METANEPHRINES, FRAC., PI. FREE
|
Facility
|
OP
|
$42.35
|
|
Service Code
|
HCPCS 83835
|
Hospital Charge Code |
40609098
|
Hospital Revenue Code
|
300
|
Min. Negotiated Rate |
$11.86 |
Max. Negotiated Rate |
$31.76 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$23.29
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$16.94
|
Rate for Payer: Aetna Government |
$16.94
|
Rate for Payer: Affinity Essential Plan 1&2 |
$11.86
|
Rate for Payer: Affinity Essential Plan 3&4 |
$11.86
|
Rate for Payer: Affinity Medicaid/CHP/HARP |
$11.86
|
Rate for Payer: Brighton Health Commercial |
$31.76
|
Rate for Payer: Cash Price |
$16.94
|
Rate for Payer: Cash Price |
$16.94
|
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$16.94
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$26.94
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$22.79
|
Rate for Payer: Elderplan Medicare Advantage |
$16.94
|
Rate for Payer: EmblemHealth Commercial |
$16.94
|
Rate for Payer: Fidelis Essential Plan Aliesa |
$14.40
|
Rate for Payer: Fidelis Essential Plan QHP |
$15.08
|
Rate for Payer: Fidelis Medicare Advantage |
$16.94
|
Rate for Payer: Fidelis Qualified Health Plan |
$15.08
|
Rate for Payer: Group Health Inc Commercial |
$16.94
|
Rate for Payer: Group Health Inc Medicare |
$16.94
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$21.18
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$16.94
|
Rate for Payer: Healthfirst Medicare Advantage |
$16.94
|
Rate for Payer: Healthfirst QHP |
$16.94
|
Rate for Payer: Humana Medicare |
$17.28
|
Rate for Payer: Senior Whole Health Medicare Advantage |
$16.94
|
Rate for Payer: United Healthcare Commercial |
$21.46
|
Rate for Payer: United Healthcare Medicare Advantage |
$16.94
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$16.94
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$13.55
|
Rate for Payer: Wellcare Medicare |
$15.25
|
|
METANEPHRINES, FRAC, QN, 24-HR
|
Facility
|
IP
|
$42.35
|
|
Service Code
|
HCPCS 83835
|
Hospital Charge Code |
40609099
|
Hospital Revenue Code
|
300
|
Rate for Payer: Cash Price |
$16.94
|
|
METANEPHRINES, FRAC, QN, 24-HR
|
Facility
|
OP
|
$42.35
|
|
Service Code
|
HCPCS 83835
|
Hospital Charge Code |
40609099
|
Hospital Revenue Code
|
300
|
Min. Negotiated Rate |
$11.86 |
Max. Negotiated Rate |
$31.76 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$23.29
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$16.94
|
Rate for Payer: Aetna Government |
$16.94
|
Rate for Payer: Affinity Essential Plan 1&2 |
$11.86
|
Rate for Payer: Affinity Essential Plan 3&4 |
$11.86
|
Rate for Payer: Affinity Medicaid/CHP/HARP |
$11.86
|
Rate for Payer: Brighton Health Commercial |
$31.76
|
Rate for Payer: Cash Price |
$16.94
|
Rate for Payer: Cash Price |
$16.94
|
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$16.94
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$26.94
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$22.79
|
Rate for Payer: Elderplan Medicare Advantage |
$16.94
|
Rate for Payer: EmblemHealth Commercial |
$16.94
|
Rate for Payer: Fidelis Essential Plan Aliesa |
$14.40
|
Rate for Payer: Fidelis Essential Plan QHP |
$15.08
|
Rate for Payer: Fidelis Medicare Advantage |
$16.94
|
Rate for Payer: Fidelis Qualified Health Plan |
$15.08
|
Rate for Payer: Group Health Inc Commercial |
$16.94
|
Rate for Payer: Group Health Inc Medicare |
$16.94
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$21.18
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$16.94
|
Rate for Payer: Healthfirst Medicare Advantage |
$16.94
|
Rate for Payer: Healthfirst QHP |
$16.94
|
Rate for Payer: Humana Medicare |
$17.28
|
Rate for Payer: Senior Whole Health Medicare Advantage |
$16.94
|
Rate for Payer: United Healthcare Commercial |
$21.46
|
Rate for Payer: United Healthcare Medicare Advantage |
$16.94
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$16.94
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$13.55
|
Rate for Payer: Wellcare Medicare |
$15.25
|
|
METANEPHRINES, PHEOCHROMOCYT
|
Facility
|
IP
|
$12.95
|
|
Service Code
|
HCPCS 82570
|
Hospital Charge Code |
40609059
|
Hospital Revenue Code
|
300
|
Rate for Payer: Cash Price |
$5.18
|
|
METANEPHRINES, PHEOCHROMOCYT
|
Facility
|
OP
|
$12.95
|
|
Service Code
|
HCPCS 82570
|
Hospital Charge Code |
40609059
|
Hospital Revenue Code
|
300
|
Min. Negotiated Rate |
$3.63 |
Max. Negotiated Rate |
$9.71 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.12
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.18
|
Rate for Payer: Aetna Government |
$5.18
|
Rate for Payer: Affinity Essential Plan 1&2 |
$3.63
|
Rate for Payer: Affinity Essential Plan 3&4 |
$3.63
|
Rate for Payer: Affinity Medicaid/CHP/HARP |
$3.63
|
Rate for Payer: Brighton Health Commercial |
$9.71
|
Rate for Payer: Cash Price |
$5.18
|
Rate for Payer: Cash Price |
$5.18
|
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.18
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.23
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.96
|
Rate for Payer: Elderplan Medicare Advantage |
$5.18
|
Rate for Payer: EmblemHealth Commercial |
$5.18
|
Rate for Payer: Fidelis Essential Plan Aliesa |
$4.40
|
Rate for Payer: Fidelis Essential Plan QHP |
$4.61
|
Rate for Payer: Fidelis Medicare Advantage |
$5.18
|
Rate for Payer: Fidelis Qualified Health Plan |
$4.61
|
Rate for Payer: Group Health Inc Commercial |
$5.18
|
Rate for Payer: Group Health Inc Medicare |
