Ellenville Regional Hospital

All Charges

Charge

Type

Setting

Price

METHIMAZOLE 5MG TABS 10X10EA

Facility

$6.18

Service Code	NDC 68084027501
Hospital Charge Code	4400498
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

METHIMAZOLE 5MG TABS 10X10EA

Facility

$6.18

Service Code	NDC 68084027501
Hospital Charge Code	4400498
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

METHYLDOPA 250 MG TAB

Facility

$6.18

Service Code	NDC 51079020020
Hospital Charge Code	4409080
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

METHYLDOPA 250 MG TAB

Facility

$6.18

Service Code	NDC 51079020020
Hospital Charge Code	4409080
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

METHYLENE BLUE 0.01 SDV 10X10ML

Facility

$506.50

Service Code	NDC 17478050410
Hospital Charge Code	4400500
Hospital Revenue Code	250
Min. Negotiated Rate	$75.97
Max. Negotiated Rate	$405.20
Rate for Payer: Aetna of NY Commercial	$354.55
Rate for Payer: Aetna of NY Medicare	$232.99
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$202.60
Rate for Payer: Cash Price	$379.88
Rate for Payer: CDPHP Medicare	$187.41
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$405.20
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$405.20
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$405.20
Rate for Payer: EmblemHealth Medicaid	$405.20
Rate for Payer: EmblemHealth Medicare	$172.21
Rate for Payer: EmblemHealth Select Care	$364.68
Rate for Payer: Fidelis Medicare	$202.60
Rate for Payer: Galaxy Health Commercial	$329.23
Rate for Payer: Hamaspik Choice Medicare	$202.60
Rate for Payer: Humana Medicare	$202.60
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$354.55
Rate for Payer: Local 1199SEIU Medicare	$232.99
Rate for Payer: MVP Health Care of NY Commercial	$379.88
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$285.16
Rate for Payer: MVP Health Care of NY Medicare	$212.73
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$75.97
Rate for Payer: United Healthcare Medicare	$202.60
Rate for Payer: WellCare Medicare	$278.57

METHYLENE BLUE 0.01 SDV 10X10ML

Facility

$506.50

Service Code	NDC 17478050410
Hospital Charge Code	4400500
Hospital Revenue Code	250
Min. Negotiated Rate	$278.57
Max. Negotiated Rate	$329.23
Rate for Payer: Cash Price	$379.88
Rate for Payer: Galaxy Health Commercial	$329.23
Rate for Payer: WellCare Medicare	$278.57

METHYLMALONIC ACID, SERUM

Facility

$64.00

Service Code	HCPCS 83921
Hospital Charge Code	4300099
Hospital Revenue Code	300
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$51.20
Rate for Payer: Aetna of NY Commercial	$41.60
Rate for Payer: Aetna of NY Medicare	$29.44
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$25.60
Rate for Payer: Cash Price	$48.00
Rate for Payer: CDPHP Medicare	$23.68
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$38.40
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$51.20
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$51.20
Rate for Payer: EmblemHealth Medicaid	$51.20
Rate for Payer: EmblemHealth Medicare	$21.76
Rate for Payer: EmblemHealth Select Care	$38.40
Rate for Payer: Fidelis Medicare	$25.60
Rate for Payer: Galaxy Health Commercial	$41.60
Rate for Payer: Hamaspik Choice Medicare	$25.60
Rate for Payer: Humana Medicare	$25.60
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$41.60
Rate for Payer: Local 1199SEIU Medicare	$29.44
Rate for Payer: MVP Health Care of NY Commercial	$48.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$36.03
Rate for Payer: MVP Health Care of NY Medicare	$26.88
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro	$48.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$9.60
Rate for Payer: United Healthcare Commercial	$48.00
Rate for Payer: United Healthcare Medicare	$25.60
Rate for Payer: WellCare Medicare	$35.20

METHYLMALONIC ACID, SERUM

Facility

$64.00

Service Code	HCPCS 83921
Hospital Charge Code	4300099
Hospital Revenue Code	300
Min. Negotiated Rate	$41.60
Max. Negotiated Rate	$41.60
Rate for Payer: Cash Price	$48.00
Rate for Payer: Galaxy Health Commercial	$41.60

