|
METHYLPREDNISOL INJ 500MG
|
Facility
|
IP
|
$49.30
|
|
| Hospital Charge Code |
60629120
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.39 |
| Max. Negotiated Rate |
$7.39 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.39
|
|
|
METHYLPREDNISOL INJ 500MG
|
Facility
|
OP
|
$49.30
|
|
| Hospital Charge Code |
60629120
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$24.65 |
| Rate for Payer: Aetna Commercial |
$14.79
|
| Rate for Payer: Aetna Medicare Advantage |
$14.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.57
|
| Rate for Payer: Cigna Commercial |
$24.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.41
|
| Rate for Payer: Oxford Commercial |
$24.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.39
|
| Rate for Payer: UnitedHealthcare Commercial |
$24.65
|
|
|
METHYLPREDNISOL INJ IM 40MG/1M
|
Facility
|
OP
|
$43.55
|
|
| Hospital Charge Code |
6003636
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$21.77 |
| Rate for Payer: Aetna Commercial |
$13.06
|
| Rate for Payer: Aetna Medicare Advantage |
$13.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.11
|
| Rate for Payer: Cigna Commercial |
$21.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.66
|
| Rate for Payer: Oxford Commercial |
$21.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$21.77
|
|
|
METHYLPREDNISOL INJ IM 40MG/1M
|
Facility
|
IP
|
$43.55
|
|
| Hospital Charge Code |
6003636
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.53 |
| Max. Negotiated Rate |
$6.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.53
|
|
|
METHYLPREDNISOL INJ IV 125MG
|
Facility
|
IP
|
$10.90
|
|
| Hospital Charge Code |
6003651
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.64 |
| Max. Negotiated Rate |
$1.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.64
|
|
|
METHYLPREDNISOL INJ IV 125MG
|
Facility
|
OP
|
$10.90
|
|
| Hospital Charge Code |
6003651
|
|
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
|
|
|
METHYLPREDNISOL INJ IV 500MG
|
Facility
|
IP
|
$64.00
|
|
| Hospital Charge Code |
6003669
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$9.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.60
|
|
|
METHYLPREDNISOL INJ IV 500MG
|
Facility
|
OP
|
$64.00
|
|
| Hospital Charge Code |
6003669
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.32 |
| Max. Negotiated Rate |
$32.00 |
| Rate for Payer: Aetna Commercial |
$19.20
|
| Rate for Payer: Aetna Medicare Advantage |
$19.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.32
|
| Rate for Payer: Cigna Commercial |
$32.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.32
|
| Rate for Payer: Oxford Commercial |
$32.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$32.00
|
|
|
METHYLPREDNISOLONE 2MG TAB
|
Facility
|
OP
|
$7.64
|
|
|
Service Code
|
NDC 9002001
|
| Hospital Charge Code |
606390546
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.99 |
| Max. Negotiated Rate |
$3.82 |
| Rate for Payer: Aetna Commercial |
$2.29
|
| Rate for Payer: Aetna Medicare Advantage |
$2.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.95
|
| Rate for Payer: Cigna Commercial |
$3.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.99
|
| Rate for Payer: Oxford Commercial |
$3.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.82
|
|
|
METHYLPREDNISOLONE 2MG TAB
|
Facility
|
IP
|
$7.64
|
|
|
Service Code
|
NDC 9002001
|
| Hospital Charge Code |
606390546
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.15 |
| Max. Negotiated Rate |
$1.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.15
|
|
|
METHYLPREDNISOLONE 4 MG TAB
|
Facility
|
IP
|
$14.41
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
60628200
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$3.49 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.16
|
|
|
METHYLPREDNISOLONE 4 MG TAB
|
Facility
|
OP
|
$14.41
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
60628200
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$4.32 |
| Rate for Payer: Aetna Commercial |
$4.32
|
| Rate for Payer: Aetna Medicare Advantage |
$4.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.67
|
| Rate for Payer: Cigna Commercial |
$0.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.16
|
|
|
METHYLPREDNISOL SOD SUC INJ 1G
|
Facility
|
OP
|
$198.59
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
60628206
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$59.58 |
| Rate for Payer: Aetna Commercial |
$59.58
|
| Rate for Payer: Aetna Medicare Advantage |
$59.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$50.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$50.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$50.64
|
| Rate for Payer: Cigna Commercial |
$0.24
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.79
|
|
|
METHYLPREDNISOL SOD SUC INJ 1G
|
Facility
|
IP
|
$198.59
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
60628206
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.79 |
| Max. Negotiated Rate |
$48.06 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.79
|
|
|
METHYLPREDNISOLSODSUCINJ40/5MG
|
Facility
|
OP
|
$28.01
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
60628205
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$8.40 |
| Rate for Payer: Aetna Commercial |
$8.40
|
| Rate for Payer: Aetna Medicare Advantage |
$8.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.14
|
| Rate for Payer: Cigna Commercial |
$0.24
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.20
|
|
|
METHYLPREDNISOLSODSUCINJ40/5MG
|
Facility
|
IP
|
$28.01
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
60628205
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.20 |
| Max. Negotiated Rate |
$6.78 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.20
|
|
|
METHYLPREDNISOL VL 40MG/ML
|
Facility
|
OP
|
$21.15
|
|
| Hospital Charge Code |
6006209
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$10.57 |
| Rate for Payer: Aetna Commercial |
$6.34
|
| Rate for Payer: Aetna Medicare Advantage |
$6.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.39
|
| Rate for Payer: Cigna Commercial |
$10.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.75
|
| Rate for Payer: Oxford Commercial |
$10.57
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.57
|
|
|
METHYLPREDNISOL VL 40MG/ML
|
Facility
|
IP
|
$21.15
|
|
| Hospital Charge Code |
6006209
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$3.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.17
|
|
|
METHYLPRENISOLSODSUCINJ125/5MG
|
Facility
|
OP
|
$72.03
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
60628204
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$21.61 |
| Rate for Payer: Aetna Commercial |
$21.61
|
| Rate for Payer: Aetna Medicare Advantage |
$21.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.37
|
| Rate for Payer: Cigna Commercial |
$0.24
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.80
|
|
|
METHYLPRENISOLSODSUCINJ125/5MG
|
Facility
|
IP
|
$72.03
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
60628204
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$17.43 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.80
|
|
|
METHYLPRENISOL SOD SUCINJ500MG
|
Facility
|
IP
|
$104.86
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
60629130
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.73 |
| Max. Negotiated Rate |
$25.38 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.73
|
|
|
METHYLPRENISOL SOD SUCINJ500MG
|
Facility
|
OP
|
$104.86
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
60629130
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$31.46 |
| Rate for Payer: Aetna Commercial |
$31.46
|
| Rate for Payer: Aetna Medicare Advantage |
$31.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26.74
|
| Rate for Payer: Cigna Commercial |
$0.24
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.73
|
|
|
METOCLOPRAMIDE 5 ML INJ
|
Facility
|
OP
|
$4.00
|
|
| Hospital Charge Code |
60634749
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.60 |
| 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 |
$0.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
METOCLOPRAMIDE 5 ML INJ
|
Facility
|
IP
|
$4.00
|
|
| Hospital Charge Code |
60634749
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
METOCLOPRAMIDE INJ 10MG/2ML
|
Facility
|
IP
|
$4.00
|
|
|
Service Code
|
HCPCS J2765
|
| Hospital Charge Code |
60628165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|