$5.18
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.48
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$5.18
|
Rate for Payer: Healthfirst Medicare Advantage |
$5.18
|
Rate for Payer: Healthfirst QHP |
$5.18
|
Rate for Payer: Humana Medicare |
$5.28
|
Rate for Payer: Senior Whole Health Medicare Advantage |
$5.18
|
Rate for Payer: United Healthcare Commercial |
$6.55
|
Rate for Payer: United Healthcare Medicare Advantage |
$5.18
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.18
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4.14
|
Rate for Payer: Wellcare Medicare |
$4.66
|
|
METATARSAL HEAD RESECTION
|
Facility
|
OP
|
$8,291.05
|
|
Service Code
|
HCPCS 28173
|
Hospital Charge Code |
40082700
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$1,468.00 |
Max. Negotiated Rate |
$6,218.29 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,743.15
|
Rate for Payer: Aetna Government |
$3,743.15
|
Rate for Payer: Affinity Essential Plan 1&2 |
$2,620.20
|
Rate for Payer: Affinity Essential Plan 3&4 |
$2,620.20
|
Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,620.20
|
Rate for Payer: Brighton Health Commercial |
$6,218.29
|
Rate for Payer: Cash Price |
$3,743.15
|
Rate for Payer: Cash Price |
$3,743.15
|
Rate for Payer: Cash Price |
$3,743.15
|
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,743.15
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
Rate for Payer: Elderplan Medicare Advantage |
$3,743.15
|
Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
Rate for Payer: Fidelis Essential Plan Aliesa |
$3,181.68
|
Rate for Payer: Fidelis Essential Plan QHP |
$3,331.40
|
Rate for Payer: Fidelis Medicare Advantage |
$3,743.15
|
Rate for Payer: Fidelis Qualified Health Plan |
$3,331.40
|
Rate for Payer: Group Health Inc Commercial |
$3,743.15
|
Rate for Payer: Group Health Inc Medicare |
$3,743.15
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,145.52
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$3,743.15
|
Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
Rate for Payer: Healthfirst QHP |
$3,743.15
|
Rate for Payer: Humana Medicare |
$3,818.01
|
Rate for Payer: Senior Whole Health Medicare Advantage |
$3,743.15
|
Rate for Payer: United Healthcare Commercial |
$1,468.00
|
Rate for Payer: United Healthcare Medicare Advantage |
$3,743.15
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,743.15
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,994.52
|
Rate for Payer: Wellcare Medicare |
$3,555.99
|
|
METATARSAL HEAD RESECTION
|
Facility
|
IP
|
$8,291.05
|
|
Service Code
|
HCPCS 28173
|
Hospital Charge Code |
40082700
|
Hospital Revenue Code
|
360
|
Rate for Payer: Cash Price |
$3,743.15
|
|
METERED DOSE INHALER COMBIVENT
|
Facility
|
IP
|
$355.00
|
|
Service Code
|
HCPCS J3535
|
Hospital Charge Code |
41656014
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$177.50 |
Max. Negotiated Rate |
$177.50 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$177.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$177.50
|
|
METERED DOSE INHALER COMBIVENT
|
Facility
|
OP
|
$355.00
|
|
Service Code
|
HCPCS J3535
|
Hospital Charge Code |
41646014
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$124.25 |
Max. Negotiated Rate |
$230.75 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$195.25
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$177.50
|
Rate for Payer: Aetna Government |
$177.50
|
Rate for Payer: Brighton Health Commercial |
$213.00
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$177.50
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$204.12
|
Rate for Payer: Group Health Inc Commercial |
$177.50
|
Rate for Payer: Group Health Inc Medicare |
$124.25
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$177.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$177.50
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$230.75
|
|
METERED DOSE INHALER COMBIVENT
|
Facility
|
IP
|
$355.00
|
|
Service Code
|
HCPCS J3535
|
Hospital Charge Code |
41646014
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$177.50 |
Max. Negotiated Rate |
$177.50 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$177.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$177.50
|
|
METERED DOSE INHALER COMBIVENT
|
Facility
|
OP
|
$355.00
|
|
Service Code
|
HCPCS J3535
|
Hospital Charge Code |
41656014
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$124.25 |
Max. Negotiated Rate |
$230.75 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$195.25
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$177.50
|
Rate for Payer: Aetna Government |
$177.50
|
Rate for Payer: Brighton Health Commercial |
$213.00
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$177.50
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$204.12
|
Rate for Payer: Group Health Inc Commercial |
$177.50
|
Rate for Payer: Group Health Inc Medicare |
$124.25
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$177.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$177.50
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$230.75
|
|
METFORMIN 500 MG TAB
|
Facility
|
OP
|
$0.08
|
|
Hospital Charge Code |
41642792
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.03 |
Max. Negotiated Rate |
$0.06 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.04
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.04
|
Rate for Payer: Aetna Government |
$0.04
|
Rate for Payer: Brighton Health Commercial |
