|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$1.77
|
|
|
Service Code
|
NDC 51079080101
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.78 |
| Max. Negotiated Rate |
$1.59 |
| Rate for Payer: Aetna American Axle |
$1.15
|
| Rate for Payer: Aetna Commercial |
$1.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.15
|
| Rate for Payer: Cash Price |
$1.42
|
| Rate for Payer: Cofinity Commercial |
$1.24
|
| Rate for Payer: Cofinity Commercial |
$1.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.42
|
| Rate for Payer: Healthscope Commercial |
$1.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.50
|
| Rate for Payer: PHP Commercial |
$1.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.15
|
| Rate for Payer: Priority Health SBD |
$1.12
|
| Rate for Payer: UMR Bronson Commercial |
$0.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.33
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$176.25
|
|
|
Service Code
|
NDC 51079080120
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$77.55 |
| Max. Negotiated Rate |
$158.62 |
| Rate for Payer: Aetna American Axle |
$114.56
|
| Rate for Payer: Aetna Commercial |
$149.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.56
|
| Rate for Payer: Cash Price |
$141.00
|
| Rate for Payer: Cofinity Commercial |
$123.38
|
| Rate for Payer: Cofinity Commercial |
$151.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$123.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.00
|
| Rate for Payer: Healthscope Commercial |
$158.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$123.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.81
|
| Rate for Payer: PHP Commercial |
$149.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.56
|
| Rate for Payer: Priority Health SBD |
$111.04
|
| Rate for Payer: UMR Bronson Commercial |
$77.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.19
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$176.25
|
|
|
Service Code
|
NDC 51079080120
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$65.21 |
| Max. Negotiated Rate |
$158.62 |
| Rate for Payer: Aetna American Axle |
$114.56
|
| Rate for Payer: Aetna Commercial |
$149.81
|
| Rate for Payer: Aetna Medicare |
$88.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.56
|
| Rate for Payer: BCBS Complete |
$70.50
|
| Rate for Payer: Cash Price |
$141.00
|
| Rate for Payer: Cofinity Commercial |
$123.38
|
| Rate for Payer: Cofinity Commercial |
$151.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$123.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.00
|
| Rate for Payer: Healthscope Commercial |
$158.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$123.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.81
|
| Rate for Payer: PHP Commercial |
$149.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.56
|
| Rate for Payer: Priority Health SBD |
$111.04
|
| Rate for Payer: UMR Bronson Commercial |
$65.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.19
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$1.77
|
|
|
Service Code
|
NDC 51079080101
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.65 |
| Max. Negotiated Rate |
$1.59 |
| Rate for Payer: Aetna American Axle |
$1.15
|
| Rate for Payer: Aetna Commercial |
$1.50
|
| Rate for Payer: Aetna Medicare |
$0.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.15
|
| Rate for Payer: BCBS Complete |
$0.71
|
| Rate for Payer: Cash Price |
$1.42
|
| Rate for Payer: Cofinity Commercial |
$1.24
|
| Rate for Payer: Cofinity Commercial |
$1.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.42
|
| Rate for Payer: Healthscope Commercial |
$1.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.50
|
| Rate for Payer: PHP Commercial |
$1.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.15
|
| Rate for Payer: Priority Health SBD |
$1.12
|
| Rate for Payer: UMR Bronson Commercial |
$0.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.33
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14.13
|
|
|
Service Code
|
NDC 00409177805
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.22 |
| Max. Negotiated Rate |
$12.72 |
| Rate for Payer: Aetna American Axle |
$9.18
|
| Rate for Payer: Aetna Commercial |
$12.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.18
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cofinity Commercial |
$12.15
|
| Rate for Payer: Cofinity Commercial |
$9.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.30
|
| Rate for Payer: Healthscope Commercial |
$12.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.01
|
| Rate for Payer: PHP Commercial |
$12.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.18
|
| Rate for Payer: Priority Health SBD |
$8.90
|
| Rate for Payer: UMR Bronson Commercial |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.60
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.94
|
|
|
Service Code
|
NDC 63323066005
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.38 |
| Max. Negotiated Rate |
$17.95 |
| Rate for Payer: Aetna American Axle |
$12.96
|
| Rate for Payer: Aetna Commercial |
$16.95
|
| Rate for Payer: Aetna Medicare |
$9.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.96
|
| Rate for Payer: BCBS Complete |
$7.98
|
| Rate for Payer: Cash Price |
$15.95
|
| Rate for Payer: Cofinity Commercial |
$13.96
|
| Rate for Payer: Cofinity Commercial |
$17.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.95
|
| Rate for Payer: Healthscope Commercial |
$17.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.95
