Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

METOPROLOL INJ 5MG/5ML

Facility

$13.07

Service Code	NDC 36000003310
Hospital Charge Code	60627581
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$6.54
Rate for Payer: Aetna Commercial	$4.97
Rate for Payer: Aetna Medicare Advantage	$3.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.33
Rate for Payer: Cigna Commercial	$6.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.40
Rate for Payer: Oxford Commercial	$2.61
Rate for Payer: Qualcare PPO/HMO/WC	$1.96
Rate for Payer: UnitedHealthcare Commercial	$2.61
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

METOPROLOL INJ 5MG/5ML

Facility

$13.07

Service Code	NDC 36000003310
Hospital Charge Code	60627581
Hospital Revenue Code	250
Min. Negotiated Rate	$1.96
Max. Negotiated Rate	$1.96
Rate for Payer: Qualcare PPO/HMO/WC	$1.96

METOPROLOL SUCCINATE 25 MG

Facility

$9.58

Service Code	NDC 186108839
Hospital Charge Code	60629170
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$4.79
Rate for Payer: Aetna Commercial	$3.64
Rate for Payer: Aetna Medicare Advantage	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.44
Rate for Payer: Cigna Commercial	$4.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.49
Rate for Payer: Oxford Commercial	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.44
Rate for Payer: UnitedHealthcare Commercial	$1.92
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

METOPROLOL SUCCINATE 25 MG

Facility

$9.58

Service Code	NDC 186108839
Hospital Charge Code	60629170
Hospital Revenue Code	250
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.44

METOPROLOL SUCCINATE 50 MG

Facility

$9.58

Service Code	NDC 186109039
Hospital Charge Code	60627577
Hospital Revenue Code	250
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.44

METOPROLOL SUCCINATE 50 MG

Facility

$9.58

Service Code	NDC 186109039
Hospital Charge Code	60627577
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$4.79
Rate for Payer: Aetna Commercial	$3.64
Rate for Payer: Aetna Medicare Advantage	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.44
Rate for Payer: Cigna Commercial	$4.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.49
Rate for Payer: Oxford Commercial	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.44
Rate for Payer: UnitedHealthcare Commercial	$1.92
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

METOPROLOL TAB CR 100MG

Facility

$14.47

Service Code	NDC 186109239
Hospital Charge Code	60628650
Hospital Revenue Code	250
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$7.24
Rate for Payer: Aetna Commercial	$5.50
Rate for Payer: Aetna Medicare Advantage	$4.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.69
Rate for Payer: Cigna Commercial	$7.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.76
Rate for Payer: Oxford Commercial	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.17
Rate for Payer: UnitedHealthcare Commercial	$2.89
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

METOPROLOL TAB CR 100MG

Facility

$14.47

Service Code	NDC 186109239
Hospital Charge Code	60628650
Hospital Revenue Code	250
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$2.17
Rate for Payer: Qualcare PPO/HMO/WC	$2.17

METOPROLOL TARTRATE 50 MG TAB

Facility

$4.00

Service Code	NDC 51079080120
Hospital Charge Code	60627580
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
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	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

METOPROLOL TARTRATE 50 MG TAB

Facility

$4.00

Service Code	NDC 51079080120
Hospital Charge Code	60627580
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

METROCLOPRAMIDE 5MG TAB

Facility

$4.00

Service Code	NDC 51079088601
Hospital Charge Code	60630015
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

METROCLOPRAMIDE 5MG TAB

Facility

$4.00

Service Code	NDC 51079088601
Hospital Charge Code	60630015
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
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	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

METRONIDAZOLE

Facility

$39.40

Service Code	NDC 409781137
Hospital Charge Code	6007207
Hospital Revenue Code	250
Min. Negotiated Rate	$5.91
Max. Negotiated Rate	$5.91
Rate for Payer: Qualcare PPO/HMO/WC	$5.91

METRONIDAZOLE

Facility

$39.40

Service Code	NDC 409781137
Hospital Charge Code	6007207
Hospital Revenue Code	250
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$19.70
Rate for Payer: Aetna Commercial	$14.97
Rate for Payer: Aetna Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.05
Rate for Payer: Cigna Commercial	$19.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.24
Rate for Payer: Oxford Commercial	$7.88
Rate for Payer: Qualcare PPO/HMO/WC	$5.91
Rate for Payer: UnitedHealthcare Commercial	$7.88
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.12