$0.06
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.06
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.05
|
Rate for Payer: Group Health Inc Commercial |
$0.04
|
Rate for Payer: Group Health Inc Medicare |
$0.03
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.04
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.04
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.05
|
|
METFORMIN 500 MG TAB
|
Facility
|
OP
|
$0.08
|
|
Hospital Charge Code |
41652792
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.03 |
Max. Negotiated Rate |
$0.06 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.04
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.04
|
Rate for Payer: Aetna Government |
$0.04
|
Rate for Payer: Brighton Health Commercial |
$0.06
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.06
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.05
|
Rate for Payer: Group Health Inc Commercial |
$0.04
|
Rate for Payer: Group Health Inc Medicare |
$0.03
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.04
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.04
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.05
|
|
METFORMIN 850 MG TAB
|
Facility
|
OP
|
$0.13
|
|
Hospital Charge Code |
41642791
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.05 |
Max. Negotiated Rate |
$0.10 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.07
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.07
|
Rate for Payer: Aetna Government |
$0.07
|
Rate for Payer: Brighton Health Commercial |
$0.10
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.10
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.09
|
Rate for Payer: Group Health Inc Commercial |
$0.07
|
Rate for Payer: Group Health Inc Medicare |
$0.05
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.07
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.07
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.08
|
|
METFORMIN 850 MG TAB
|
Facility
|
OP
|
$0.13
|
|
Hospital Charge Code |
41652791
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.05 |
Max. Negotiated Rate |
$0.10 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.07
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.07
|
Rate for Payer: Aetna Government |
$0.07
|
Rate for Payer: Brighton Health Commercial |
$0.10
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.10
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.09
|
Rate for Payer: Group Health Inc Commercial |
$0.07
|
Rate for Payer: Group Health Inc Medicare |
$0.05
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.07
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.07
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.08
|
|
METFORMIN HCL 500 MG PO TABS [10544]
|
Facility
|
OP
|
$0.71
|
|
Service Code
|
NDC 69367018010
|
Hospital Charge Code |
69367018010
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.25 |
Max. Negotiated Rate |
$0.56 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.39
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.35
|
Rate for Payer: Aetna Government |
$0.35
|
Rate for Payer: Brighton Health Commercial |
$0.53
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.56
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.48
|
Rate for Payer: Group Health Inc Commercial |
$0.35
|
Rate for Payer: Group Health Inc Medicare |
$0.25
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.35
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.35
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.46
|
|
METFORMIN HCL 500 MG PO TABS [10544]
|
Facility
|
OP
|
$0.70
|
|
Service Code
|
NDC 70010006310
|
Hospital Charge Code |
70010006310
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.25 |
Max. Negotiated Rate |
$0.56 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.39
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.35
|
Rate for Payer: Aetna Government |
$0.35
|
Rate for Payer: Brighton Health Commercial |
$0.53
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.56
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.48
|
Rate for Payer: Group Health Inc Commercial |
$0.35
|
Rate for Payer: Group Health Inc Medicare |
$0.25
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.35
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.35
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.46
|
|
METFORMIN HCL 500 MG PO TABS [10544]
|
Facility
|
OP
|
$0.71
|
|
Service Code
|
NDC 65862000801
|
Hospital Charge Code |
65862000801
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.25 |
Max. Negotiated Rate |
$0.57 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.39
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.36
|
Rate for Payer: Aetna Government |
$0.36
|
Rate for Payer: Brighton Health Commercial |
$0.53
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.57
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.48
|
Rate for Payer: Group Health Inc Commercial |
$0.36
|
Rate for Payer: Group Health Inc Medicare |
$0.25
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.36
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.36
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.46
|
|
METFORMIN HCL 500 MG PO TABS [10544]
|
Facility
|
OP
|
$0.08
|
|
Service Code
|
NDC 00904716261
|
Hospital Charge Code |
00904716261
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.03 |
Max. Negotiated Rate |
$0.06 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.04