|
| Rate for Payer: PHP Commercial |
$16.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.96
|
| Rate for Payer: Priority Health SBD |
$12.56
|
| Rate for Payer: UMR Bronson Commercial |
$7.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.96
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14.00
|
|
|
Service Code
|
NDC 00143966001
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$12.60 |
| Rate for Payer: Aetna American Axle |
$9.10
|
| Rate for Payer: Aetna Commercial |
$11.90
|
| Rate for Payer: Aetna Medicare |
$7.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.10
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$12.04
|
| Rate for Payer: Cofinity Commercial |
$9.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.20
|
| Rate for Payer: Healthscope Commercial |
$12.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.90
|
| Rate for Payer: PHP Commercial |
$11.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health SBD |
$8.82
|
| Rate for Payer: UMR Bronson Commercial |
$5.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.50
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$16.75
|
|
|
Service Code
|
NDC 36000003310
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.37 |
| Max. Negotiated Rate |
$15.08 |
| Rate for Payer: Aetna American Axle |
$10.89
|
| Rate for Payer: Aetna Commercial |
$14.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.89
|
| Rate for Payer: Cash Price |
$13.40
|
| Rate for Payer: Cofinity Commercial |
$11.72
|
| Rate for Payer: Cofinity Commercial |
$14.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.40
|
| Rate for Payer: Healthscope Commercial |
$15.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.24
|
| Rate for Payer: PHP Commercial |
$14.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.89
|
| Rate for Payer: Priority Health SBD |
$10.55
|
| Rate for Payer: UMR Bronson Commercial |
$7.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.56
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$11.75
|
|
|
Service Code
|
NDC 72572042010
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$10.58 |
| Rate for Payer: Aetna American Axle |
$7.64
|
| Rate for Payer: Aetna Commercial |
$9.99
|
| Rate for Payer: Aetna Medicare |
$5.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.64
|
| Rate for Payer: BCBS Complete |
$4.70
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cofinity Commercial |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$8.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.40
|
| Rate for Payer: Healthscope Commercial |
$10.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.99
|
| Rate for Payer: PHP Commercial |
$9.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.64
|
| Rate for Payer: Priority Health SBD |
$7.40
|
| Rate for Payer: UMR Bronson Commercial |
$4.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.81
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14.13
|
|
|
Service Code
|
NDC 00409177815
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.22 |
| Max. Negotiated Rate |
$12.72 |
| Rate for Payer: Aetna American Axle |
$9.18
|
| Rate for Payer: Aetna Commercial |
$12.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.18
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cofinity Commercial |
$12.15
|
| Rate for Payer: Cofinity Commercial |
$9.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.30
|
| Rate for Payer: Healthscope Commercial |
$12.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.01
|
| Rate for Payer: PHP Commercial |
$12.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.18
|
| Rate for Payer: Priority Health SBD |
$8.90
|
| Rate for Payer: UMR Bronson Commercial |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.60
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$16.13
|
|
|
Service Code
|
NDC 72611074010
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Aetna American Axle |
$10.48
|
| Rate for Payer: Aetna Commercial |
$13.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.48
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cofinity Commercial |
$11.29
|
| Rate for Payer: Cofinity Commercial |
$13.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$14.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.71
|
| Rate for Payer: PHP Commercial |
$13.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.48
|
| Rate for Payer: Priority Health SBD |
$10.16
|
| Rate for Payer: UMR Bronson Commercial |
$7.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.10
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$27.77
|
|
|
Service Code
|
NDC 55390007310
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$24.99 |
| Rate for Payer: Aetna American Axle |
$18.05
|
| Rate for Payer: Aetna Commercial |
$23.60
|
| Rate for Payer: Aetna Medicare |
$13.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.05
|
| Rate for Payer: BCBS Complete |
$11.11
|
| Rate for Payer: Cash Price |
$22.22
|
| Rate for Payer: Cofinity Commercial |
$19.44
|
| Rate for Payer: Cofinity Commercial |
$23.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.22
|
| Rate for Payer: Healthscope Commercial |
$24.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.60
|
| Rate for Payer: PHP Commercial |
$23.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.05
|
| Rate for Payer: Priority Health SBD |
$17.50
|
| Rate for Payer: UMR Bronson Commercial |
$10.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.83
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$16.13
