Ellenville Regional Hospital

All Charges

Charge

Type

Setting

Price

MEROCEL NASAL PACKING 8.0CM

Facility

$141.11

Hospital Charge Code	4472006
Hospital Revenue Code	270
Min. Negotiated Rate	$91.72
Max. Negotiated Rate	$91.72
Rate for Payer: Cash Price	$105.83
Rate for Payer: Galaxy Health Commercial	$91.72

MEROPENEM-0.9% NACL 1 GRAM/50 100 mg, 1 each

Facility

$8.00

Service Code	HCPCS J2185
Hospital Charge Code	4401352
Hospital Revenue Code	636
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$6.40
Rate for Payer: Aetna of NY Medicare	$3.68
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$3.20
Rate for Payer: Cash Price	$6.00
Rate for Payer: Cash Price	$6.00
Rate for Payer: CDPHP Medicare	$2.96
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$0.37
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$6.40
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$6.40
Rate for Payer: EmblemHealth Medicaid	$6.40
Rate for Payer: EmblemHealth Medicare	$2.72
Rate for Payer: EmblemHealth Select Care	$0.37
Rate for Payer: Fidelis Medicare	$3.20
Rate for Payer: Galaxy Health Commercial	$5.20
Rate for Payer: Hamaspik Choice Medicare	$3.20
Rate for Payer: Humana Medicare	$3.20
Rate for Payer: Local 1199SEIU Medicare	$3.68
Rate for Payer: MVP Health Care of NY Commercial	$6.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$4.50
Rate for Payer: MVP Health Care of NY Medicare	$3.36
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro	$0.86
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1.20
Rate for Payer: United Healthcare Commercial	$0.86
Rate for Payer: United Healthcare Medicare	$3.20
Rate for Payer: WellCare Medicare	$4.40

MEROPENEM-0.9% NACL 1 GRAM/50 100 mg, 1 each

Facility

$8.00

Service Code	HCPCS J2185
Hospital Charge Code	4401352
Hospital Revenue Code	636
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$5.20
Rate for Payer: Aetna of NY Commercial	$4.40
Rate for Payer: Cash Price	$6.00
Rate for Payer: Cash Price	$6.00
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$0.37
Rate for Payer: EmblemHealth Select Care	$0.37
Rate for Payer: Galaxy Health Commercial	$5.20
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$4.40
Rate for Payer: WellCare Medicare	$4.40

MEROPENEM 100 MG INJ

Facility

$10.50

Service Code	HCPCS J2185
Hospital Charge Code	4409188
Hospital Revenue Code	636
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna of NY Commercial	$5.78
Rate for Payer: Cash Price	$7.88
Rate for Payer: Cash Price	$7.88
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$0.37
Rate for Payer: EmblemHealth Select Care	$0.37
Rate for Payer: Galaxy Health Commercial	$6.83
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$5.78
Rate for Payer: WellCare Medicare	$5.78

MEROPENEM 100 MG INJ

Facility

$10.50

Service Code	HCPCS J2185
Hospital Charge Code	4409188
Hospital Revenue Code	636
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$8.40
Rate for Payer: Aetna of NY Medicare	$4.83
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$4.20
Rate for Payer: Cash Price	$7.88
Rate for Payer: Cash Price	$7.88
Rate for Payer: CDPHP Medicare	$3.88
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$0.37
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$8.40
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$8.40
Rate for Payer: EmblemHealth Medicaid	$8.40
Rate for Payer: EmblemHealth Medicare	$3.57
Rate for Payer: EmblemHealth Select Care	$0.37
Rate for Payer: Fidelis Medicare	$4.20
Rate for Payer: Galaxy Health Commercial	$6.83
Rate for Payer: Hamaspik Choice Medicare	$4.20
Rate for Payer: Humana Medicare	$4.20
Rate for Payer: Local 1199SEIU Medicare	$4.83
Rate for Payer: MVP Health Care of NY Commercial	$7.88
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$5.91
Rate for Payer: MVP Health Care of NY Medicare	$4.41
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro	$0.86
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1.57
Rate for Payer: United Healthcare Commercial	$0.86
Rate for Payer: United Healthcare Medicare	$4.20
Rate for Payer: WellCare Medicare	$5.78

