Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN

Facility

OP

$1.95

Service Code	HCPCS J2765
Hospital Charge Code	7604521300
Hospital Revenue Code	250
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$1.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.13
Rate for Payer: Aetna Government	$1.13
Rate for Payer: Brighton Health Commercial	$1.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.33
Rate for Payer: EmblemHealth Commercial	$0.98
Rate for Payer: Group Health Inc Commercial	$0.98
Rate for Payer: Group Health Inc Medicare	$0.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.98
Rate for Payer: Hamaspik Choice Inc Medicare	$0.98
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.27

METOCLOPRAMIDE HCL 5 MG PO TABS

Facility

IP

$0.90

Service Code	NDC 5107988601
Hospital Charge Code	5107988601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.45

METOCLOPRAMIDE HCL 5 MG PO TABS

Facility

OP

$0.90

Service Code	NDC 5107988601
Hospital Charge Code	5107988601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$0.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.45
Rate for Payer: Aetna Government	$0.45
Rate for Payer: Brighton Health Commercial	$0.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.61
Rate for Payer: EmblemHealth Commercial	$0.45
Rate for Payer: Group Health Inc Commercial	$0.45
Rate for Payer: Group Health Inc Medicare	$0.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.45
Rate for Payer: Hamaspik Choice Inc Medicare	$0.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.59

METOCLOPRAMIDE HCL 5 MG PO TABS

Facility

OP

$0.33

Service Code	NDC 0093220401
Hospital Charge Code	0093220401
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.17
Rate for Payer: Aetna Government	$0.17
Rate for Payer: Brighton Health Commercial	$0.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.23
Rate for Payer: EmblemHealth Commercial	$0.17
Rate for Payer: Group Health Inc Commercial	$0.17
Rate for Payer: Group Health Inc Medicare	$0.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.17
Rate for Payer: Hamaspik Choice Inc Medicare	$0.17
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.22

METOCLOPRAMIDE HCL 5 MG PO TABS

Facility

IP

$0.33

Service Code	NDC 0093220401
Hospital Charge Code	0093220401
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.17

METOCLOPRAMIDE HCL 5 MG PO TABS

Facility

IP

$0.90

Service Code	NDC 5107988620
Hospital Charge Code	5107988620
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.45

METOCLOPRAMIDE HCL 5 MG PO TABS

Facility

OP

$0.69

Service Code	NDC 6068762011
Hospital Charge Code	6068762011
Hospital Revenue Code	250
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.35
Rate for Payer: Aetna Government	$0.35
Rate for Payer: Brighton Health Commercial	$0.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.47
Rate for Payer: EmblemHealth Commercial	$0.35
Rate for Payer: Group Health Inc Commercial	$0.35
Rate for Payer: Group Health Inc Medicare	$0.24
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	$0.45

METOCLOPRAMIDE HCL 5 MG PO TABS

Facility

IP

$0.69

Service Code	NDC 6068762011
Hospital Charge Code	6068762011
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.35

METOCLOPRAMIDE HCL 5 MG PO TABS

Facility

OP

$0.90

Service Code	NDC 5107988620
Hospital Charge Code	5107988620
Hospital Revenue Code	250
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$0.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.45
Rate for Payer: Aetna Government	$0.45
Rate for Payer: Brighton Health Commercial	$0.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.61
Rate for Payer: EmblemHealth Commercial	$0.45
Rate for Payer: Group Health Inc Commercial	$0.45
Rate for Payer: Group Health Inc Medicare	$0.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.45
Rate for Payer: Hamaspik Choice Inc Medicare	$0.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.59

METOLAZONE 10 MG PO TABS

Facility

IP

$2.82

Service Code	NDC 0185560001
Hospital Charge Code	0185560001
Hospital Revenue Code	250
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$1.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.41

