|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
OP
|
$171.55
|
|
|
Service Code
|
NDC 51079025520
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$68.62 |
| Max. Negotiated Rate |
$171.55 |
| Rate for Payer: Aetna Commercial |
$154.40
|
| Rate for Payer: Aetna Medicare |
$85.78
|
| Rate for Payer: ASR ASR |
$166.40
|
| Rate for Payer: ASR Commercial |
$166.40
|
| Rate for Payer: BCBS Complete |
$68.62
|
| Rate for Payer: BCBS Trust/PPO |
$140.48
|
| Rate for Payer: BCN Commercial |
$133.00
|
| Rate for Payer: Cash Price |
$137.24
|
| Rate for Payer: Cofinity Commercial |
$161.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.24
|
| Rate for Payer: Healthscope Commercial |
$171.55
|
| Rate for Payer: Healthscope Whirlpool |
$166.40
|
| Rate for Payer: Mclaren Commercial |
$154.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.82
|
| Rate for Payer: Nomi Health Commercial |
$140.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.31
|
| Rate for Payer: Priority Health Narrow Network |
$120.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$150.96
|
|
|
METOPROLOL TARTRATE 25 MG TABLET
|
Facility
|
IP
|
$171.55
|
|
|
Service Code
|
NDC 51079025520
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$111.51 |
| Max. Negotiated Rate |
$171.55 |
| Rate for Payer: Aetna Commercial |
$154.40
|
| Rate for Payer: ASR ASR |
$166.40
|
| Rate for Payer: ASR Commercial |
$166.40
|
| Rate for Payer: BCBS Trust/PPO |
$139.80
|
| Rate for Payer: BCN Commercial |
$133.00
|
| Rate for Payer: Cash Price |
$137.24
|
| Rate for Payer: Cofinity Commercial |
$161.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.24
|
| Rate for Payer: Healthscope Commercial |
$171.55
|
| Rate for Payer: Healthscope Whirlpool |
$166.40
|
| Rate for Payer: Mclaren Commercial |
$154.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.82
|
| Rate for Payer: Nomi Health Commercial |
$140.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$150.96
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$225.60
|
|
|
Service Code
|
NDC 62584026611
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$146.64 |
| Max. Negotiated Rate |
$225.60 |
| Rate for Payer: Aetna Commercial |
$203.04
|
| Rate for Payer: ASR ASR |
$218.83
|
| Rate for Payer: ASR Commercial |
$218.83
|
| Rate for Payer: BCBS Trust/PPO |
$183.84
|
| Rate for Payer: BCN Commercial |
$174.91
|
| Rate for Payer: Cash Price |
$180.48
|
| Rate for Payer: Cofinity Commercial |
$212.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.48
|
| Rate for Payer: Healthscope Commercial |
$225.60
|
| Rate for Payer: Healthscope Whirlpool |
$218.83
|
| Rate for Payer: Mclaren Commercial |
$203.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.76
|
| Rate for Payer: Nomi Health Commercial |
$184.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.53
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$225.60
|
|
|
Service Code
|
NDC 62584026601
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$90.24 |
| Max. Negotiated Rate |
$225.60 |
| Rate for Payer: Aetna Commercial |
$203.04
|
| Rate for Payer: Aetna Medicare |
$112.80
|
| Rate for Payer: ASR ASR |
$218.83
|
| Rate for Payer: ASR Commercial |
$218.83
|
| Rate for Payer: BCBS Complete |
$90.24
|
| Rate for Payer: BCBS Trust/PPO |
$184.74
|
| Rate for Payer: BCN Commercial |
$174.91
|
| Rate for Payer: Cash Price |
$180.48
|
| Rate for Payer: Cofinity Commercial |
$212.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.48
|
| Rate for Payer: Healthscope Commercial |
$225.60
|
| Rate for Payer: Healthscope Whirlpool |
$218.83
|
| Rate for Payer: Mclaren Commercial |
$203.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.76
|
| Rate for Payer: Nomi Health Commercial |
$184.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.67
|
| Rate for Payer: Priority Health Narrow Network |
$158.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.53
