|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR [30070]
|
Facility
|
IP
|
$4.00
|
|
|
Service Code
|
NDC 60687040211
|
|
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: Kaiser Permanente Commercial |
$3.60
|
| Rate for Payer: MDX Hawaii PPO |
$3.88
|
|
|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR [30070]
|
Facility
|
OP
|
$4.00
|
|
|
Service Code
|
NDC 60687040211
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.24 |
| Max. Negotiated Rate |
$3.88 |
| Rate for Payer: AlohaCare Medicaid |
$2.00
|
| Rate for Payer: AlohaCare Medicare |
$1.24
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Devoted Health Medicare |
$1.36
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1.24
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3.80
|
| Rate for Payer: Health Management Network Commercial |
$3.40
|
| Rate for Payer: Humana Medicare |
$1.24
|
| Rate for Payer: Kaiser Permanente Commercial |
$3.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2.04
|
| Rate for Payer: Kaiser Permanente Medicare |
$1.24
|
| Rate for Payer: MDX Hawaii PPO |
$3.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$1.24
|
| Rate for Payer: UnitedHealthcare Medicare |
$1.24
|
| Rate for Payer: University Health Alliance Commercial |
$2.92
|
|
|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR [30070]
|
Facility
|
IP
|
$4.00
|
|
|
Service Code
|
NDC 60687040201
|
|
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: Kaiser Permanente Commercial |
$3.60
|
| Rate for Payer: MDX Hawaii PPO |
$3.88
|
|
|
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: Kaiser Permanente Commercial |
$0.90
|
| Rate for Payer: MDX Hawaii PPO |
$0.97
|
|
|
METOPROLOL TARTRATE 25 MG TABLET [37637]
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
NDC 51079025520
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: AlohaCare Medicaid |
$0.50
|
| Rate for Payer: AlohaCare Medicare |
$0.31
|
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Devoted Health Medicare |
$0.34
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$0.31
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$0.95
|
| Rate for Payer: Health Management Network Commercial |
$0.85
|
| Rate for Payer: Humana Medicare |
$0.31
|
| Rate for Payer: Kaiser Permanente Commercial |
$0.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$0.51
|
| Rate for Payer: Kaiser Permanente Medicare |
$0.31
|
| Rate for Payer: MDX Hawaii PPO |
$0.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$0.31
|
| Rate for Payer: Ohana Health Plan Medicare |
$0.31
|
| Rate for Payer: UnitedHealthcare Medicare |
$0.31
|
| Rate for Payer: University Health Alliance Commercial |
$0.73
|
|
|
METOPROLOL TARTRATE 25 MG TABLET [37637]
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
NDC 51079025520
|
|
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: Kaiser Permanente Commercial |
$0.90
|
| 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 |
$0.31 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: AlohaCare Medicaid |
$0.50
|
| Rate for Payer: AlohaCare Medicare |
$0.31
|
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Devoted Health Medicare |
$0.34
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$0.31
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$0.95
|
| Rate for Payer: Health Management Network Commercial |
$0.85
|
| Rate for Payer: Humana Medicare |
$0.31
|
| Rate for Payer: Kaiser Permanente Commercial |
$0.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$0.51
|
| Rate for Payer: Kaiser Permanente Medicare |
$0.31
|
| Rate for Payer: MDX Hawaii PPO |
$0.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$0.31
|
| Rate for Payer: Ohana Health Plan Medicare |
$0.31
|
| Rate for Payer: UnitedHealthcare Medicare |
$0.31
|
| Rate for Payer: University Health Alliance Commercial |
$0.73
|
|
|
METOPROLOL TARTRATE 50 MG TABLET [5009]
|
Facility
|
OP
|
$3.00
|
|
|
Service Code
|
NDC 51079080101
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$2.91 |
| Rate for Payer: AlohaCare Medicaid |
$1.50
|
| Rate for Payer: AlohaCare Medicare |
$0.93
|
| Rate for Payer: Cash Price |
$1.80
|
| Rate for Payer: Devoted Health Medicare |
$1.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$0.93