METHYLPREDNISOLONE 4 MG TAB

Facility

$6.18

Service Code	NDC 68084014911
Hospital Charge Code	4409045
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

METHYLPREDNISOLONE 4 MG TAB

Facility

$6.18

Service Code	NDC 68084014911
Hospital Charge Code	4409045
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

METOCLOPRAMIDE HCL 10MG TABS 100 EA

Facility

$6.18

Service Code	NDC 63739029310
Hospital Charge Code	4400501
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

METOCLOPRAMIDE HCL 10MG TABS 100 EA

Facility

$6.18

Service Code	NDC 63739029310
Hospital Charge Code	4400501
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

METOCLOPRAMIDE HCL TO 10 MG

Facility

$19.10

Service Code	HCPCS J2765
Hospital Charge Code	4400502
Hospital Revenue Code	636
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$12.41
Rate for Payer: Aetna of NY Commercial	$10.51
Rate for Payer: Cash Price	$14.32
Rate for Payer: Cash Price	$14.32
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$0.95
Rate for Payer: EmblemHealth Select Care	$0.95
Rate for Payer: Galaxy Health Commercial	$12.41
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$10.51
Rate for Payer: WellCare Medicare	$10.51

METOCLOPRAMIDE HCL TO 10 MG

Facility

$19.10

Service Code	HCPCS J2765
Hospital Charge Code	4400502
Hospital Revenue Code	636
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$15.28
Rate for Payer: Aetna of NY Medicare	$8.79
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$7.64
Rate for Payer: Cash Price	$14.32
Rate for Payer: Cash Price	$14.32
Rate for Payer: CDPHP Medicare	$7.07
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$0.95
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$15.28
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$15.28
Rate for Payer: EmblemHealth Medicaid	$15.28
Rate for Payer: EmblemHealth Medicare	$6.49
Rate for Payer: EmblemHealth Select Care	$0.95
Rate for Payer: Fidelis Medicare	$7.64
Rate for Payer: Galaxy Health Commercial	$12.41
Rate for Payer: Hamaspik Choice Medicare	$7.64
Rate for Payer: Humana Medicare	$7.64
Rate for Payer: Local 1199SEIU Medicare	$8.79
Rate for Payer: MVP Health Care of NY Commercial	$14.32
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$10.75
Rate for Payer: MVP Health Care of NY Medicare	$8.02
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro	$2.05
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$2.87
Rate for Payer: United Healthcare Commercial	$2.05
Rate for Payer: United Healthcare Medicare	$7.64
Rate for Payer: WellCare Medicare	$10.51

METOCLOPRAMIDE ORAL SOLUTION, 10 MG

Facility

$6.18

Service Code	NDC 121157610
Hospital Charge Code	4409108
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

METOCLOPRAMIDE ORAL SOLUTION, 10 MG

Facility

$6.18

Service Code	NDC 121157610
Hospital Charge Code	4409108
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

METOLAZONE 2.5MG TABS 10X10EA

Facility

$10.04

Service Code	NDC 51079002320
Hospital Charge Code	4400504
Hospital Revenue Code	250
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$8.03
Rate for Payer: Aetna of NY Commercial	$7.03
Rate for Payer: Aetna of NY Medicare	$4.62
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$4.02
Rate for Payer: Cash Price	$7.53
Rate for Payer: CDPHP Medicare	$3.71
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$8.03
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$8.03
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$8.03
Rate for Payer: EmblemHealth Medicaid	$8.03
Rate for Payer: EmblemHealth Medicare	$3.41
Rate for Payer: EmblemHealth Select Care	$7.23
Rate for Payer: Fidelis Medicare	$4.02
Rate for Payer: Galaxy Health Commercial	$6.53
Rate for Payer: Hamaspik Choice Medicare	$4.02
Rate for Payer: Humana Medicare	$4.02
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$7.03
Rate for Payer: Local 1199SEIU Medicare	$4.62
Rate for Payer: MVP Health Care of NY Commercial	$7.53
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$5.65
Rate for Payer: MVP Health Care of NY Medicare	$4.22
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1.51
Rate for Payer: United Healthcare Medicare	$4.02
Rate for Payer: WellCare Medicare	$5.52

