
|
| Rate for Payer: Cash Price |
$180.48
|
| Rate for Payer: Cofinity Commercial |
$157.92
|
| Rate for Payer: Cofinity Commercial |
$194.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$157.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.48
|
| Rate for Payer: Healthscope Commercial |
$203.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.76
|
| Rate for Payer: PHP Commercial |
$191.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.64
|
| Rate for Payer: Priority Health SBD |
$142.13
|
| Rate for Payer: UMR Bronson Commercial |
$83.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.20
|
|
|
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 Commercial |
$51.00
|
| Rate for Payer: Cofinity Commercial |
$62.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.00
|
| 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 |
$51.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.92
|
| Rate for Payer: PHP Commercial |
$61.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.35
|
| 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
|
$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 Commercial |
$51.00
|
| Rate for Payer: Cofinity Commercial |
$62.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.00
|
| 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 |
$51.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.92
|
| Rate for Payer: PHP Commercial |
$61.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.35
|
| Rate for Payer: Priority Health SBD |
$45.90
|
| Rate for Payer: UMR Bronson Commercial |
$26.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.64
|
|