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$56.40
|
|
|
Service Code
|
NDC 62332011331
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$36.66 |
| Max. Negotiated Rate |
$56.40 |
| Rate for Payer: Aetna Commercial |
$50.76
|
| Rate for Payer: ASR ASR |
$54.71
|
| Rate for Payer: ASR Commercial |
$54.71
|
| Rate for Payer: BCBS Trust/PPO |
$45.96
|
| Rate for Payer: BCN Commercial |
$43.73
|
| Rate for Payer: Cash Price |
$45.12
|
| Rate for Payer: Cofinity Commercial |
$53.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.12
|
| Rate for Payer: Healthscope Commercial |
$56.40
|
| Rate for Payer: Healthscope Whirlpool |
$54.71
|
| Rate for Payer: Mclaren Commercial |
$50.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.94
|
| Rate for Payer: Nomi Health Commercial |
$46.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.63
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$164.50
|
|
|
Service Code
|
NDC 00904711861
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$65.80 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$148.05
|
| Rate for Payer: Aetna Medicare |
$82.25
|
| Rate for Payer: ASR ASR |
$159.56
|
| Rate for Payer: ASR Commercial |
$159.56
|
| Rate for Payer: BCBS Complete |
$65.80
|
| Rate for Payer: BCBS Trust/PPO |
$134.71
|
| Rate for Payer: BCN Commercial |
$127.54
|
| Rate for Payer: Cash Price |
$131.60
|
| Rate for Payer: Cofinity Commercial |
$154.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.60
|
| Rate for Payer: Healthscope Commercial |
$164.50
|
| Rate for Payer: Healthscope Whirlpool |
$159.56
|
| Rate for Payer: Mclaren Commercial |
$148.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.82
|
| Rate for Payer: Nomi Health Commercial |
$134.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.13
|
| Rate for Payer: Priority Health Narrow Network |
$115.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$144.76
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$108.10
|
|
|
Service Code
|
NDC 00378003201
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.24 |
| Max. Negotiated Rate |
$108.10 |
| Rate for Payer: Aetna Commercial |
$97.29
|
| Rate for Payer: Aetna Medicare |
$54.05
|
| Rate for Payer: ASR ASR |
$104.86
|
| Rate for Payer: ASR Commercial |
$104.86
|
| Rate for Payer: BCBS Complete |
$43.24
|
| Rate for Payer: BCBS Trust/PPO |
$88.52
|
| Rate for Payer: BCN Commercial |
$83.81
|
| Rate for Payer: Cash Price |
$86.48
|
| Rate for Payer: Cofinity Commercial |
$101.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.48
|
| Rate for Payer: Healthscope Commercial |
$108.10
|
| Rate for Payer: Healthscope Whirlpool |
$104.86
|
| Rate for Payer: Mclaren Commercial |
$97.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.88
|
| Rate for Payer: Nomi Health Commercial |
$88.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.72
|
| Rate for Payer: Priority Health Narrow Network |
$75.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.13
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$56.40
|
|
|
Service Code
|
NDC 62332011331
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$22.56 |
| Max. Negotiated Rate |
$56.40 |
| Rate for Payer: Aetna Commercial |
$50.76
|
| Rate for Payer: Aetna Medicare |
$28.20
|
| Rate for Payer: ASR ASR |
$54.71
|
| Rate for Payer: ASR Commercial |
$54.71
|
| Rate for Payer: BCBS Complete |
$22.56
|
| Rate for Payer: BCBS Trust/PPO |
$46.19
|
| Rate for Payer: BCN Commercial |
$43.73
|
| Rate for Payer: Cash Price |
$45.12
|
| Rate for Payer: Cofinity Commercial |
$53.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.12
|
| Rate for Payer: Healthscope Commercial |
$56.40
|
| Rate for Payer: Healthscope Whirlpool |
$54.71
|
| Rate for Payer: Mclaren Commercial |
$50.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.94
|
| Rate for Payer: Nomi Health Commercial |
$46.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.42
