|
METHERGINE/0.2MG/1ML
|
Facility
|
IP
|
$18.00
|
|
| Hospital Charge Code |
60633384
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.70 |
| Max. Negotiated Rate |
$2.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.70
|
|
|
METHERGINE/0.2MG/TAB
|
Facility
|
OP
|
$4.00
|
|
| Hospital Charge Code |
60633382
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Aetna Commercial |
$1.20
|
| Rate for Payer: Aetna Medicare Advantage |
$1.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.02
|
| Rate for Payer: Cigna Commercial |
$2.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.52
|
| Rate for Payer: Oxford Commercial |
$2.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.00
|
|
|
METHERGINE/0.2MG/TAB
|
Facility
|
IP
|
$3.00
|
|
| Hospital Charge Code |
60633381
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$0.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.45
|
|
|
METHERGINE/0.2MG/TAB
|
Facility
|
OP
|
$3.00
|
|
| Hospital Charge Code |
60633381
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$1.50 |
| Rate for Payer: Aetna Commercial |
$0.90
|
| Rate for Payer: Aetna Medicare Advantage |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.77
|
| Rate for Payer: Cigna Commercial |
$1.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.39
|
| Rate for Payer: Oxford Commercial |
$1.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.50
|
|
|
METHERGINE/0.2MG/TAB
|
Facility
|
IP
|
$4.00
|
|
| Hospital Charge Code |
60633382
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
METHICILLIN OPH DROPS 50MG/ML
|
Facility
|
IP
|
$82.60
|
|
| Hospital Charge Code |
6003594
|
|
Hospital Revenue Code
|
252
|
| Min. Negotiated Rate |
$12.39 |
| Max. Negotiated Rate |
$12.39 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.39
|
|
|
METHICILLIN OPH DROPS 50MG/ML
|
Facility
|
OP
|
$82.60
|
|
| Hospital Charge Code |
6003594
|
|
Hospital Revenue Code
|
252
|
| Min. Negotiated Rate |
$10.74 |
| Max. Negotiated Rate |
$41.30 |
| Rate for Payer: Aetna Commercial |
$24.78
|
| Rate for Payer: Aetna Medicare Advantage |
$24.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$21.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$21.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$21.06
|
| Rate for Payer: Cigna Commercial |
$41.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.74
|
| Rate for Payer: Oxford Commercial |
$41.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.39
|
| Rate for Payer: UnitedHealthcare Commercial |
$41.30
|
|
|
METHICILLIN OPH IVT 20MG/ML
|
Facility
|
IP
|
$52.50
|
|
| Hospital Charge Code |
6003578
|
|
Hospital Revenue Code
|
252
|
| Min. Negotiated Rate |
$7.88 |
| Max. Negotiated Rate |
$7.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.88
|
|
|
METHICILLIN OPH IVT 20MG/ML
|
Facility
|
OP
|
$52.50
|
|
| Hospital Charge Code |
6003578
|
|
Hospital Revenue Code
|
252
|
| Min. Negotiated Rate |
$6.83 |
| Max. Negotiated Rate |
$26.25 |
| Rate for Payer: Aetna Commercial |
$15.75
|
| Rate for Payer: Aetna Medicare Advantage |
$15.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.39
|
| Rate for Payer: Cigna Commercial |
$26.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.83
|
| Rate for Payer: Oxford Commercial |
$26.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$26.25
|
|
|
METHICILLIN OPH SBCN 500MG/ML
|
Facility
|
IP
|
$90.90
|
|
| Hospital Charge Code |
6003586
|
|
Hospital Revenue Code
|
252
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$13.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.63
|
|
|
METHICILLIN OPH SBCN 500MG/ML
|
Facility
|
OP
|
$90.90
|
|
| Hospital Charge Code |
6003586
|
|
Hospital Revenue Code
|
252
|
| Min. Negotiated Rate |
$11.82 |
| Max. Negotiated Rate |
$45.45 |
| Rate for Payer: Aetna Commercial |
$27.27
|
| Rate for Payer: Aetna Medicare Advantage |
$27.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.18
|
| Rate for Payer: Cigna Commercial |
$45.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.82
|
| Rate for Payer: Oxford Commercial |
$45.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$45.45
|
|
|
Methicillin R Staph A culture
|
Facility
|
OP
|
$104.49
|
|
|
Service Code
|
HCPCS 87081
|
| Hospital Charge Code |
3000073
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.31 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$21.48
|
| Rate for Payer: Aetna Medicare Advantage |
$6.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$24.29
|
| Rate for Payer: Cigna Commercial |
$6.63
|
| Rate for Payer: Cigna Medicare Advantage |
$3.31
|
| Rate for Payer: Clover Medicare Advantage |
$6.30
|
| Rate for Payer: EmblemHealth Commercial |
$19.89
|
| Rate for Payer: Humana Medicare Advantage |
$6.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.58
