Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION [10571]

Facility

OP

$94.00

Service Code	HCPCS J2210
Hospital Revenue Code	636
Min. Negotiated Rate	$22.06
Max. Negotiated Rate	$91.18
Rate for Payer: Cash Price	$56.40
Rate for Payer: Cash Price	$56.40
Rate for Payer: Hawaii Medical Service Association ABD	$22.06
Rate for Payer: Hawaii Medical Service Association Non-ABD	$22.06
Rate for Payer: Hawaii Western Management Group Commercial	$89.30
Rate for Payer: Health Management Network Commercial	$79.90
Rate for Payer: Kaiser Permanente Commercial	$59.22
Rate for Payer: Kaiser Permanente Medicaid	$47.94
Rate for Payer: MDX Hawaii PPO	$91.18
Rate for Payer: UnitedHealthcare Medicaid	$56.40
Rate for Payer: University Health Alliance Commercial	$68.52

METHYLERGONOVINE 0.2 MG TABLET [10572]

Facility

IP

$135.00

Service Code	NDC 00054063905
Hospital Revenue Code	250
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$130.95
Rate for Payer: Cash Price	$81.00
Rate for Payer: Health Management Network Commercial	$114.75
Rate for Payer: MDX Hawaii PPO	$130.95

METHYLERGONOVINE 0.2 MG TABLET [10572]

Facility

OP

$135.00

Service Code	NDC 00054063905
Hospital Revenue Code	637
Min. Negotiated Rate	$68.85
Max. Negotiated Rate	$130.95
Rate for Payer: Cash Price	$81.00
Rate for Payer: Hawaii Western Management Group Commercial	$128.25
Rate for Payer: Health Management Network Commercial	$114.75
Rate for Payer: Kaiser Permanente Commercial	$85.05
Rate for Payer: Kaiser Permanente Medicaid	$68.85
Rate for Payer: MDX Hawaii PPO	$130.95
Rate for Payer: University Health Alliance Commercial	$98.40

METHYLERGONOVINE 0.2 MG TABLET [10572]

Facility

OP

$142.00

Service Code	NDC 70010078612
Hospital Revenue Code	637
Min. Negotiated Rate	$72.42
Max. Negotiated Rate	$137.74
Rate for Payer: Cash Price	$85.20
Rate for Payer: Hawaii Western Management Group Commercial	$134.90
Rate for Payer: Health Management Network Commercial	$120.70
Rate for Payer: Kaiser Permanente Commercial	$89.46
Rate for Payer: Kaiser Permanente Medicaid	$72.42
Rate for Payer: MDX Hawaii PPO	$137.74
Rate for Payer: University Health Alliance Commercial	$103.50

METHYLERGONOVINE 0.2 MG TABLET [10572]

Facility

OP

$135.00

Service Code	NDC 70010078628
Hospital Revenue Code	637
Min. Negotiated Rate	$68.85
Max. Negotiated Rate	$130.95
Rate for Payer: Cash Price	$81.00
Rate for Payer: Hawaii Western Management Group Commercial	$128.25
Rate for Payer: Health Management Network Commercial	$114.75
Rate for Payer: Kaiser Permanente Commercial	$85.05
Rate for Payer: Kaiser Permanente Medicaid	$68.85
Rate for Payer: MDX Hawaii PPO	$130.95
Rate for Payer: University Health Alliance Commercial	$98.40

METHYLERGONOVINE 0.2 MG TABLET [10572]

Facility

IP

$142.00

Service Code	NDC 70010078612
Hospital Revenue Code	250
Min. Negotiated Rate	$120.70
Max. Negotiated Rate	$137.74
Rate for Payer: Cash Price	$85.20
Rate for Payer: Health Management Network Commercial	$120.70
Rate for Payer: MDX Hawaii PPO	$137.74

METHYLERGONOVINE 0.2 MG TABLET [10572]

Facility

IP

$135.00

Service Code	NDC 70010078628
Hospital Revenue Code	250
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$130.95
Rate for Payer: Cash Price	$81.00
Rate for Payer: Health Management Network Commercial	$114.75
Rate for Payer: MDX Hawaii PPO	$130.95

METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION [91651]

Facility

IP

$337.00

Service Code	NDC 65649055102
Hospital Revenue Code	250
Min. Negotiated Rate	$286.45
Max. Negotiated Rate	$326.89
Rate for Payer: Cash Price	$202.20
Rate for Payer: Health Management Network Commercial	$286.45
Rate for Payer: MDX Hawaii PPO	$326.89

METHYLPHENIDATE 20 MG TABLET [4987]

Facility

OP

$6.00

Service Code	NDC 00406114601
Hospital Revenue Code	637
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$5.82
Rate for Payer: Cash Price	$3.60
Rate for Payer: Hawaii Western Management Group Commercial	$5.70
Rate for Payer: Health Management Network Commercial	$5.10
Rate for Payer: Kaiser Permanente Commercial	$3.78
Rate for Payer: Kaiser Permanente Medicaid	$3.06
Rate for Payer: MDX Hawaii PPO	$5.82
Rate for Payer: University Health Alliance Commercial	$4.37

METHYLPHENIDATE 20 MG TABLET [4987]

Facility

OP

$6.00

Service Code	NDC 31722017501
Hospital Revenue Code	637
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$5.82
Rate for Payer: Cash Price	$3.60
Rate for Payer: Hawaii Western Management Group Commercial	$5.70
Rate for Payer: Health Management Network Commercial	$5.10
Rate for Payer: Kaiser Permanente Commercial	$3.78
Rate for Payer: Kaiser Permanente Medicaid	$3.06
Rate for Payer: MDX Hawaii PPO	$5.82
Rate for Payer: University Health Alliance Commercial	$4.37

METHYLPHENIDATE 20 MG TABLET [4987]

Facility

IP

$6.00

Service Code	NDC 31722017501
Hospital Revenue Code	250
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.82
Rate for Payer: Cash Price	$3.60
Rate for Payer: Health Management Network Commercial	$5.10
Rate for Payer: MDX Hawaii PPO	$5.82

METHYLPHENIDATE 20 MG TABLET [4987]

Facility

IP

$6.00

Service Code	NDC 00406114601
Hospital Revenue Code	250
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.82
Rate for Payer: Cash Price	$3.60
Rate for Payer: Health Management Network Commercial	$5.10
Rate for Payer: MDX Hawaii PPO	$5.82

METHYLPHENIDATE 5 MG TABLET [4988]

Facility

OP

$3.00

Service Code	NDC 31722017301
Hospital Revenue Code	637
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$1.80
Rate for Payer: Hawaii Western Management Group Commercial	$2.85
Rate for Payer: Health Management Network Commercial	$2.55
Rate for Payer: Kaiser Permanente Commercial	$1.89
Rate for Payer: Kaiser Permanente Medicaid	$1.53
Rate for Payer: MDX Hawaii PPO	$2.91
Rate for Payer: University Health Alliance Commercial	$2.19

METHYLPHENIDATE 5 MG TABLET [4988]

Facility

OP

$3.00

Service Code	NDC 57664022888
Hospital Revenue Code	637
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$1.80
Rate for Payer: Hawaii Western Management Group Commercial	$2.85
Rate for Payer: Health Management Network Commercial	$2.55
Rate for Payer: Kaiser Permanente Commercial	$1.89
Rate for Payer: Kaiser Permanente Medicaid	$1.53
Rate for Payer: MDX Hawaii PPO	$2.91
Rate for Payer: University Health Alliance Commercial	$2.19

METHYLPHENIDATE 5 MG TABLET [4988]

Facility

IP

$3.00

Service Code	NDC 31722017301
Hospital Revenue Code	250
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$1.80
Rate for Payer: Health Management Network Commercial	$2.55
Rate for Payer: MDX Hawaii PPO	$2.91

METHYLPHENIDATE 5 MG TABLET [4988]

Facility

IP

$3.00

Service Code	NDC 57664022888
Hospital Revenue Code	250
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$1.80
Rate for Payer: Health Management Network Commercial	$2.55
Rate for Payer: MDX Hawaii PPO	$2.91

METHYLPREDNISOLONE 4 MG TABLET [4993]