|
| Rate for Payer: Priority Health Narrow Network |
$39.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.63
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$225.60
|
|
|
Service Code
|
NDC 62584026611
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$90.24 |
| Max. Negotiated Rate |
$225.60 |
| Rate for Payer: Aetna Commercial |
$203.04
|
| Rate for Payer: Aetna Medicare |
$112.80
|
| Rate for Payer: ASR ASR |
$218.83
|
| Rate for Payer: ASR Commercial |
$218.83
|
| Rate for Payer: BCBS Complete |
$90.24
|
| Rate for Payer: BCBS Trust/PPO |
$184.74
|
| Rate for Payer: BCN Commercial |
$174.91
|
| Rate for Payer: Cash Price |
$180.48
|
| Rate for Payer: Cofinity Commercial |
$212.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.48
|
| Rate for Payer: Healthscope Commercial |
$225.60
|
| Rate for Payer: Healthscope Whirlpool |
$218.83
|
| Rate for Payer: Mclaren Commercial |
$203.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.76
|
| Rate for Payer: Nomi Health Commercial |
$184.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.67
|
| Rate for Payer: Priority Health Narrow Network |
$158.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.53
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
OP
|
$1.76
|
|
|
Service Code
|
NDC 51079080101
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.70 |
| Max. Negotiated Rate |
$1.76 |
| Rate for Payer: Aetna Commercial |
$1.58
|
| Rate for Payer: Aetna Medicare |
$0.88
|
| Rate for Payer: ASR ASR |
$1.71
|
| Rate for Payer: ASR Commercial |
$1.71
|
| Rate for Payer: BCBS Complete |
$0.70
|
| Rate for Payer: BCBS Trust/PPO |
$1.44
|
| Rate for Payer: BCN Commercial |
$1.36
|
| Rate for Payer: Cash Price |
$1.41
|
| Rate for Payer: Cofinity Commercial |
$1.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.41
|
| Rate for Payer: Healthscope Commercial |
$1.76
|
| Rate for Payer: Healthscope Whirlpool |
$1.71
|
| Rate for Payer: Mclaren Commercial |
$1.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.50
|
| Rate for Payer: Nomi Health Commercial |
$1.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.54
|
| Rate for Payer: Priority Health Narrow Network |
$1.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.55
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$1.76
|
|
|
Service Code
|
NDC 51079080101
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.14 |
| Max. Negotiated Rate |
$1.76 |
| Rate for Payer: Aetna Commercial |
$1.58
|
| Rate for Payer: ASR ASR |
$1.71
|
| Rate for Payer: ASR Commercial |
$1.71
|
| Rate for Payer: BCBS Trust/PPO |
$1.43
|
| Rate for Payer: BCN Commercial |
$1.36
|
| Rate for Payer: Cash Price |
$1.41
|
| Rate for Payer: Cofinity Commercial |
$1.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.41
|
| Rate for Payer: Healthscope Commercial |
$1.76
|
| Rate for Payer: Healthscope Whirlpool |
$1.71
|
| Rate for Payer: Mclaren Commercial |
$1.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.50
|
| Rate for Payer: Nomi Health Commercial |
$1.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.55
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$164.50
|
|
|
Service Code
|
NDC 00904711861
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$106.92 |
| Max. Negotiated Rate |
$164.50 |
| Rate for Payer: Aetna Commercial |
$148.05
|
| Rate for Payer: ASR ASR |
$159.56
|
| Rate for Payer: ASR Commercial |
$159.56
|
| Rate for Payer: BCBS Trust/PPO |
$134.05
|
| Rate for Payer: BCN Commercial |
$127.54
|
| Rate for Payer: Cash Price |
$131.60
|
| Rate for Payer: Cofinity Commercial |
$154.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.60
|
| Rate for Payer: Healthscope Commercial |
$164.50
|
| Rate for Payer: Healthscope Whirlpool |
$159.56
|
| Rate for Payer: Mclaren Commercial |
$148.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.82
|
| Rate for Payer: Nomi Health Commercial |