METAMUCIL FIBER SINGLES PACKET 1 ea, 44 eaches

Facility

$6.00

Service Code	NDC 37000025445
Hospital Charge Code	4401419
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$4.80
Rate for Payer: Aetna of NY Commercial	$4.20
Rate for Payer: Aetna of NY Medicare	$2.76
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$2.40
Rate for Payer: Cash Price	$4.50
Rate for Payer: CDPHP Medicare	$2.22
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$4.80
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$4.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$4.80
Rate for Payer: EmblemHealth Medicaid	$4.80
Rate for Payer: EmblemHealth Medicare	$2.04
Rate for Payer: EmblemHealth Select Care	$4.32
Rate for Payer: Fidelis Medicare	$2.40
Rate for Payer: Galaxy Health Commercial	$3.90
Rate for Payer: Hamaspik Choice Medicare	$2.40
Rate for Payer: Humana Medicare	$2.40
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$4.20
Rate for Payer: Local 1199SEIU Medicare	$2.76
Rate for Payer: MVP Health Care of NY Commercial	$4.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$3.38
Rate for Payer: MVP Health Care of NY Medicare	$2.52
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$0.90
Rate for Payer: United Healthcare Medicare	$2.40
Rate for Payer: WellCare Medicare	$3.30

METAMUCIL FIBER SINGLES PACKET 1 ea, 44 eaches

Facility

$6.00

Service Code	NDC 37000025445
Hospital Charge Code	4401419
Hospital Revenue Code	250
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.90
Rate for Payer: Cash Price	$4.50
Rate for Payer: Galaxy Health Commercial	$3.90
Rate for Payer: WellCare Medicare	$3.30

METANEPHRINES 24 HR URIN

Facility

$51.00

Service Code	HCPCS 83835
Hospital Charge Code	4300556
Hospital Revenue Code	301
Min. Negotiated Rate	$33.15
Max. Negotiated Rate	$33.15
Rate for Payer: Cash Price	$38.25
Rate for Payer: Galaxy Health Commercial	$33.15

METANEPHRINES 24 HR URIN

Facility

$51.00

Service Code	HCPCS 83835
Hospital Charge Code	4300556
Hospital Revenue Code	301
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$40.80
Rate for Payer: Aetna of NY Commercial	$33.15
Rate for Payer: Aetna of NY Medicare	$23.46
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$20.40
Rate for Payer: Cash Price	$38.25
Rate for Payer: CDPHP Medicare	$18.87
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$30.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$40.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$40.80
Rate for Payer: EmblemHealth Medicaid	$40.80
Rate for Payer: EmblemHealth Medicare	$17.34
Rate for Payer: EmblemHealth Select Care	$30.60
Rate for Payer: Fidelis Medicare	$20.40
Rate for Payer: Galaxy Health Commercial	$33.15
Rate for Payer: Hamaspik Choice Medicare	$20.40
Rate for Payer: Humana Medicare	$20.40
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$33.15
Rate for Payer: Local 1199SEIU Medicare	$23.46
Rate for Payer: MVP Health Care of NY Commercial	$38.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$28.71
Rate for Payer: MVP Health Care of NY Medicare	$21.42
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro	$38.25
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$7.65
Rate for Payer: United Healthcare Commercial	$38.25
Rate for Payer: United Healthcare Medicare	$20.40
Rate for Payer: WellCare Medicare	$28.05

METATARSAL DECOMPRESSION IMPLANT (MDI)

Facility

$17,240.14

Service Code	HCPCS C1776
Hospital Charge Code	4471665
Hospital Revenue Code	278
Min. Negotiated Rate	$7,758.06
Max. Negotiated Rate	$12,068.10
Rate for Payer: Aetna of NY Commercial	$12,068.10
Rate for Payer: Cash Price	$12,930.10
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$8,620.07
Rate for Payer: EmblemHealth Select Care	$8,620.07
Rate for Payer: Galaxy Health Commercial	$11,206.09
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$12,068.10
Rate for Payer: Multiplan Commercial	$7,758.06
Rate for Payer: MVP Health Care of NY Commercial	$11,206.09
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$11,206.09
Rate for Payer: WellCare Medicare	$9,482.08

METATARSAL DECOMPRESSION IMPLANT (MDI)