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.67
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.63
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$7.03
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.63
|
|
|
Methicillin R Staph A culture
|
Facility
|
IP
|
$104.49
|
|
|
Service Code
|
HCPCS 87081
|
| Hospital Charge Code |
3000073
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.67 |
| Max. Negotiated Rate |
$15.67 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.67
|
|
|
METHIMAZOLE 10 MG TAB
|
Facility
|
OP
|
$16.75
|
|
|
Service Code
|
NDC 60793010501
|
| Hospital Charge Code |
60629902
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$8.38 |
| Rate for Payer: Aetna Commercial |
$5.03
|
| Rate for Payer: Aetna Medicare Advantage |
$5.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.27
|
| Rate for Payer: Cigna Commercial |
$8.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.18
|
| Rate for Payer: Oxford Commercial |
$8.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.38
|
|
|
METHIMAZOLE 10 MG TAB
|
Facility
|
IP
|
$16.75
|
|
|
Service Code
|
NDC 60793010501
|
| Hospital Charge Code |
60629902
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.51 |
| Max. Negotiated Rate |
$2.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.51
|
|
|
METHIMAZOLE 5 MG TAB
|
Facility
|
OP
|
$4.00
|
|
|
Service Code
|
NDC 49884064001
|
| Hospital Charge Code |
60628264
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Aetna Commercial |
$1.20
|
| Rate for Payer: Aetna Medicare Advantage |
$1.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.02
|
| Rate for Payer: Cigna Commercial |
$2.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.52
|
| Rate for Payer: Oxford Commercial |
$2.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.00
|
|
|
METHIMAZOLE 5 MG TAB
|
Facility
|
IP
|
$4.00
|
|
|
Service Code
|
NDC 49884064001
|
| Hospital Charge Code |
60628264
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
METHOCARBAMOL 100 MG/ML SOL
|
Facility
|
OP
|
$39.25
|
|
| Hospital Charge Code |
60627485
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$19.62 |
| Rate for Payer: Aetna Commercial |
$11.78
|
| Rate for Payer: Aetna Medicare Advantage |
$11.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.01
|
| Rate for Payer: Cigna Commercial |
$19.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.10
|
| Rate for Payer: Oxford Commercial |
$19.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$19.62
|
|
|
METHOCARBAMOL 100 MG/ML SOL
|
Facility
|
IP
|
$39.25
|
|
| Hospital Charge Code |
60627485
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$5.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.89
|
|
|
METHOCARBAMOL 500 MG TAB
|
Facility
|
IP
|
$4.00
|
|
|
Service Code
|
NDC 31722053301
|
| Hospital Charge Code |
60627486
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
METHOCARBAMOL 500 MG TAB
|
Facility
|
OP
|
$4.00
|
|
|
Service Code
|
NDC 31722053301
|
| Hospital Charge Code |
60627486
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Aetna Commercial |
$1.20
|
| Rate for Payer: Aetna Medicare Advantage |
$1.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.02
|
| Rate for Payer: Cigna Commercial |
$2.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.52
|
| Rate for Payer: Oxford Commercial |
$2.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.00
|
|
|
METHOCARBAMOL/500MG/TAB
|
Facility
|
OP
|
$4.00
|
|
| Hospital Charge Code |
60633386
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Aetna Commercial |
$1.20
|
| Rate for Payer: Aetna Medicare Advantage |
$1.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.02
|
| Rate for Payer: Cigna Commercial |
$2.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.52
|
| Rate for Payer: Oxford Commercial |
$2.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.00
|
|
|
METHOCARBAMOL/500MG/TAB
|
Facility
|
IP
|
$4.00
|
|
| Hospital Charge Code |
60633386
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
METHOCARBAMOL 750 MG TAB
|
Facility
|
IP
|
$4.89
|
|
|
Service Code
|
NDC 31722053401
|
| Hospital Charge Code |
60627487
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.73 |
| Max. Negotiated Rate |
$0.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.73
|
|
|
METHOCARBAMOL 750 MG TAB
|
Facility
|
OP
|
$4.89
|
|
|
Service Code
|
NDC 31722053401
|
| Hospital Charge Code |
60627487
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$2.44 |
| Rate for Payer: Aetna Commercial |
$1.47
|
| Rate for Payer: Aetna Medicare Advantage |
$1.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.25
|
| Rate for Payer: Cigna Commercial |
$2.44
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.64
|
| Rate for Payer: Oxford Commercial |
$2.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.44
|
|