$134.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$144.76
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$108.10
|
|
|
Service Code
|
NDC 00378003201
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$70.26 |
| Max. Negotiated Rate |
$108.10 |
| Rate for Payer: Aetna Commercial |
$97.29
|
| Rate for Payer: ASR ASR |
$104.86
|
| Rate for Payer: ASR Commercial |
$104.86
|
| Rate for Payer: BCBS Trust/PPO |
$88.09
|
| Rate for Payer: BCN Commercial |
$83.81
|
| Rate for Payer: Cash Price |
$86.48
|
| Rate for Payer: Cofinity Commercial |
$101.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.48
|
| Rate for Payer: Healthscope Commercial |
$108.10
|
| Rate for Payer: Healthscope Whirlpool |
$104.86
|
| Rate for Payer: Mclaren Commercial |
$97.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.88
|
| Rate for Payer: Nomi Health Commercial |
$88.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.13
|
|
|
METOPROLOL TARTRATE 50 MG TABLET
|
Facility
|
IP
|
$225.60
|
|
|
Service Code
|
NDC 62584026601
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$146.64 |
| Max. Negotiated Rate |
$225.60 |
| Rate for Payer: Aetna Commercial |
$203.04
|
| Rate for Payer: ASR ASR |
$218.83
|
| Rate for Payer: ASR Commercial |
$218.83
|
| Rate for Payer: BCBS Trust/PPO |
$183.84
|
| Rate for Payer: BCN Commercial |
$174.91
|
| Rate for Payer: Cash Price |
$180.48
|
| Rate for Payer: Cofinity Commercial |
$212.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.48
|
| Rate for Payer: Healthscope Commercial |
$225.60
|
| Rate for Payer: Healthscope Whirlpool |
$218.83
|
| Rate for Payer: Mclaren Commercial |
$203.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.76
|
| Rate for Payer: Nomi Health Commercial |
$184.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.53
|
|
|
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 |
$9.10 |
| Max. Negotiated Rate |
$14.00 |
| Rate for Payer: Aetna Commercial |
$12.60
|
| Rate for Payer: ASR ASR |
$13.58
|
| Rate for Payer: ASR Commercial |
$13.58
|
| Rate for Payer: BCBS Trust/PPO |
$11.41
|
| Rate for Payer: BCN Commercial |
$10.85
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.20
|
| Rate for Payer: Healthscope Commercial |
$14.00
|
| Rate for Payer: Healthscope Whirlpool |
$13.58
|
| Rate for Payer: Mclaren Commercial |
$12.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.90
|
| Rate for Payer: Nomi Health Commercial |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.32
|
|
|
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 |
$12.96 |
| Max. Negotiated Rate |
$19.94 |
| Rate for Payer: Aetna Commercial |
$17.95
|
| Rate for Payer: ASR ASR |
$19.34
|
| Rate for Payer: ASR Commercial |
$19.34
|
| Rate for Payer: BCBS Trust/PPO |
$16.25
|
| Rate for Payer: BCN Commercial |
$15.46
|
| Rate for Payer: Cash Price |
$15.95
|
| Rate for Payer: Cofinity Commercial |
$18.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.95
|
| Rate for Payer: Healthscope Commercial |
$19.94
|
| Rate for Payer: Healthscope Whirlpool |
$19.34
|
| Rate for Payer: Mclaren Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.95
|
| Rate for Payer: Nomi Health Commercial |
$16.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.55
|
|
|
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 |
$7.98 |
| Max. Negotiated Rate |
$19.94 |
| Rate for Payer: Aetna Commercial |
$17.95
|
| Rate for Payer: Aetna Medicare |
$9.97
|
| Rate for Payer: ASR ASR |
$19.34
|
| Rate for Payer: ASR Commercial |
$19.34
|
| Rate for Payer: BCBS Complete |
$7.98
|
| Rate for Payer: BCBS Trust/PPO |
$16.33
|
| Rate for Payer: BCN Commercial |
$15.46
|
| Rate for Payer: Cash Price |
$15.95
|
| Rate for Payer: Cofinity Commercial |
$18.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.95
|
| Rate for Payer: Healthscope Commercial |
$19.94
|
| Rate for Payer: Healthscope Whirlpool |
$19.34
|