METOLAZONE 2.5MG TABS 10X10EA

Facility

$10.04

Service Code	NDC 51079002320
Hospital Charge Code	4400504
Hospital Revenue Code	250
Min. Negotiated Rate	$5.52
Max. Negotiated Rate	$6.53
Rate for Payer: Cash Price	$7.53
Rate for Payer: Galaxy Health Commercial	$6.53
Rate for Payer: WellCare Medicare	$5.52

METOLAZONE 5MG TABS 10X10EA

Facility

$11.59

Service Code	NDC 51079002420
Hospital Charge Code	4400505
Hospital Revenue Code	250
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$9.27
Rate for Payer: Aetna of NY Commercial	$8.11
Rate for Payer: Aetna of NY Medicare	$5.33
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$4.64
Rate for Payer: Cash Price	$8.69
Rate for Payer: CDPHP Medicare	$4.29
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$9.27
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$9.27
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$9.27
Rate for Payer: EmblemHealth Medicaid	$9.27
Rate for Payer: EmblemHealth Medicare	$3.94
Rate for Payer: EmblemHealth Select Care	$8.34
Rate for Payer: Fidelis Medicare	$4.64
Rate for Payer: Galaxy Health Commercial	$7.53
Rate for Payer: Hamaspik Choice Medicare	$4.64
Rate for Payer: Humana Medicare	$4.64
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$8.11
Rate for Payer: Local 1199SEIU Medicare	$5.33
Rate for Payer: MVP Health Care of NY Commercial	$8.69
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$6.53
Rate for Payer: MVP Health Care of NY Medicare	$4.87
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$1.74
Rate for Payer: United Healthcare Medicare	$4.64
Rate for Payer: WellCare Medicare	$6.37

METOLAZONE 5MG TABS 10X10EA

Facility

$11.59

Service Code	NDC 51079002420
Hospital Charge Code	4400505
Hospital Revenue Code	250
Min. Negotiated Rate	$6.37
Max. Negotiated Rate	$7.53
Rate for Payer: Cash Price	$8.69
Rate for Payer: Galaxy Health Commercial	$7.53
Rate for Payer: WellCare Medicare	$6.37

METOPROLOL SUCCINATE 25MG TABS 10X10EA

Facility

$6.18

Service Code	NDC 68084065911
Hospital Charge Code	4400766
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

METOPROLOL SUCCINATE 25MG TABS 10X10EA

Facility

$6.18

Service Code	NDC 68084065911
Hospital Charge Code	4400766
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

METOPROLOL SUCCINATE 50MG TABS 10X10EA

Facility

$6.35

Service Code	NDC 904632361
Hospital Charge Code	4400767
Hospital Revenue Code	250
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$4.13
Rate for Payer: Cash Price	$4.76
Rate for Payer: Galaxy Health Commercial	$4.13
Rate for Payer: WellCare Medicare	$3.49

METOPROLOL SUCCINATE 50MG TABS 10X10EA

Facility

$6.35

Service Code	NDC 904632361
Hospital Charge Code	4400767
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$5.08
Rate for Payer: Aetna of NY Commercial	$4.45
Rate for Payer: Aetna of NY Medicare	$2.92
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare	$2.54
Rate for Payer: Cash Price	$4.76
Rate for Payer: CDPHP Medicare	$2.35
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access	$5.08
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2	$5.08
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4	$5.08
Rate for Payer: EmblemHealth Medicaid	$5.08
Rate for Payer: EmblemHealth Medicare	$2.16
Rate for Payer: EmblemHealth Select Care	$4.57
Rate for Payer: Fidelis Medicare	$2.54
Rate for Payer: Galaxy Health Commercial	$4.13
Rate for Payer: Hamaspik Choice Medicare	$2.54
Rate for Payer: Humana Medicare	$2.54
Rate for Payer: Local 1199SEIU Aetna Signature Administrators	$4.45
Rate for Payer: Local 1199SEIU Medicare	$2.92
Rate for Payer: MVP Health Care of NY Commercial	$4.76
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan	$3.58
Rate for Payer: MVP Health Care of NY Medicare	$2.67
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid	$0.95
Rate for Payer: United Healthcare Medicare	$2.54
Rate for Payer: WellCare Medicare	$3.49

METOPROLOL TARTRATE 100MG TABS 100 EA

Facility

$6.18

Service Code	NDC 51079080220
Hospital Charge Code	4400507
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

Know your out-of-pocket cost for care.

All Charges