Facility

$17,240.14

Service Code	HCPCS C1776
Hospital Charge Code	4471665
Hospital Revenue Code	278
Min. Negotiated Rate	$2,586.02
Max. Negotiated Rate	$13,792.11
Rate for Payer: Aetna of NY Commercial	$12,068.10
Rate for Payer: Aetna of NY Medicare	$7,930.46
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$6,896.06
Rate for Payer: Cash Price	$12,930.10
Rate for Payer: CDPHP Medicare	$6,378.85
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$8,620.07
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$13,792.11
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$13,792.11
Rate for Payer: EmblemHealth Medicaid	$13,792.11
Rate for Payer: EmblemHealth Medicare	$5,861.65
Rate for Payer: EmblemHealth Select Care	$8,620.07
Rate for Payer: Fidelis Medicare	$6,896.06
Rate for Payer: Galaxy Health Commercial	$11,206.09
Rate for Payer: Hamaspik Choice Medicare	$6,896.06
Rate for Payer: Humana Medicare	$6,896.06
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$12,068.10
Rate for Payer: Local 1199SEIU Medicare	$7,930.46
Rate for Payer: MVP Health Care of NY Commercial	$11,206.09
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$11,206.09
Rate for Payer: MVP Health Care of NY Medicare	$7,240.86
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2,586.02
Rate for Payer: United Healthcare Medicare	$6,896.06
Rate for Payer: WellCare Medicare	$9,482.08

METAXALONE 800 MG

Facility

$18.54

Service Code	NDC 50268053011
Hospital Charge Code	4409020
Hospital Revenue Code	250
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$14.83
Rate for Payer: Aetna of NY Commercial	$12.98
Rate for Payer: Aetna of NY Medicare	$8.53
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$7.42
Rate for Payer: Cash Price	$13.90
Rate for Payer: CDPHP Medicare	$6.86
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$14.83
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$14.83
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$14.83
Rate for Payer: EmblemHealth Medicaid	$14.83
Rate for Payer: EmblemHealth Medicare	$6.30
Rate for Payer: EmblemHealth Select Care	$13.35
Rate for Payer: Fidelis Medicare	$7.42
Rate for Payer: Galaxy Health Commercial	$12.05
Rate for Payer: Hamaspik Choice Medicare	$7.42
Rate for Payer: Humana Medicare	$7.42
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$12.98
Rate for Payer: Local 1199SEIU Medicare	$8.53
Rate for Payer: MVP Health Care of NY Commercial	$13.90
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$10.44
Rate for Payer: MVP Health Care of NY Medicare	$7.79
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2.78
Rate for Payer: United Healthcare Medicare	$7.42
Rate for Payer: WellCare Medicare	$10.20

METAXALONE 800 MG

Facility

$18.54

Service Code	NDC 50268053011
Hospital Charge Code	4409020
Hospital Revenue Code	250
Min. Negotiated Rate	$10.20
Max. Negotiated Rate	$12.05
Rate for Payer: Cash Price	$13.90
Rate for Payer: Galaxy Health Commercial	$12.05
Rate for Payer: WellCare Medicare	$10.20

METER PEAK FLOW

Facility

$74.16

Hospital Charge Code	4471034
Hospital Revenue Code	270
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$48.20
Rate for Payer: Cash Price	$55.62
Rate for Payer: Galaxy Health Commercial	$48.20

METER PEAK FLOW

Facility

$74.16

Hospital Charge Code	4471034
Hospital Revenue Code	270
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$59.33
Rate for Payer: Aetna of NY Commercial	$51.91
Rate for Payer: Aetna of NY Medicare	$34.11
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$29.66
Rate for Payer: Cash Price	$55.62
Rate for Payer: CDPHP Medicare	$27.44
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$59.33
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$59.33
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$59.33
Rate for Payer: EmblemHealth Medicaid	$59.33
Rate for Payer: EmblemHealth Medicare	$25.21
Rate for Payer: EmblemHealth Select Care	$53.40
Rate for Payer: Fidelis Medicare	$29.66
Rate for Payer: Galaxy Health Commercial	$48.20
Rate for Payer: Hamaspik Choice Medicare	$29.66
Rate for Payer: Humana Medicare	$29.66
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$51.91
Rate for Payer: Local 1199SEIU Medicare	$34.11
Rate for Payer: MVP Health Care of NY Commercial	$55.62
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$41.75
Rate for Payer: MVP Health Care of NY Medicare	$31.15
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$11.12
Rate for Payer: United Healthcare Medicare	$29.66
Rate for Payer: WellCare Medicare	$40.79