| Rate for Payer: Mclaren Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.95
|
| Rate for Payer: Nomi Health Commercial |
$16.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.47
|
| Rate for Payer: Priority Health Narrow Network |
$13.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.55
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14.12
|
|
|
Service Code
|
NDC 47781058717
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$14.12 |
| Rate for Payer: Aetna Commercial |
$12.71
|
| Rate for Payer: Aetna Medicare |
$7.06
|
| Rate for Payer: ASR ASR |
$13.70
|
| Rate for Payer: ASR Commercial |
$13.70
|
| Rate for Payer: BCBS Complete |
$5.65
|
| Rate for Payer: BCBS Trust/PPO |
$11.56
|
| Rate for Payer: BCN Commercial |
$10.95
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cofinity Commercial |
$13.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.30
|
| Rate for Payer: Healthscope Commercial |
$14.12
|
| Rate for Payer: Healthscope Whirlpool |
$13.70
|
| Rate for Payer: Mclaren Commercial |
$12.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.00
|
| Rate for Payer: Nomi Health Commercial |
$11.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.37
|
| Rate for Payer: Priority Health Narrow Network |
$9.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.43
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14.12
|
|
|
Service Code
|
NDC 47781058720
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$14.12 |
| Rate for Payer: Aetna Commercial |
$12.71
|
| Rate for Payer: Aetna Medicare |
$7.06
|
| Rate for Payer: ASR ASR |
$13.70
|
| Rate for Payer: ASR Commercial |
$13.70
|
| Rate for Payer: BCBS Complete |
$5.65
|
| Rate for Payer: BCBS Trust/PPO |
$11.56
|
| Rate for Payer: BCN Commercial |
$10.95
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cofinity Commercial |
$13.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.30
|
| Rate for Payer: Healthscope Commercial |
$14.12
|
| Rate for Payer: Healthscope Whirlpool |
$13.70
|
| Rate for Payer: Mclaren Commercial |
$12.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.00
|
| Rate for Payer: Nomi Health Commercial |
$11.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.37
|
| Rate for Payer: Priority Health Narrow Network |
$9.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.43
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14.25
|
|
|
Service Code
|
NDC 00409201610
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.70 |
| Max. Negotiated Rate |
$14.25 |
| Rate for Payer: Aetna Commercial |
$12.82
|
| Rate for Payer: Aetna Medicare |
$7.12
|
| Rate for Payer: ASR ASR |
$13.82
|
| Rate for Payer: ASR Commercial |
$13.82
|
| Rate for Payer: BCBS Complete |
$5.70
|
| Rate for Payer: BCBS Trust/PPO |
$11.67
|
| Rate for Payer: BCN Commercial |
$11.05
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cofinity Commercial |
$13.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.40
|
| Rate for Payer: Healthscope Commercial |
$14.25
|
| Rate for Payer: Healthscope Whirlpool |
$13.82
|
| Rate for Payer: Mclaren Commercial |
$12.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.11
|
| Rate for Payer: Nomi Health Commercial |
$11.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.49
|
| Rate for Payer: Priority Health Narrow Network |
$9.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.54
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14.12
|
|
|
Service Code
|
NDC 47781058717
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.18 |
| Max. Negotiated Rate |
$14.12 |
| Rate for Payer: Aetna Commercial |
$12.71
|
| Rate for Payer: ASR ASR |
$13.70
|
| Rate for Payer: ASR Commercial |
$13.70
|
| Rate for Payer: BCBS Trust/PPO |
$11.51
|
| Rate for Payer: BCN Commercial |
$10.95
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cofinity Commercial |
$13.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.30
|
| Rate for Payer: Healthscope Commercial |
