St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

METHYLPREDNISOLONE IVP

Facility

$17.94

Service Code	HCPCS J2930
Hospital Charge Code	41647823
Hospital Revenue Code	636
Min. Negotiated Rate	$5.57
Max. Negotiated Rate	$11.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.57
Rate for Payer: Aetna Government	$5.57
Rate for Payer: Brighton Health Commercial	$10.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.32
Rate for Payer: Group Health Inc Commercial	$8.97
Rate for Payer: Group Health Inc Medicare	$6.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.97
Rate for Payer: Hamaspik Choice Inc Medicare	$8.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.66

METHYLPREDNISOLONE IVP

Facility

$17.94

Service Code	HCPCS J2930
Hospital Charge Code	41657823
Hospital Revenue Code	636
Min. Negotiated Rate	$8.97
Max. Negotiated Rate	$8.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.97
Rate for Payer: Hamaspik Choice Inc Medicare	$8.97

METHYLPREDNISOLONE IVP

Facility

$17.94

Service Code	HCPCS J2930
Hospital Charge Code	41657823
Hospital Revenue Code	636
Min. Negotiated Rate	$5.57
Max. Negotiated Rate	$11.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.57
Rate for Payer: Aetna Government	$5.57
Rate for Payer: Brighton Health Commercial	$10.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.32
Rate for Payer: Group Health Inc Commercial	$8.97
Rate for Payer: Group Health Inc Medicare	$6.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.97
Rate for Payer: Hamaspik Choice Inc Medicare	$8.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.66

METHYLPREDNISOLONE IVP

Facility

$17.94

Service Code	HCPCS J2930
Hospital Charge Code	41647823
Hospital Revenue Code	636
Min. Negotiated Rate	$8.97
Max. Negotiated Rate	$8.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.97
Rate for Payer: Hamaspik Choice Inc Medicare	$8.97

METHYLPREDNISOLONE NA SUC (PF) 500 MG IJ SOLR [188820]

Facility

$56.86

Service Code	HCPCS J2919
Hospital Charge Code	00009000302
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$45.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.43
Rate for Payer: Aetna Government	$28.43
Rate for Payer: Brighton Health Commercial	$42.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$45.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.66
Rate for Payer: Group Health Inc Commercial	$28.43
Rate for Payer: Group Health Inc Medicare	$19.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.43
Rate for Payer: Hamaspik Choice Inc Medicare	$28.43
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.27
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.29
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.29
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$36.96

METHYLPREDNISOLONE SODIUM SUCC 1000 MG IJ SOLR (WRAPPED) [401310]

Facility

$50.27

Service Code	HCPCS J2919
Hospital Charge Code	00143985101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$40.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.14
Rate for Payer: Aetna Government	$25.14
Rate for Payer: Brighton Health Commercial	$37.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.18
Rate for Payer: Group Health Inc Commercial	$25.14
Rate for Payer: Group Health Inc Medicare	$17.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.14
Rate for Payer: Hamaspik Choice Inc Medicare	$25.14
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.27
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.29
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.29
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$32.68

METHYLPREDNISOLONE SODIUM SUCC 1000 MG IJ SOLR (WRAPPED) [401310]

Facility

$52.78

Service Code	HCPCS J2919
Hospital Charge Code	00009069801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$42.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.39
Rate for Payer: Aetna Government	$26.39
Rate for Payer: Brighton Health Commercial	$39.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.89
Rate for Payer: Group Health Inc Commercial	$26.39
Rate for Payer: Group Health Inc Medicare	$18.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.39
Rate for Payer: Hamaspik Choice Inc Medicare	$26.39
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.27
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.29
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.29
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.31

METHYLPREDNISOLONE SODIUM SUCC 1000 MG IJ SOLR (WRAPPED) [401310]

Facility

$82.70

Service Code	HCPCS J2919
Hospital Charge Code	00009001820
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$66.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$41.35
Rate for Payer: Aetna Government	$41.35
Rate for Payer: Brighton Health Commercial	$62.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$56.24
Rate for Payer: Group Health Inc Commercial	$41.35
Rate for Payer: Group Health Inc Medicare	$28.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.35
Rate for Payer: Hamaspik Choice Inc Medicare	$41.35
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.27
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.29
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.29
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$53.76

METHYLPREDNISOLONE SODIUM SUCC 1000 MG IJ SOLR (WRAPPED) [401310]