METFORMIN 500 MG TAB

Facility

$6.18

Service Code	NDC 60687015511
Hospital Charge Code	4409019
Hospital Revenue Code	250
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$4.94
Rate for Payer: Aetna of NY Commercial	$4.33
Rate for Payer: Aetna of NY Medicare	$2.84
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$2.47
Rate for Payer: Cash Price	$4.64
Rate for Payer: CDPHP Medicare	$2.29
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$4.94
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$4.94
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$4.94
Rate for Payer: EmblemHealth Medicaid	$4.94
Rate for Payer: EmblemHealth Medicare	$2.10
Rate for Payer: EmblemHealth Select Care	$4.45
Rate for Payer: Fidelis Medicare	$2.47
Rate for Payer: Galaxy Health Commercial	$4.02
Rate for Payer: Hamaspik Choice Medicare	$2.47
Rate for Payer: Humana Medicare	$2.47
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$4.33
Rate for Payer: Local 1199SEIU Medicare	$2.84
Rate for Payer: MVP Health Care of NY Commercial	$4.63
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$3.48
Rate for Payer: MVP Health Care of NY Medicare	$2.60
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$0.93
Rate for Payer: United Healthcare Medicare	$2.47
Rate for Payer: WellCare Medicare	$3.40

METFORMIN 500 MG TAB

Facility

$6.18

Service Code	NDC 60687015511
Hospital Charge Code	4409019
Hospital Revenue Code	250
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$4.02
Rate for Payer: Cash Price	$4.64
Rate for Payer: Galaxy Health Commercial	$4.02
Rate for Payer: WellCare Medicare	$3.40

METFORMIN HCL 1000MG TABS 10X10EA

Facility

$6.18

Service Code	NDC 904716461
Hospital Charge Code	4400493
Hospital Revenue Code	250
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$4.02
Rate for Payer: Cash Price	$4.64
Rate for Payer: Galaxy Health Commercial	$4.02
Rate for Payer: WellCare Medicare	$3.40

METFORMIN HCL 1000MG TABS 10X10EA

Facility

$6.18

Service Code	NDC 904716461
Hospital Charge Code	4400493
Hospital Revenue Code	250
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$4.94
Rate for Payer: Aetna of NY Commercial	$4.33
Rate for Payer: Aetna of NY Medicare	$2.84
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$2.47
Rate for Payer: Cash Price	$4.64
Rate for Payer: CDPHP Medicare	$2.29
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$4.94
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$4.94
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$4.94
Rate for Payer: EmblemHealth Medicaid	$4.94
Rate for Payer: EmblemHealth Medicare	$2.10
Rate for Payer: EmblemHealth Select Care	$4.45
Rate for Payer: Fidelis Medicare	$2.47
Rate for Payer: Galaxy Health Commercial	$4.02
Rate for Payer: Hamaspik Choice Medicare	$2.47
Rate for Payer: Humana Medicare	$2.47
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$4.33
Rate for Payer: Local 1199SEIU Medicare	$2.84
Rate for Payer: MVP Health Care of NY Commercial	$4.63
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$3.48
Rate for Payer: MVP Health Care of NY Medicare	$2.60
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$0.93
Rate for Payer: United Healthcare Medicare	$2.47
Rate for Payer: WellCare Medicare	$3.40

METFORMIN HCL 500MG TABS 100 EA

Facility

$20.00

Service Code	NDC 50268053115
Hospital Charge Code	4400492
Hospital Revenue Code	250
Min. Negotiated Rate	$11.00
Max. Negotiated Rate	$13.00
Rate for Payer: Cash Price	$15.00
Rate for Payer: Galaxy Health Commercial	$13.00
Rate for Payer: WellCare Medicare	$11.00