$14.12
|
| Rate for Payer: Healthscope Whirlpool |
$13.70
|
| Rate for Payer: Mclaren Commercial |
$12.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.00
|
| Rate for Payer: Nomi Health Commercial |
$11.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.43
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$24.29
|
|
|
Service Code
|
NDC 70860030005
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.72 |
| Max. Negotiated Rate |
$24.29 |
| Rate for Payer: Aetna Commercial |
$21.86
|
| Rate for Payer: Aetna Medicare |
$12.14
|
| Rate for Payer: ASR ASR |
$23.56
|
| Rate for Payer: ASR Commercial |
$23.56
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS Trust/PPO |
$19.89
|
| Rate for Payer: BCN Commercial |
$18.83
|
| Rate for Payer: Cash Price |
$19.43
|
| Rate for Payer: Cofinity Commercial |
$22.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.43
|
| Rate for Payer: Healthscope Commercial |
$24.29
|
| Rate for Payer: Healthscope Whirlpool |
$23.56
|
| Rate for Payer: Mclaren Commercial |
$21.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.65
|
| Rate for Payer: Nomi Health Commercial |
$19.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.28
|
| Rate for Payer: Priority Health Narrow Network |
$17.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.38
|
|
|
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 |
$5.60 |
| Max. Negotiated Rate |
$14.00 |
| Rate for Payer: Aetna Commercial |
$12.60
|
| Rate for Payer: Aetna Medicare |
$7.00
|
| Rate for Payer: ASR ASR |
$13.58
|
| Rate for Payer: ASR Commercial |
$13.58
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Trust/PPO |
$11.46
|
| Rate for Payer: BCN Commercial |
$10.85
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.20
|
| Rate for Payer: Healthscope Commercial |
$14.00
|
| Rate for Payer: Healthscope Whirlpool |
$13.58
|
| Rate for Payer: Mclaren Commercial |
$12.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.90
|
| Rate for Payer: Nomi Health Commercial |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.27
|
| Rate for Payer: Priority Health Narrow Network |
$9.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.32
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14.25
|
|
|
Service Code
|
NDC 00409201610
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$14.25 |
| Rate for Payer: Aetna Commercial |
$12.82
|
| Rate for Payer: ASR ASR |
$13.82
|
| Rate for Payer: ASR Commercial |
$13.82
|
| Rate for Payer: BCBS Trust/PPO |
$11.61
|
| Rate for Payer: BCN Commercial |
$11.05
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cofinity Commercial |
$13.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.40
|
| Rate for Payer: Healthscope Commercial |
$14.25
|
| Rate for Payer: Healthscope Whirlpool |
$13.82
|
| Rate for Payer: Mclaren Commercial |
$12.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.11
|
| Rate for Payer: Nomi Health Commercial |
$11.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.54
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14.00
|
|
|
Service Code
|
NDC 00143966010
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$14.00 |
| Rate for Payer: Aetna Commercial |
$12.60
|
| Rate for Payer: Aetna Medicare |
$7.00
|
| Rate for Payer: ASR ASR |
$13.58
|
| Rate for Payer: ASR Commercial |
$13.58
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Trust/PPO |
$11.46
|
| Rate for Payer: BCN Commercial |
$10.85
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.20
|
| Rate for Payer: Healthscope Commercial |
$14.00
|
| Rate for Payer: Healthscope Whirlpool |
$13.58
|
| Rate for Payer: Mclaren Commercial |
$12.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.90
|
| Rate for Payer: Nomi Health Commercial |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.27
|
| Rate for Payer: Priority Health Narrow Network |
$9.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.32
|
|