Facility

$39.00

Service Code	HCPCS J2919
Hospital Charge Code	43598013074
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$31.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$21.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$19.50
Rate for Payer: Aetna Government	$19.50
Rate for Payer: Brighton Health Commercial	$29.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$31.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$26.52
Rate for Payer: Group Health Inc Commercial	$19.50
Rate for Payer: Group Health Inc Medicare	$13.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.50
Rate for Payer: Hamaspik Choice Inc Medicare	$19.50
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.27
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.29
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.29
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$25.35

METHYLPREDNISOLONE SODIUM SUCC 1000 MG IJ SOLR (WRAPPED) [401310]

Facility

$52.78

Service Code	HCPCS J2919
Hospital Charge Code	00009069802
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$42.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.39
Rate for Payer: Aetna Government	$26.39
Rate for Payer: Brighton Health Commercial	$39.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.89
Rate for Payer: Group Health Inc Commercial	$26.39
Rate for Payer: Group Health Inc Medicare	$18.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.39
Rate for Payer: Hamaspik Choice Inc Medicare	$26.39
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.27
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.29
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.29
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.31

METHYLPREDNISOLONE SODIUM SUCC 125 MG IJ SOLR (WRAPPED) [401311]

Facility

$12.50

Service Code	HCPCS J2930
Hospital Charge Code	00009004722
Hospital Revenue Code	250
Min. Negotiated Rate	$4.38
Max. Negotiated Rate	$10.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.57
Rate for Payer: Aetna Government	$5.57
Rate for Payer: Brighton Health Commercial	$9.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.50
Rate for Payer: Group Health Inc Commercial	$6.25
Rate for Payer: Group Health Inc Medicare	$4.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.25
Rate for Payer: Hamaspik Choice Inc Medicare	$6.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.13

METHYLPREDNISOLONE SODIUM SUCC 125 MG IJ SOLR (WRAPPED) [401311]

Facility

$13.06

Service Code	HCPCS J2930
Hospital Charge Code	00009004704
Hospital Revenue Code	250
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$10.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.57
Rate for Payer: Aetna Government	$5.57
Rate for Payer: Brighton Health Commercial	$9.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.88
Rate for Payer: Group Health Inc Commercial	$6.53
Rate for Payer: Group Health Inc Medicare	$4.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.53
Rate for Payer: Hamaspik Choice Inc Medicare	$6.53
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.49

METHYLPREDNISOLONE SODIUM SUCC 2000 MG IJ SOLR [10579]

Facility

$124.42

Service Code	HCPCS J2919
Hospital Charge Code	00009085001
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$99.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.21
Rate for Payer: Aetna Government	$62.21
Rate for Payer: Brighton Health Commercial	$93.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$99.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$84.61
Rate for Payer: Group Health Inc Commercial	$62.21
Rate for Payer: Group Health Inc Medicare	$43.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.21
Rate for Payer: Hamaspik Choice Inc Medicare	$62.21
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.27
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.29
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.29
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$80.87

METHYLPREDNISOLONE SODIUM SUCC 40 MG IJ SOLR (WRAPPED) [401312]

Facility

$7.76

Service Code	HCPCS J2919
Hospital Charge Code	00009003928
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$6.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.88
Rate for Payer: Aetna Government	$3.88
Rate for Payer: Brighton Health Commercial	$5.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.28
Rate for Payer: Group Health Inc Commercial	$3.88
Rate for Payer: Group Health Inc Medicare	$2.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.88
Rate for Payer: Hamaspik Choice Inc Medicare	$3.88
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.27
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.29
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.29
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.05

METHYLPREDNISOLONE SODIUM SUCC 40 MG IJ SOLR (WRAPPED) [401312]

Facility

$7.76

Service Code	HCPCS J2919
Hospital Charge Code	00009003930
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$6.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.88
Rate for Payer: Aetna Government	$3.88
Rate for Payer: Brighton Health Commercial	$5.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.28
Rate for Payer: Group Health Inc Commercial	$3.88
Rate for Payer: Group Health Inc Medicare	$2.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.88
Rate for Payer: Hamaspik Choice Inc Medicare	$3.88
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.27
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.29
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.29
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.04

METHYLPREDNISOLONE SODIUM SUCC 40 MG IJ SOLR (WRAPPED) (PEDIATRIC) [401339]