METFORMIN HCL 500MG TABS 100 EA

Facility

$20.00

Service Code	NDC 50268053115
Hospital Charge Code	4400492
Hospital Revenue Code	250
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna of NY Commercial	$14.00
Rate for Payer: Aetna of NY Medicare	$9.20
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$8.00
Rate for Payer: Cash Price	$15.00
Rate for Payer: CDPHP Medicare	$7.40
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$16.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$16.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$16.00
Rate for Payer: EmblemHealth Medicaid	$16.00
Rate for Payer: EmblemHealth Medicare	$6.80
Rate for Payer: EmblemHealth Select Care	$14.40
Rate for Payer: Fidelis Medicare	$8.00
Rate for Payer: Galaxy Health Commercial	$13.00
Rate for Payer: Hamaspik Choice Medicare	$8.00
Rate for Payer: Humana Medicare	$8.00
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$14.00
Rate for Payer: Local 1199SEIU Medicare	$9.20
Rate for Payer: MVP Health Care of NY Commercial	$15.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$11.26
Rate for Payer: MVP Health Care of NY Medicare	$8.40
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$3.00
Rate for Payer: United Healthcare Medicare	$8.00
Rate for Payer: WellCare Medicare	$11.00

METHADONE HCL 10MG TABS 10X10EA

Facility

$6.18

Service Code	NDC 68084073801
Hospital Charge Code	4400497
Hospital Revenue Code	250
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$4.94
Rate for Payer: Aetna of NY Commercial	$4.33
Rate for Payer: Aetna of NY Medicare	$2.84
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$2.47
Rate for Payer: Cash Price	$4.64
Rate for Payer: CDPHP Medicare	$2.29
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$4.94
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$4.94
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$4.94
Rate for Payer: EmblemHealth Medicaid	$4.94
Rate for Payer: EmblemHealth Medicare	$2.10
Rate for Payer: EmblemHealth Select Care	$4.45
Rate for Payer: Fidelis Medicare	$2.47
Rate for Payer: Galaxy Health Commercial	$4.02
Rate for Payer: Hamaspik Choice Medicare	$2.47
Rate for Payer: Humana Medicare	$2.47
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$4.33
Rate for Payer: Local 1199SEIU Medicare	$2.84
Rate for Payer: MVP Health Care of NY Commercial	$4.63
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$3.48
Rate for Payer: MVP Health Care of NY Medicare	$2.60
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$0.93
Rate for Payer: United Healthcare Medicare	$2.47
Rate for Payer: WellCare Medicare	$3.40

METHADONE HCL 10MG TABS 10X10EA

Facility

$6.18

Service Code	NDC 68084073801
Hospital Charge Code	4400497
Hospital Revenue Code	250
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$4.02
Rate for Payer: Cash Price	$4.64
Rate for Payer: Galaxy Health Commercial	$4.02
Rate for Payer: WellCare Medicare	$3.40

METHENAMINE 1G

Facility

$6.44

Service Code	NDC 50268054915
Hospital Charge Code	4409066
Hospital Revenue Code	250
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$5.15
Rate for Payer: Aetna of NY Commercial	$4.51
Rate for Payer: Aetna of NY Medicare	$2.96
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$2.58
Rate for Payer: Cash Price	$4.83
Rate for Payer: CDPHP Medicare	$2.38
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$5.15
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$5.15
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$5.15
Rate for Payer: EmblemHealth Medicaid	$5.15
Rate for Payer: EmblemHealth Medicare	$2.19
Rate for Payer: EmblemHealth Select Care	$4.64
Rate for Payer: Fidelis Medicare	$2.58
Rate for Payer: Galaxy Health Commercial	$4.19
Rate for Payer: Hamaspik Choice Medicare	$2.58
Rate for Payer: Humana Medicare	$2.58
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$4.51
Rate for Payer: Local 1199SEIU Medicare	$2.96
Rate for Payer: MVP Health Care of NY Commercial	$4.83
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$3.63
Rate for Payer: MVP Health Care of NY Medicare	$2.70
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$0.97
Rate for Payer: United Healthcare Medicare	$2.58
Rate for Payer: WellCare Medicare	$3.54

METHENAMINE 1G

Facility

$6.44

Service Code	NDC 50268054915
Hospital Charge Code	4409066
Hospital Revenue Code	250
Min. Negotiated Rate	$3.54
Max. Negotiated Rate	$4.19
Rate for Payer: Cash Price	$4.83
Rate for Payer: Galaxy Health Commercial	$4.19
Rate for Payer: WellCare Medicare	$3.54

Know your out-of-pocket cost for care.

All Charges