METRONIDAZOLE 250 MG TAB

Facility

$4.00

Service Code	NDC 904145361
Hospital Charge Code	60627356
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

METRONIDAZOLE 250 MG TAB

Facility

$4.00

Service Code	NDC 904145361
Hospital Charge Code	60627356
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
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	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

METRONIDAZOLE 500 MG TAB

Facility

$7.64

Service Code	NDC 68084096611
Hospital Charge Code	6024087
Hospital Revenue Code	251
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$1.15
Rate for Payer: Qualcare PPO/HMO/WC	$1.15

METRONIDAZOLE 500 MG TAB

Facility

$7.64

Service Code	NDC 68084096611
Hospital Charge Code	6024087
Hospital Revenue Code	251
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$3.82
Rate for Payer: Aetna Commercial	$2.90
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	$1.99
Rate for Payer: Oxford Commercial	$1.53
Rate for Payer: Qualcare PPO/HMO/WC	$1.15
Rate for Payer: UnitedHealthcare Commercial	$1.53
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

METRONIZAZOLE GEL TOP 0.75%

Facility

$2,110.50

Service Code	NDC 67405011045
Hospital Charge Code	60627354
Hospital Revenue Code	250
Min. Negotiated Rate	$316.57
Max. Negotiated Rate	$316.57
Rate for Payer: Qualcare PPO/HMO/WC	$316.57

METRONIZAZOLE GEL TOP 0.75%

Facility

$2,110.50

Service Code	NDC 67405011045
Hospital Charge Code	60627354
Hospital Revenue Code	250
Min. Negotiated Rate	$59.94
Max. Negotiated Rate	$1,055.25
Rate for Payer: Aetna Commercial	$801.99
Rate for Payer: Aetna Medicare Advantage	$633.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$538.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$538.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$538.18
Rate for Payer: Cigna Commercial	$1,055.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.73
Rate for Payer: Oxford Commercial	$422.10
Rate for Payer: Qualcare PPO/HMO/WC	$316.57
Rate for Payer: UnitedHealthcare Commercial	$422.10
Rate for Payer: UnitedHealthcare Community & State	$66.69
Rate for Payer: Wellpoint Medicaid Managed Care	$59.94

MEXILETINE

Facility

$272.00

Service Code	HCPCS 80299
Hospital Charge Code	38472031
Hospital Revenue Code	301
Min. Negotiated Rate	$7.72
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$50.70
Rate for Payer: Aetna Medicare Advantage	$60.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.62
Rate for Payer: Cigna Commercial	$136.00
Rate for Payer: Cigna Medicare Advantage	$18.64
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.72
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.80
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Medicare Advantage	$18.64
Rate for Payer: Wellpoint Medicaid Managed Care	$7.72

MEXILETINE

Facility

$272.00

Service Code	HCPCS 80299
Hospital Charge Code	38472031
Hospital Revenue Code	301
Min. Negotiated Rate	$40.80
Max. Negotiated Rate	$40.80
Rate for Payer: Qualcare PPO/HMO/WC	$40.80

MEXILETINE CAP 150MG

Facility

$17.02

Service Code	NDC 93873901
Hospital Charge Code	60627582
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$8.51
Rate for Payer: Aetna Commercial	$6.47
Rate for Payer: Aetna Medicare Advantage	$5.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.34
Rate for Payer: Cigna Commercial	$8.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.43
Rate for Payer: Oxford Commercial	$3.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$3.40
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

MEXILETINE CAP 150MG

Facility

$17.02

Service Code	NDC 93873901
Hospital Charge Code	60627582
Hospital Revenue Code	250
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

MEXILETINE CAP 200MG

Facility

$20.30

Service Code	NDC 93874001
Hospital Charge Code	60627583
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$10.15
Rate for Payer: Aetna Commercial	$7.71
Rate for Payer: Aetna Medicare Advantage	$6.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.18
Rate for Payer: Cigna Commercial	$10.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.28
Rate for Payer: Oxford Commercial	$4.06
Rate for Payer: Qualcare PPO/HMO/WC	$3.04
Rate for Payer: UnitedHealthcare Commercial	$4.06
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

Know your out-of-pocket cost for care.

All Charges