Facility

OP

$8.00

Service Code	HCPCS J7509
Hospital Revenue Code	636
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$7.76
Rate for Payer: Cash Price	$4.80
Rate for Payer: Cash Price	$3.60
Rate for Payer: Cash Price	$4.80
Rate for Payer: Cash Price	$3.60
Rate for Payer: Hawaii Medical Service Association ABD	$0.23
Rate for Payer: Hawaii Medical Service Association ABD	$0.23
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.23
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.23
Rate for Payer: Hawaii Western Management Group Commercial	$5.70
Rate for Payer: Hawaii Western Management Group Commercial	$7.60
Rate for Payer: Health Management Network Commercial	$6.80
Rate for Payer: Health Management Network Commercial	$5.10
Rate for Payer: Kaiser Permanente Commercial	$5.04
Rate for Payer: Kaiser Permanente Commercial	$3.78
Rate for Payer: Kaiser Permanente Medicaid	$4.08
Rate for Payer: Kaiser Permanente Medicaid	$3.06
Rate for Payer: MDX Hawaii PPO	$5.82
Rate for Payer: MDX Hawaii PPO	$7.76
Rate for Payer: UnitedHealthcare Medicaid	$3.60
Rate for Payer: UnitedHealthcare Medicaid	$4.80
Rate for Payer: University Health Alliance Commercial	$5.83
Rate for Payer: University Health Alliance Commercial	$4.37

METHYLPREDNISOLONE 4 MG TABLET [4993]

Facility

IP

$6.00

Service Code	HCPCS J7509
Hospital Revenue Code	250
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.82
Rate for Payer: Cash Price	$3.60
Rate for Payer: Cash Price	$4.80
Rate for Payer: Health Management Network Commercial	$6.80
Rate for Payer: Health Management Network Commercial	$5.10
Rate for Payer: MDX Hawaii PPO	$5.82
Rate for Payer: MDX Hawaii PPO	$7.76

METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK [131608]

Facility

OP

$76.00

Service Code	HCPCS J7509
Hospital Revenue Code	636
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$73.72
Rate for Payer: Cash Price	$45.60
Rate for Payer: Cash Price	$3.60
Rate for Payer: Cash Price	$3.60
Rate for Payer: Cash Price	$45.60
Rate for Payer: Hawaii Medical Service Association ABD	$0.23
Rate for Payer: Hawaii Medical Service Association ABD	$0.23
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.23
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.23
Rate for Payer: Hawaii Western Management Group Commercial	$5.70
Rate for Payer: Hawaii Western Management Group Commercial	$72.20
Rate for Payer: Health Management Network Commercial	$64.60
Rate for Payer: Health Management Network Commercial	$5.10
Rate for Payer: Kaiser Permanente Commercial	$47.88
Rate for Payer: Kaiser Permanente Commercial	$3.78
Rate for Payer: Kaiser Permanente Medicaid	$3.06
Rate for Payer: Kaiser Permanente Medicaid	$38.76
Rate for Payer: MDX Hawaii PPO	$73.72
Rate for Payer: MDX Hawaii PPO	$5.82
Rate for Payer: UnitedHealthcare Medicaid	$3.60
Rate for Payer: UnitedHealthcare Medicaid	$45.60
Rate for Payer: University Health Alliance Commercial	$4.37
Rate for Payer: University Health Alliance Commercial	$55.40

METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK [131608]

Facility

IP

$6.00

Service Code	HCPCS J7509
Hospital Revenue Code	250
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.82
Rate for Payer: Cash Price	$3.60
Rate for Payer: Cash Price	$45.60
Rate for Payer: Health Management Network Commercial	$5.10
Rate for Payer: Health Management Network Commercial	$64.60
Rate for Payer: MDX Hawaii PPO	$5.82
Rate for Payer: MDX Hawaii PPO	$73.72

METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION [4995]