Facility

$7.76

Service Code	HCPCS J2919
Hospital Charge Code	00009003930
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$6.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.88
Rate for Payer: Aetna Government	$3.88
Rate for Payer: Brighton Health Commercial	$5.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.28
Rate for Payer: Group Health Inc Commercial	$3.88
Rate for Payer: Group Health Inc Medicare	$2.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.88
Rate for Payer: Hamaspik Choice Inc Medicare	$3.88
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.27
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.29
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.29
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.04

METHYLPREDNISOLONE SODIUM SUCC 40 MG IJ SOLR (WRAPPED) (PEDIATRIC) [401339]

Facility

$7.76

Service Code	HCPCS J2919
Hospital Charge Code	00009003928
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$6.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.88
Rate for Payer: Aetna Government	$3.88
Rate for Payer: Brighton Health Commercial	$5.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.28
Rate for Payer: Group Health Inc Commercial	$3.88
Rate for Payer: Group Health Inc Medicare	$2.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.88
Rate for Payer: Hamaspik Choice Inc Medicare	$3.88
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.27
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.29
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.29
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.05

METHYLPREDNISOLONE SODIUM SUCC 500 MG IJ SOLR [10581]

Facility

$29.14

Service Code	HCPCS J2919
Hospital Charge Code	00009075801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$23.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.57
Rate for Payer: Aetna Government	$14.57
Rate for Payer: Brighton Health Commercial	$21.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$23.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.82
Rate for Payer: Group Health Inc Commercial	$14.57
Rate for Payer: Group Health Inc Medicare	$10.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.57
Rate for Payer: Hamaspik Choice Inc Medicare	$14.57
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.27
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.29
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.29
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$18.94

METHYLPREDNISOLONE SODIUM SUCCINATE 1000

Facility

$3.24

Service Code	HCPCS J2930
Hospital Charge Code	41640518
Hospital Revenue Code	636
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$5.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.57
Rate for Payer: Aetna Government	$5.57
Rate for Payer: Brighton Health Commercial	$1.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.86
Rate for Payer: Group Health Inc Commercial	$1.62
Rate for Payer: Group Health Inc Medicare	$1.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.11

METHYLPREDNISOLONE SODIUM SUCCINATE 1000

Facility

$3.24

Service Code	HCPCS J2930
Hospital Charge Code	41650518
Hospital Revenue Code	636
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$5.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.57
Rate for Payer: Aetna Government	$5.57
Rate for Payer: Brighton Health Commercial	$1.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.86
Rate for Payer: Group Health Inc Commercial	$1.62
Rate for Payer: Group Health Inc Medicare	$1.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.11

METHYLPREDNISOLONE SODIUM SUCCINATE 1000

Facility

$3.24

Service Code	HCPCS J2930
Hospital Charge Code	41640518
Hospital Revenue Code	636
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$1.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1.62

METHYLPREDNISOLONE SODIUM SUCCINATE 1000

Facility

$3.24

Service Code	HCPCS J2930
Hospital Charge Code	41650518
Hospital Revenue Code	636
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$1.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1.62

METHYLPREDNISOLONE SODIUM SUCCINATE 125

Facility

$5.35

Service Code	HCPCS J2930
Hospital Charge Code	41643268
Hospital Revenue Code	636
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$5.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.57
Rate for Payer: Aetna Government	$5.57
Rate for Payer: Brighton Health Commercial	$3.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.08
Rate for Payer: Group Health Inc Commercial	$2.68
Rate for Payer: Group Health Inc Medicare	$1.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.68
Rate for Payer: Hamaspik Choice Inc Medicare	$2.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.48

METHYLPREDNISOLONE SODIUM SUCCINATE 125

Facility

$5.35

Service Code	HCPCS J2930
Hospital Charge Code	41653268
Hospital Revenue Code	636
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$5.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.57
Rate for Payer: Aetna Government	$5.57
Rate for Payer: Brighton Health Commercial	$3.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.08
Rate for Payer: Group Health Inc Commercial	$2.68
Rate for Payer: Group Health Inc Medicare	$1.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.68
Rate for Payer: Hamaspik Choice Inc Medicare	$2.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.48

METHYLPREDNISOLONE SODIUM SUCCINATE 125

Facility

$5.35

Service Code	HCPCS J2930
Hospital Charge Code	41653268
Hospital Revenue Code	636
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$2.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.68
Rate for Payer: Hamaspik Choice Inc Medicare	$2.68

Know your out-of-pocket cost for care.

All Charges