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.04
|
Rate for Payer: Aetna Government |
$0.04
|
Rate for Payer: Brighton Health Commercial |
$0.06
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.06
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.05
|
Rate for Payer: Group Health Inc Commercial |
$0.04
|
Rate for Payer: Group Health Inc Medicare |
$0.03
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.04
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.04
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.05
|
|
METFORMIN HCL 500 MG PO TABS [10544]
|
Facility
|
OP
|
$0.04
|
|
Service Code
|
NDC 23155010205
|
Hospital Charge Code |
23155010205
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.03 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.02
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.02
|
Rate for Payer: Aetna Government |
$0.02
|
Rate for Payer: Brighton Health Commercial |
$0.03
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.03
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.03
|
Rate for Payer: Group Health Inc Commercial |
$0.02
|
Rate for Payer: Group Health Inc Medicare |
$0.01
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.02
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.02
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.02
|
|
METFORMIN HCL 500 MG PO TABS [10544]
|
Facility
|
OP
|
$0.03
|
|
Service Code
|
NDC 23155010210
|
Hospital Charge Code |
23155010210
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.03 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.02
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.02
|
Rate for Payer: Aetna Government |
$0.02
|
Rate for Payer: Brighton Health Commercial |
$0.03
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.03
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.02
|
Rate for Payer: Group Health Inc Commercial |
$0.02
|
Rate for Payer: Group Health Inc Medicare |
$0.01
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.02
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.02
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.02
|
|
METFORMIN HCL 850 MG PO TABS [14719]
|
Facility
|
OP
|
$1.21
|
|
Service Code
|
NDC 67877056205
|
Hospital Charge Code |
67877056205
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.42 |
Max. Negotiated Rate |
$0.96 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.66
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.60
|
Rate for Payer: Aetna Government |
$0.60
|
Rate for Payer: Brighton Health Commercial |
$0.90
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.96
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.82
|
Rate for Payer: Group Health Inc Commercial |
$0.60
|
Rate for Payer: Group Health Inc Medicare |
$0.42
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.60
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.60
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.78
|
|
METFORMIN HCL 850 MG PO TABS [14719]
|
Facility
|
OP
|
$1.20
|
|
Service Code
|
NDC 65862000901
|
Hospital Charge Code |
65862000901
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.42 |
Max. Negotiated Rate |
$0.96 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.66
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.60
|
Rate for Payer: Aetna Government |
$0.60
|
Rate for Payer: Brighton Health Commercial |
$0.90
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.96
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.82
|
Rate for Payer: Group Health Inc Commercial |
$0.60
|
Rate for Payer: Group Health Inc Medicare |
$0.42
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.60
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.60
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.78
|
|
METFORMIN HCL 850 MG PO TABS [14719]
|
Facility
|
OP
|
$0.25
|
|
Service Code
|
NDC 00904716361
|
Hospital Charge Code |
00904716361
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.09 |
Max. Negotiated Rate |
$0.20 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.14
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.12
|
Rate for Payer: Aetna Government |
$0.12
|
Rate for Payer: Brighton Health Commercial |
$0.19
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.20
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.17
|
Rate for Payer: Group Health Inc Commercial |
$0.12
|
Rate for Payer: Group Health Inc Medicare |
$0.09
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.12
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.12
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.16
|
|
METFORMIN HCL 850 MG PO TABS [14719]
|
Facility
|
OP
|
$1.20
|
|
Service Code
|
NDC 60687014301
|
Hospital Charge Code |
60687014301
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.42 |
Max. Negotiated Rate |
$0.96 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.66
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.60
|
Rate for Payer: Aetna Government |
$0.60
|
Rate for Payer: Brighton Health Commercial |
$0.90
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.96
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.82
|
Rate for Payer: Group Health Inc Commercial |
$0.60
|
Rate for Payer: Group Health Inc Medicare |
$0.42
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.60
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.60
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.78
|
|