Facility

IP

$129.00

Service Code	HCPCS J1010
Hospital Revenue Code	250
Min. Negotiated Rate	$109.65
Max. Negotiated Rate	$125.13
Rate for Payer: Cash Price	$77.40
Rate for Payer: Cash Price	$88.80
Rate for Payer: Health Management Network Commercial	$109.65
Rate for Payer: Health Management Network Commercial	$125.80
Rate for Payer: MDX Hawaii PPO	$125.13
Rate for Payer: MDX Hawaii PPO	$143.56

METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION [4995]

Facility

OP

$148.00

Service Code	HCPCS J1010
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$143.56
Rate for Payer: Cash Price	$88.80
Rate for Payer: Cash Price	$77.40
Rate for Payer: Cash Price	$88.80
Rate for Payer: Cash Price	$77.40
Rate for Payer: Hawaii Medical Service Association ABD	$0.12
Rate for Payer: Hawaii Medical Service Association ABD	$0.12
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.12
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.12
Rate for Payer: Hawaii Western Management Group Commercial	$122.55
Rate for Payer: Hawaii Western Management Group Commercial	$140.60
Rate for Payer: Health Management Network Commercial	$109.65
Rate for Payer: Health Management Network Commercial	$125.80
Rate for Payer: Kaiser Permanente Commercial	$81.27
Rate for Payer: Kaiser Permanente Commercial	$93.24
Rate for Payer: Kaiser Permanente Medicaid	$75.48
Rate for Payer: Kaiser Permanente Medicaid	$65.79
Rate for Payer: MDX Hawaii PPO	$143.56
Rate for Payer: MDX Hawaii PPO	$125.13
Rate for Payer: UnitedHealthcare Medicaid	$77.40
Rate for Payer: UnitedHealthcare Medicaid	$88.80
Rate for Payer: University Health Alliance Commercial	$94.03
Rate for Payer: University Health Alliance Commercial	$107.88

METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION [4996]

Facility

IP

$60.00

Service Code	HCPCS J1010
Hospital Revenue Code	250
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$58.20
Rate for Payer: Cash Price	$36.00
Rate for Payer: Cash Price	$29.40
Rate for Payer: Health Management Network Commercial	$41.65
Rate for Payer: Health Management Network Commercial	$51.00
Rate for Payer: MDX Hawaii PPO	$47.53
Rate for Payer: MDX Hawaii PPO	$58.20

METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION [4996]

Facility

OP

$60.00

Service Code	HCPCS J1010
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$58.20
Rate for Payer: Cash Price	$36.00
Rate for Payer: Cash Price	$29.40
Rate for Payer: Cash Price	$36.00
Rate for Payer: Cash Price	$29.40
Rate for Payer: Hawaii Medical Service Association ABD	$0.12
Rate for Payer: Hawaii Medical Service Association ABD	$0.12
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.12
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.12
Rate for Payer: Hawaii Western Management Group Commercial	$46.55
Rate for Payer: Hawaii Western Management Group Commercial	$57.00
Rate for Payer: Health Management Network Commercial	$51.00
Rate for Payer: Health Management Network Commercial	$41.65
Rate for Payer: Kaiser Permanente Commercial	$37.80
Rate for Payer: Kaiser Permanente Commercial	$30.87
Rate for Payer: Kaiser Permanente Medicaid	$24.99
Rate for Payer: Kaiser Permanente Medicaid	$30.60
Rate for Payer: MDX Hawaii PPO	$58.20
Rate for Payer: MDX Hawaii PPO	$47.53
Rate for Payer: UnitedHealthcare Medicaid	$29.40
Rate for Payer: UnitedHealthcare Medicaid	$36.00
Rate for Payer: University Health Alliance Commercial	$43.73
Rate for Payer: University Health Alliance Commercial	$35.72

METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION [10581]

Facility

IP

$66.00

Service Code	HCPCS J2919
Hospital Revenue Code	250
Min. Negotiated Rate	$56.10
Max. Negotiated Rate	$64.02
Rate for Payer: Cash Price	$39.60
Rate for Payer: Cash Price	$43.80
Rate for Payer: Health Management Network Commercial	$56.10
Rate for Payer: Health Management Network Commercial	$62.05
Rate for Payer: MDX Hawaii PPO	$64.02
Rate for Payer: MDX Hawaii PPO	$70.81

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