Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

METOPROLOL TARTRATE 25 MG TABLET [37637]

Facility

IP

$1.00

Service Code	NDC 51079025501
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.60
Rate for Payer: Health Management Network Commercial	$0.85
Rate for Payer: MDX Hawaii PPO	$0.97

METOPROLOL TARTRATE 25 MG TABLET [37637]

Facility

OP

$1.00

Service Code	NDC 51079025501
Hospital Revenue Code	637
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.60
Rate for Payer: Hawaii Western Management Group Commercial	$0.95
Rate for Payer: Health Management Network Commercial	$0.85
Rate for Payer: Kaiser Permanente Commercial	$0.63
Rate for Payer: Kaiser Permanente Medicaid	$0.51
Rate for Payer: MDX Hawaii PPO	$0.97
Rate for Payer: University Health Alliance Commercial	$0.73

METOPROLOL TARTRATE 25 MG TABLET [37637]

Facility

OP

$1.00

Service Code	NDC 51079025520
Hospital Revenue Code	637
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.60
Rate for Payer: Hawaii Western Management Group Commercial	$0.95
Rate for Payer: Health Management Network Commercial	$0.85
Rate for Payer: Kaiser Permanente Commercial	$0.63
Rate for Payer: Kaiser Permanente Medicaid	$0.51
Rate for Payer: MDX Hawaii PPO	$0.97
Rate for Payer: University Health Alliance Commercial	$0.73

METOPROLOL TARTRATE 50 MG TABLET [5009]

Facility

IP

$3.00

Service Code	NDC 51079080101
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

METOPROLOL TARTRATE 50 MG TABLET [5009]

Facility

IP

$1.00

Service Code	NDC 62584026601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.60
Rate for Payer: Health Management Network Commercial	$0.85
Rate for Payer: MDX Hawaii PPO	$0.97

METOPROLOL TARTRATE 50 MG TABLET [5009]

Facility

IP

$1.00

Service Code	NDC 62584026611
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.60
Rate for Payer: Health Management Network Commercial	$0.85
Rate for Payer: MDX Hawaii PPO	$0.97

METOPROLOL TARTRATE 50 MG TABLET [5009]

Facility

OP

$3.00

Service Code	NDC 51079080101
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

METOPROLOL TARTRATE 50 MG TABLET [5009]

Facility

OP

$1.00

Service Code	NDC 62584026601
Hospital Revenue Code	637
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.60
Rate for Payer: Hawaii Western Management Group Commercial	$0.95
Rate for Payer: Health Management Network Commercial	$0.85
Rate for Payer: Kaiser Permanente Commercial	$0.63
Rate for Payer: Kaiser Permanente Medicaid	$0.51
Rate for Payer: MDX Hawaii PPO	$0.97
Rate for Payer: University Health Alliance Commercial	$0.73

METOPROLOL TARTRATE 50 MG TABLET [5009]

Facility

OP

$1.00

Service Code	NDC 62584026611
Hospital Revenue Code	637
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.60
Rate for Payer: Hawaii Western Management Group Commercial	$0.95
Rate for Payer: Health Management Network Commercial	$0.85
Rate for Payer: Kaiser Permanente Commercial	$0.63
Rate for Payer: Kaiser Permanente Medicaid	$0.51
Rate for Payer: MDX Hawaii PPO	$0.97
Rate for Payer: University Health Alliance Commercial	$0.73

METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION [92079]

Facility

IP

$6.00

Service Code	NDC 00409177815
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

METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION [92079]

Facility

IP

$5.00

Service Code	NDC 36000003310
Hospital Revenue Code	250
Min. Negotiated Rate	$4.25
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.00
Rate for Payer: Health Management Network Commercial	$4.25
Rate for Payer: MDX Hawaii PPO	$4.85

METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION [92079]

Facility

IP

$6.00

Service Code	NDC 00409177805
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

METOPROLOL TARTRATE TABLETS (LOPRESSOR) 50 MG (TAKE HOME) [4080375]

Facility

OP

$15.00

Service Code	NDC 00004080163
Hospital Revenue Code	253
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$14.55
Rate for Payer: Cash Price	$9.00
Rate for Payer: Hawaii Western Management Group Commercial	$14.25
Rate for Payer: Health Management Network Commercial	$12.75
Rate for Payer: Kaiser Permanente Commercial	$9.45
Rate for Payer: Kaiser Permanente Medicaid	$7.65
Rate for Payer: MDX Hawaii PPO	$14.55
Rate for Payer: University Health Alliance Commercial	$10.93

METOPROLOL TARTRATE TABLETS (LOPRESSOR) 50 MG (TAKE HOME) [4080375]

Facility

IP

$15.00

Service Code	NDC 00004080163
Hospital Revenue Code	253
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$14.55
Rate for Payer: Cash Price	$9.00
Rate for Payer: Health Management Network Commercial	$12.75
Rate for Payer: MDX Hawaii PPO	$14.55

METRONIDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL [10592]