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2.85
|
| Rate for Payer: Health Management Network Commercial |
$2.55
|
| Rate for Payer: Humana Medicare |
$0.93
|
| Rate for Payer: Kaiser Permanente Commercial |
$2.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1.53
|
| Rate for Payer: Kaiser Permanente Medicare |
$0.93
|
| Rate for Payer: MDX Hawaii PPO |
$2.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$0.93
|
| Rate for Payer: Ohana Health Plan Medicare |
$0.93
|
| Rate for Payer: UnitedHealthcare Medicare |
$0.93
|
| Rate for Payer: University Health Alliance Commercial |
$2.19
|
|
|
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: Kaiser Permanente Commercial |
$0.90
|
| Rate for Payer: MDX Hawaii PPO |
$0.97
|
|
|
METOPROLOL TARTRATE 50 MG TABLET [5009]
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
NDC 62584026601
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: AlohaCare Medicaid |
$0.50
|
| Rate for Payer: AlohaCare Medicare |
$0.31
|
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Devoted Health Medicare |
$0.34
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$0.31
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$0.95
|
| Rate for Payer: Health Management Network Commercial |
$0.85
|
| Rate for Payer: Humana Medicare |
$0.31
|
| Rate for Payer: Kaiser Permanente Commercial |
$0.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$0.51
|
| Rate for Payer: Kaiser Permanente Medicare |
$0.31
|
| Rate for Payer: MDX Hawaii PPO |
$0.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$0.31
|
| Rate for Payer: Ohana Health Plan Medicare |
$0.31
|
| Rate for Payer: UnitedHealthcare Medicare |
$0.31
|
| 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: Kaiser Permanente Commercial |
$2.70
|
| Rate for Payer: MDX Hawaii PPO |
$2.91
|
|
|
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: Kaiser Permanente Commercial |
$0.90
|
| Rate for Payer: MDX Hawaii PPO |
$0.97
|
|
|
METOPROLOL TARTRATE 50 MG TABLET [5009]
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
NDC 62584026611
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: AlohaCare Medicaid |
$0.50
|
| Rate for Payer: AlohaCare Medicare |
$0.31
|
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Devoted Health Medicare |
$0.34
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$0.31
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$0.95
|
| Rate for Payer: Health Management Network Commercial |
$0.85
|
| Rate for Payer: Humana Medicare |
$0.31
|
| Rate for Payer: Kaiser Permanente Commercial |
$0.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$0.51
|
| Rate for Payer: Kaiser Permanente Medicare |
$0.31
|
| Rate for Payer: MDX Hawaii PPO |
$0.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$0.31
|
| Rate for Payer: Ohana Health Plan Medicare |
$0.31
|
| Rate for Payer: UnitedHealthcare Medicare |
$0.31
|
| Rate for Payer: University Health Alliance Commercial |
$0.73
|
|
|
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: Kaiser Permanente Commercial |
$4.50
|
| Rate for Payer: MDX Hawaii PPO |
$4.85
|
|
|
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: Kaiser Permanente Commercial |
$5.40
|
| Rate for Payer: MDX Hawaii PPO |
$5.82
|
|
|
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: Kaiser Permanente Commercial |
$5.40
|
| 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 |
$4.65 |
| Max. Negotiated Rate |
$14.55 |
| Rate for Payer: AlohaCare Medicaid |
$7.50
|
| Rate for Payer: AlohaCare Medicare |
$4.65
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Devoted Health Medicare |
$5.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$4.65
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$14.25
|
| Rate for Payer: Health Management Network Commercial |
$12.75
|
| Rate for Payer: Humana Medicare |
$4.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$13.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$7.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$4.65
|
| Rate for Payer: MDX Hawaii PPO |
$14.55
|
| Rate for Payer: Ohana Health Plan Medicaid |
$4.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$4.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$4.65
|