|
|
|
Service Code
|
NDC 72611074001
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Aetna American Axle |
$10.48
|
| Rate for Payer: Aetna Commercial |
$13.71
|
| Rate for Payer: Aetna Medicare |
$8.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.48
|
| Rate for Payer: BCBS Complete |
$6.45
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cofinity Commercial |
$11.29
|
| Rate for Payer: Cofinity Commercial |
$13.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$14.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.71
|
| Rate for Payer: PHP Commercial |
$13.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.48
|
| Rate for Payer: Priority Health SBD |
$10.16
|
| Rate for Payer: UMR Bronson Commercial |
$5.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.10
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.94
|
|
|
Service Code
|
NDC 63323066005
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.77 |
| Max. Negotiated Rate |
$17.95 |
| Rate for Payer: Aetna American Axle |
$12.96
|
| Rate for Payer: Aetna Commercial |
$16.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.96
|
| Rate for Payer: Cash Price |
$15.95
|
| Rate for Payer: Cofinity Commercial |
$13.96
|
| Rate for Payer: Cofinity Commercial |
$17.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.95
|
| Rate for Payer: Healthscope Commercial |
$17.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.95
|
| Rate for Payer: PHP Commercial |
$16.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.96
|
| Rate for Payer: Priority Health SBD |
$12.56
|
| Rate for Payer: UMR Bronson Commercial |
$8.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.96
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$16.13
|
|
|
Service Code
|
NDC 72611074010
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Aetna American Axle |
$10.48
|
| Rate for Payer: Aetna Commercial |
$13.71
|
| Rate for Payer: Aetna Medicare |
$8.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.48
|
| Rate for Payer: BCBS Complete |
$6.45
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cofinity Commercial |
$11.29
|
| Rate for Payer: Cofinity Commercial |
$13.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$14.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.71
|
| Rate for Payer: PHP Commercial |
$13.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.48
|
| Rate for Payer: Priority Health SBD |
$10.16
|
| Rate for Payer: UMR Bronson Commercial |
$5.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.10
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14.00
|
|
|
Service Code
|
NDC 00143966001
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.16 |
| Max. Negotiated Rate |
$12.60 |
| Rate for Payer: Aetna American Axle |
$9.10
|
| Rate for Payer: Aetna Commercial |
$11.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.10
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$12.04
|
| Rate for Payer: Cofinity Commercial |
$9.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.20
|
| Rate for Payer: Healthscope Commercial |
$12.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.90
|
| Rate for Payer: PHP Commercial |
$11.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health SBD |
$8.82
|
| Rate for Payer: UMR Bronson Commercial |
$6.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.50
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$16.13
|
|
|
Service Code
|
NDC 72611074001
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Aetna American Axle |
$10.48
|
| Rate for Payer: Aetna Commercial |
$13.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.48
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cofinity Commercial |
$11.29
|
| Rate for Payer: Cofinity Commercial |
$13.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$14.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.71
|
| Rate for Payer: PHP Commercial |
$13.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.48
|
| Rate for Payer: Priority Health SBD |
$10.16
|
| Rate for Payer: UMR Bronson Commercial |
$7.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.10
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$16.75
|
|
|
Service Code
|
NDC 36000003310
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.20 |
| Max. Negotiated Rate |
$15.08 |
| Rate for Payer: Aetna American Axle |
$10.89
|
| Rate for Payer: Aetna Commercial |
$14.24
|
| Rate for Payer: Aetna Medicare |
$8.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.89
|
| Rate for Payer: BCBS Complete |
$6.70
|
| Rate for Payer: Cash Price |
$13.40
|
| Rate for Payer: Cofinity Commercial |
$11.72
|
| Rate for Payer: Cofinity Commercial |
$14.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.40
|
| Rate for Payer: Healthscope Commercial |
$15.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.24
|
| Rate for Payer: PHP Commercial |
$14.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.89
|
| Rate for Payer: Priority Health SBD |
$10.55
|
| Rate for Payer: UMR Bronson Commercial |
$6.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.56
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$27.77
|
|
|
Service Code
|
NDC 55390007310
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.22 |
| Max. Negotiated Rate |
$24.99 |
| Rate for Payer: Aetna American Axle |
$18.05
|
| Rate for Payer: Aetna Commercial |
$23.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.05
|
| Rate for Payer: Cash Price |
$22.22
|
| Rate for Payer: Cofinity Commercial |
$19.44
|