Facility

OP

$535.00

Service Code	NDC 45802013970
Hospital Revenue Code	637
Min. Negotiated Rate	$272.85
Max. Negotiated Rate	$518.95
Rate for Payer: Cash Price	$321.00
Rate for Payer: Hawaii Western Management Group Commercial	$508.25
Rate for Payer: Health Management Network Commercial	$454.75
Rate for Payer: Kaiser Permanente Commercial	$337.05
Rate for Payer: Kaiser Permanente Medicaid	$272.85
Rate for Payer: MDX Hawaii PPO	$518.95
Rate for Payer: University Health Alliance Commercial	$389.96

METRONIDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL [10592]

Facility

IP

$535.00

Service Code	NDC 45802013970
Hospital Revenue Code	250
Min. Negotiated Rate	$454.75
Max. Negotiated Rate	$518.95
Rate for Payer: Cash Price	$321.00
Rate for Payer: Health Management Network Commercial	$454.75
Rate for Payer: MDX Hawaii PPO	$518.95

METRONIDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL [10592]

Facility

IP

$535.00

Service Code	NDC 21922003923
Hospital Revenue Code	250
Min. Negotiated Rate	$454.75
Max. Negotiated Rate	$518.95
Rate for Payer: Cash Price	$321.00
Rate for Payer: Health Management Network Commercial	$454.75
Rate for Payer: MDX Hawaii PPO	$518.95

METRONIDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL [10592]

Facility

OP

$535.00

Service Code	NDC 21922003923
Hospital Revenue Code	637
Min. Negotiated Rate	$272.85
Max. Negotiated Rate	$518.95
Rate for Payer: Cash Price	$321.00
Rate for Payer: Hawaii Western Management Group Commercial	$508.25
Rate for Payer: Health Management Network Commercial	$454.75
Rate for Payer: Kaiser Permanente Commercial	$337.05
Rate for Payer: Kaiser Permanente Medicaid	$272.85
Rate for Payer: MDX Hawaii PPO	$518.95
Rate for Payer: University Health Alliance Commercial	$389.96

METRONIDAZOLE 250 MG TABLET [5015]

Facility

OP

$2.00

Service Code	NDC 00904715661
Hospital Revenue Code	637
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.94
Rate for Payer: Cash Price	$1.20
Rate for Payer: Hawaii Western Management Group Commercial	$1.90
Rate for Payer: Health Management Network Commercial	$1.70
Rate for Payer: Kaiser Permanente Commercial	$1.26
Rate for Payer: Kaiser Permanente Medicaid	$1.02
Rate for Payer: MDX Hawaii PPO	$1.94
Rate for Payer: University Health Alliance Commercial	$1.46

METRONIDAZOLE 250 MG TABLET [5015]

Facility

IP

$2.00

Service Code	NDC 00904715661
Hospital Revenue Code	250
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$1.94
Rate for Payer: Cash Price	$1.20
Rate for Payer: Health Management Network Commercial	$1.70
Rate for Payer: MDX Hawaii PPO	$1.94

METRONIDAZOLE 250 MG TABLET [5015]

Facility

IP

$2.00

Service Code	NDC 68001036400
Hospital Revenue Code	250
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$1.94
Rate for Payer: Cash Price	$1.20
Rate for Payer: Health Management Network Commercial	$1.70
Rate for Payer: MDX Hawaii PPO	$1.94

METRONIDAZOLE 250 MG TABLET [5015]

Facility

OP

$2.00

Service Code	NDC 68001036400
Hospital Revenue Code	637
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.94
Rate for Payer: Cash Price	$1.20
Rate for Payer: Hawaii Western Management Group Commercial	$1.90
Rate for Payer: Health Management Network Commercial	$1.70
Rate for Payer: Kaiser Permanente Commercial	$1.26
Rate for Payer: Kaiser Permanente Medicaid	$1.02
Rate for Payer: MDX Hawaii PPO	$1.94
Rate for Payer: University Health Alliance Commercial	$1.46

METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK [183828]

Facility

OP

$9.00

Service Code	HCPCS J1836
Hospital Revenue Code	636
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$5.40
Rate for Payer: Cash Price	$5.40
Rate for Payer: Hawaii Medical Service Association ABD	$0.03
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.03
Rate for Payer: Hawaii Western Management Group Commercial	$8.55
Rate for Payer: Health Management Network Commercial	$7.65
Rate for Payer: Kaiser Permanente Commercial	$5.67
Rate for Payer: Kaiser Permanente Medicaid	$4.59
Rate for Payer: MDX Hawaii PPO	$8.73
Rate for Payer: UnitedHealthcare Medicaid	$5.40
Rate for Payer: University Health Alliance Commercial	$6.56

METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK [183828]

Facility

IP

$9.00

Service Code	HCPCS J1836
Hospital Revenue Code	250
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$5.40
Rate for Payer: Health Management Network Commercial	$7.65
Rate for Payer: MDX Hawaii PPO	$8.73

METRONIDAZOLE 500 MG TABLET [5016]

Facility

IP

$4.00

Service Code	NDC 60687055001
Hospital Revenue Code	250
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$2.40
Rate for Payer: Health Management Network Commercial	$3.40
Rate for Payer: MDX Hawaii PPO	$3.88

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