|
METANEPHRINES (FRACTIONAL)
|
Facility
|
OP
|
$281.65
|
|
|
Service Code
|
HCPCS 83835
|
| Hospital Charge Code |
3007622
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.47 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$54.89
|
| Rate for Payer: Aetna Medicare Advantage |
$16.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$62.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$62.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$62.07
|
| Rate for Payer: Cigna Commercial |
$16.94
|
| Rate for Payer: Cigna Medicare Advantage |
$8.47
|
| Rate for Payer: Clover Medicare Advantage |
$16.09
|
| Rate for Payer: EmblemHealth Commercial |
$50.82
|
| Rate for Payer: Humana Medicare Advantage |
$17.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.61
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.94
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$17.96
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.94
|
|
|
METANEPHRINES,UR
|
Facility
|
IP
|
$647.00
|
|
|
Service Code
|
HCPCS 83835
|
| Hospital Charge Code |
38479106
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$97.05 |
| Max. Negotiated Rate |
$97.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.05
|
|
|
METANEPHRINES,UR
|
Facility
|
OP
|
$647.00
|
|
|
Service Code
|
HCPCS 83835
|
| Hospital Charge Code |
38479106
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.47 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$54.89
|
| Rate for Payer: Aetna Medicare Advantage |
$16.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$62.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$62.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$62.07
|
| Rate for Payer: Cigna Commercial |
$16.94
|
| Rate for Payer: Cigna Medicare Advantage |
$8.47
|
| Rate for Payer: Clover Medicare Advantage |
$16.09
|
| Rate for Payer: EmblemHealth Commercial |
$50.82
|
| Rate for Payer: Humana Medicare Advantage |
$17.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$84.11
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.94
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$17.96
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.94
|
|
|
METAPROTERANOL/10MG/TAB
|
Facility
|
IP
|
$1.00
|
|
| Hospital Charge Code |
60634837
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$0.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.15
|
|
|
METAPROTERANOL/10MG/TAB
|
Facility
|
OP
|
$1.00
|
|
| Hospital Charge Code |
60634837
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$0.50 |
| Rate for Payer: Aetna Commercial |
$0.30
|
| Rate for Payer: Aetna Medicare Advantage |
$0.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.26
|
| Rate for Payer: Cigna Commercial |
$0.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.13
|
| Rate for Payer: Oxford Commercial |
$0.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.50
|
|
|
METAPROTERENOL INJ 15MG/ML
|
Facility
|
OP
|
$133.80
|
|
| Hospital Charge Code |
6003537
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.39 |
| Max. Negotiated Rate |
$66.90 |
| Rate for Payer: Aetna Commercial |
$40.14
|
| Rate for Payer: Aetna Medicare Advantage |
$40.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.12
|
| Rate for Payer: Cigna Commercial |
$66.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.39
|
| Rate for Payer: Oxford Commercial |
$66.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.07
|
| Rate for Payer: UnitedHealthcare Commercial |
$66.90
|
|
|
METAPROTERENOL INJ 15MG/ML
|
Facility
|
IP
|
$133.80
|
|
| Hospital Charge Code |
6003537
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.07 |
| Max. Negotiated Rate |
$20.07 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.07
|
|
|
METAPROTERENOL LIQ 10MG/5ML
|
Facility
|
IP
|
$53.80
|
|
| Hospital Charge Code |
6003545
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$8.07 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.07
|
|
|
METAPROTERENOL LIQ 10MG/5ML
|
Facility
|
OP
|
$53.80
|
|
| Hospital Charge Code |
6003545
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.99 |
| Max. Negotiated Rate |
$26.90 |
| Rate for Payer: Aetna Commercial |
$16.14
|
| Rate for Payer: Aetna Medicare Advantage |
$16.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.72
|
| Rate for Payer: Cigna Commercial |
$26.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.99
|
| Rate for Payer: Oxford Commercial |
$26.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.07
|
| Rate for Payer: UnitedHealthcare Commercial |
$26.90
|
|
|
METAPROTERENOL ORL INH 0.65MG
|
Facility
|
IP
|
$170.25
|
|
| Hospital Charge Code |
60627458
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$25.54 |
| Max. Negotiated Rate |
$25.54 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.54
|
|
|
METAPROTERENOL ORL INH 0.65MG
|
Facility
|
OP
|
$170.25
|
|
| Hospital Charge Code |
60627458
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$22.13 |
| Max. Negotiated Rate |
$85.12 |
| Rate for Payer: Aetna Commercial |
$51.08
|
| Rate for Payer: Aetna Medicare Advantage |
$51.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.41
|
| Rate for Payer: Cigna Commercial |
$85.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.13
|
| Rate for Payer: Oxford Commercial |