| Rate for Payer: Cofinity Commercial |
$23.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.22
|
| Rate for Payer: Healthscope Commercial |
$24.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.60
|
| Rate for Payer: PHP Commercial |
$23.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.05
|
| Rate for Payer: Priority Health SBD |
$17.50
|
| Rate for Payer: UMR Bronson Commercial |
$12.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.83
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14.13
|
|
|
Service Code
|
NDC 00409177815
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.23 |
| Max. Negotiated Rate |
$12.72 |
| Rate for Payer: Aetna American Axle |
$9.18
|
| Rate for Payer: Aetna Commercial |
$12.01
|
| Rate for Payer: Aetna Medicare |
$7.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.18
|
| Rate for Payer: BCBS Complete |
$5.65
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cofinity Commercial |
$12.15
|
| Rate for Payer: Cofinity Commercial |
$9.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.30
|
| Rate for Payer: Healthscope Commercial |
$12.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.01
|
| Rate for Payer: PHP Commercial |
$12.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.18
|
| Rate for Payer: Priority Health SBD |
$8.90
|
| Rate for Payer: UMR Bronson Commercial |
$5.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.60
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$11.75
|
|
|
Service Code
|
NDC 72572042001
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$10.58 |
| Rate for Payer: Aetna American Axle |
$7.64
|
| Rate for Payer: Aetna Commercial |
$9.99
|
| Rate for Payer: Aetna Medicare |
$5.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.64
|
| Rate for Payer: BCBS Complete |
$4.70
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cofinity Commercial |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$8.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.40
|
| Rate for Payer: Healthscope Commercial |
$10.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.99
|
| Rate for Payer: PHP Commercial |
$9.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.64
|
| Rate for Payer: Priority Health SBD |
$7.40
|
| Rate for Payer: UMR Bronson Commercial |
$4.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.81
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$11.75
|
|
|
Service Code
|
NDC 72572042001
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$10.58 |
| Rate for Payer: Aetna American Axle |
$7.64
|
| Rate for Payer: Aetna Commercial |
$9.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.64
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cofinity Commercial |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$8.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.40
|
| Rate for Payer: Healthscope Commercial |
$10.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.99
|
| Rate for Payer: PHP Commercial |
$9.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.64
|
| Rate for Payer: Priority Health SBD |
$7.40
|
| Rate for Payer: UMR Bronson Commercial |
$5.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.81
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14.13
|
|
|
Service Code
|
NDC 00409177805
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.23 |
| Max. Negotiated Rate |
$12.72 |
| Rate for Payer: Aetna American Axle |
$9.18
|
| Rate for Payer: Aetna Commercial |
$12.01
|
| Rate for Payer: Aetna Medicare |
$7.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.18
|
| Rate for Payer: BCBS Complete |
$5.65
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cofinity Commercial |
$12.15
|
| Rate for Payer: Cofinity Commercial |
$9.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.30
|
| Rate for Payer: Healthscope Commercial |
$12.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.01
|
| Rate for Payer: PHP Commercial |
$12.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.18
|
| Rate for Payer: Priority Health SBD |
$8.90
|
| Rate for Payer: UMR Bronson Commercial |
$5.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.60
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$11.75
|
|
|
Service Code
|
NDC 72572042010
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$10.58 |
| Rate for Payer: Aetna American Axle |
$7.64
|
| Rate for Payer: Aetna Commercial |
$9.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.64
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cofinity Commercial |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$8.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.40
|
| Rate for Payer: Healthscope Commercial |
$10.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.99
|
| Rate for Payer: PHP Commercial |
$9.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.64
|
| Rate for Payer: Priority Health SBD |
$7.40
|
| Rate for Payer: UMR Bronson Commercial |
$5.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.81
|
|
|
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 |
$59.42
|
| 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 Commercial |
$102.19
|
| Rate for Payer: Cofinity Commercial |
$83.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.18
|
| 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: PHP Commercial |
$101.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.24
|
| Rate for Payer: Priority Health SBD |
$74.86
|
| Rate for Payer: UMR Bronson Commercial |
$43.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.12
|
|