| 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: Kaiser Permanente Commercial |
$13.50
|
| 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 |
$165.85 |
| Max. Negotiated Rate |
$518.95 |
| Rate for Payer: AlohaCare Medicaid |
$267.50
|
| Rate for Payer: AlohaCare Medicare |
$165.85
|
| Rate for Payer: Cash Price |
$321.00
|
| Rate for Payer: Devoted Health Medicare |
$181.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$165.85
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$508.25
|
| Rate for Payer: Health Management Network Commercial |
$454.75
|
| Rate for Payer: Humana Medicare |
$165.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$481.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$272.85
|
| Rate for Payer: Kaiser Permanente Medicare |
$165.85
|
| Rate for Payer: MDX Hawaii PPO |
$518.95
|
| Rate for Payer: Ohana Health Plan Medicaid |
$165.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$165.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$165.85
|
| Rate for Payer: University Health Alliance Commercial |
$389.96
|
|
|
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 |
$165.85 |
| Max. Negotiated Rate |
$518.95 |
| Rate for Payer: AlohaCare Medicaid |
$267.50
|
| Rate for Payer: AlohaCare Medicare |
$165.85
|
| Rate for Payer: Cash Price |
$321.00
|
| Rate for Payer: Devoted Health Medicare |
$181.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$165.85
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$508.25
|
| Rate for Payer: Health Management Network Commercial |
$454.75
|
| Rate for Payer: Humana Medicare |
$165.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$481.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$272.85
|
| Rate for Payer: Kaiser Permanente Medicare |
$165.85
|
| Rate for Payer: MDX Hawaii PPO |
$518.95
|
| Rate for Payer: Ohana Health Plan Medicaid |
$165.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$165.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$165.85
|
| 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 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: Kaiser Permanente Commercial |
$481.50
|
| 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 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: Kaiser Permanente Commercial |
$481.50
|
| Rate for Payer: MDX Hawaii PPO |
$518.95
|
|
|
METRONIDAZOLE 250 MG TABLET [5015]
|
Facility
|
OP
|
$2.00
|
|
|
Service Code
|
NDC 68001036400
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.62 |
| Max. Negotiated Rate |
$1.94 |
| Rate for Payer: AlohaCare Medicaid |
$1.00
|
| Rate for Payer: AlohaCare Medicare |
$0.62
|
| Rate for Payer: Cash Price |
$1.20
|
| Rate for Payer: Devoted Health Medicare |
$0.68
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$0.62
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1.90
|
| Rate for Payer: Health Management Network Commercial |
$1.70
|
| Rate for Payer: Humana Medicare |
$0.62
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$0.62
|
| Rate for Payer: MDX Hawaii PPO |
$1.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$0.62
|
| Rate for Payer: Ohana Health Plan Medicare |
$0.62
|
| Rate for Payer: UnitedHealthcare Medicare |
$0.62
|
| Rate for Payer: University Health Alliance Commercial |
$1.46
|
|
|
METRONIDAZOLE 250 MG TABLET [5015]
|
Facility
|
OP
|
$2.00
|
|
|
Service Code
|
NDC 00904715661
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.62 |
| Max. Negotiated Rate |
$1.94 |
| Rate for Payer: AlohaCare Medicaid |
$1.00
|
| Rate for Payer: AlohaCare Medicare |
$0.62
|
| Rate for Payer: Cash Price |
$1.20
|
| Rate for Payer: Devoted Health Medicare |
$0.68
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$0.62
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1.90
|
| Rate for Payer: Health Management Network Commercial |
$1.70
|
| Rate for Payer: Humana Medicare |
$0.62
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$0.62
|
| Rate for Payer: MDX Hawaii PPO |
$1.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$0.62
|
| Rate for Payer: Ohana Health Plan Medicare |
$0.62
|
| Rate for Payer: UnitedHealthcare Medicare |
$0.62
|
| 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: Kaiser Permanente Commercial |
$1.80
|
| Rate for Payer: MDX Hawaii PPO |
$1.94
|
|