$85.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$85.12
|
|
|
METAPROTERENOL SOL 0.4% 2.5ML
|
Facility
|
OP
|
$13.65
|
|
| Hospital Charge Code |
60627456
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.77 |
| Max. Negotiated Rate |
$6.83 |
| Rate for Payer: Aetna Commercial |
$4.09
|
| Rate for Payer: Aetna Medicare Advantage |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.48
|
| Rate for Payer: Cigna Commercial |
$6.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.77
|
| Rate for Payer: Oxford Commercial |
$6.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.83
|
|
|
METAPROTERENOL SOL 0.4% 2.5ML
|
Facility
|
IP
|
$13.65
|
|
| Hospital Charge Code |
60627456
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.05 |
| Max. Negotiated Rate |
$2.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.05
|
|
|
METAPROTERENOL SOL 0.6% 2.5ML
|
Facility
|
IP
|
$10.90
|
|
| Hospital Charge Code |
60627457
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.64 |
| Max. Negotiated Rate |
$1.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.64
|
|
|
METAPROTERENOL SOL 0.6% 2.5ML
|
Facility
|
OP
|
$10.90
|
|
| Hospital Charge Code |
60627457
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.42 |
| Max. Negotiated Rate |
$5.45 |
| Rate for Payer: Aetna Commercial |
$3.27
|
| Rate for Payer: Aetna Medicare Advantage |
$3.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.78
|
| Rate for Payer: Cigna Commercial |
$5.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.42
|
| Rate for Payer: Oxford Commercial |
$5.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.45
|
|
|
METAPROTERENOL SOL 5% 10ML
|
Facility
|
IP
|
$124.20
|
|
| Hospital Charge Code |
60627460
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.63 |
| Max. Negotiated Rate |
$18.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.63
|
|
|
METAPROTERENOL SOL 5% 10ML
|
Facility
|
OP
|
$124.20
|
|
| Hospital Charge Code |
60627460
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.15 |
| Max. Negotiated Rate |
$62.10 |
| Rate for Payer: Aetna Commercial |
$37.26
|
| Rate for Payer: Aetna Medicare Advantage |
$37.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.67
|
| Rate for Payer: Cigna Commercial |
$62.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.15
|
| Rate for Payer: Oxford Commercial |
$62.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$62.10
|
|
|
METAPROTERENOL SYRP 10MG/5ML
|
Facility
|
IP
|
$3.20
|
|
| Hospital Charge Code |
60627459
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.48 |
| Max. Negotiated Rate |
$0.48 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.48
|
|
|
METAPROTERENOL SYRP 10MG/5ML
|
Facility
|
OP
|
$3.20
|
|
| Hospital Charge Code |
60627459
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.42 |
| Max. Negotiated Rate |
$1.60 |
| Rate for Payer: Aetna Commercial |
$0.96
|
| Rate for Payer: Aetna Medicare Advantage |
$0.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.82
|
| Rate for Payer: Cigna Commercial |
$1.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.42
|
| Rate for Payer: Oxford Commercial |
$1.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.60
|
|
|
METAPROTERNL .4% INH SOL 2.5ML
|
Facility
|
OP
|
$3.20
|
|
| Hospital Charge Code |
6022685
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.42 |
| Max. Negotiated Rate |
$1.60 |
| Rate for Payer: Aetna Commercial |
$0.96
|
| Rate for Payer: Aetna Medicare Advantage |
$0.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.82
|
| Rate for Payer: Cigna Commercial |
$1.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.42
|
| Rate for Payer: Oxford Commercial |
$1.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.60
|
|
|
METAPROTERNL .4% INH SOL 2.5ML
|
Facility
|
IP
|
$3.20
|
|
| Hospital Charge Code |
6022685
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.48 |
| Max. Negotiated Rate |
$0.48 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.48
|
|
|
METAPROTERONOL LIQ/16OZ
|
Facility
|
OP
|
$13.00
|
|
| Hospital Charge Code |
60634588
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Aetna Commercial |
$3.90
|
| Rate for Payer: Aetna Medicare Advantage |
$3.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.31
|
| Rate for Payer: Cigna Commercial |
$6.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.69
|
| Rate for Payer: Oxford Commercial |
$6.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.50
|
|
|
METAPROTERONOL LIQ/16OZ
|
Facility
|
IP
|
$13.00
|
|
| Hospital Charge Code |
60634588
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$1.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.95
|
|
|
METARAMINOL INJ 1%
|
Facility
|
OP
|
$5.36
|
|
| Hospital Charge Code |
60627461
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$2.68 |
| Rate for Payer: Aetna Commercial |
$1.61
|
| Rate for Payer: Aetna Medicare Advantage |
$1.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.37
|
| Rate for Payer: Cigna Commercial |
$2.68
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.80
|
|
|
METARAMINOL INJ 1%
|
Facility
|
IP
|
$5.36
|
|
| Hospital Charge Code |
60627461
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$1.30 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.80
|
|