METOLAZONE 10 MG PO TABS

Facility

OP

$2.82

Service Code	NDC 7288805401
Hospital Charge Code	7288805401
Hospital Revenue Code	250
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$2.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.41
Rate for Payer: Aetna Government	$1.41
Rate for Payer: Brighton Health Commercial	$2.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.92
Rate for Payer: EmblemHealth Commercial	$1.41
Rate for Payer: Group Health Inc Commercial	$1.41
Rate for Payer: Group Health Inc Medicare	$0.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.41
Rate for Payer: Hamaspik Choice Inc Medicare	$1.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.83

METOLAZONE 10 MG PO TABS

Facility

OP

$2.82

Service Code	NDC 0185560001
Hospital Charge Code	0185560001
Hospital Revenue Code	250
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$2.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.41
Rate for Payer: Aetna Government	$1.41
Rate for Payer: Brighton Health Commercial	$2.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.92
Rate for Payer: EmblemHealth Commercial	$1.41
Rate for Payer: Group Health Inc Commercial	$1.41
Rate for Payer: Group Health Inc Medicare	$0.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.41
Rate for Payer: Hamaspik Choice Inc Medicare	$1.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.83

METOLAZONE 10 MG PO TABS

Facility

IP

$2.82

Service Code	NDC 7288805401
Hospital Charge Code	7288805401
Hospital Revenue Code	250
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$1.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.41

METOLAZONE 2.5 MG PO TABS

Facility

OP

$2.07

Service Code	NDC 0185505001
Hospital Charge Code	0185505001
Hospital Revenue Code	250
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$1.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.04
Rate for Payer: Aetna Government	$1.04
Rate for Payer: Brighton Health Commercial	$1.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.41
Rate for Payer: EmblemHealth Commercial	$1.04
Rate for Payer: Group Health Inc Commercial	$1.04
Rate for Payer: Group Health Inc Medicare	$0.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.04
Rate for Payer: Hamaspik Choice Inc Medicare	$1.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.35

METOLAZONE 2.5 MG PO TABS

Facility

IP

$2.07

Service Code	NDC 0185505001
Hospital Charge Code	0185505001
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$1.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.04

METOLAZONE 2.5 MG PO TABS

Facility

OP

$3.75

Service Code	NDC 0904713861
Hospital Charge Code	0904713861
Hospital Revenue Code	250
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$3.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.88
Rate for Payer: Aetna Government	$1.88
Rate for Payer: Brighton Health Commercial	$2.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.55
Rate for Payer: EmblemHealth Commercial	$1.88
Rate for Payer: Group Health Inc Commercial	$1.88
Rate for Payer: Group Health Inc Medicare	$1.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.88
Rate for Payer: Hamaspik Choice Inc Medicare	$1.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.44

METOLAZONE 2.5 MG PO TABS

Facility

IP

$3.75

Service Code	NDC 0904713861
Hospital Charge Code	0904713861
Hospital Revenue Code	250
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.88

METOLAZONE 5 MG PO TABS

Facility

IP

$4.26

Service Code	NDC 0904713961
Hospital Charge Code	0904713961
Hospital Revenue Code	250
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$2.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.13

METOLAZONE 5 MG PO TABS

Facility

OP

$3.73

Service Code	NDC 5107902401
Hospital Charge Code	5107902401
Hospital Revenue Code	250
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$2.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.86
Rate for Payer: Aetna Government	$1.86
Rate for Payer: Brighton Health Commercial	$2.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.54
Rate for Payer: EmblemHealth Commercial	$1.86
Rate for Payer: Group Health Inc Commercial	$1.86
Rate for Payer: Group Health Inc Medicare	$1.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.86
Rate for Payer: Hamaspik Choice Inc Medicare	$1.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.42

METOLAZONE 5 MG PO TABS

Facility

OP

$4.26

Service Code	NDC 0904713961
Hospital Charge Code	0904713961
Hospital Revenue Code	250
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$3.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.13
Rate for Payer: Aetna Government	$2.13
Rate for Payer: Brighton Health Commercial	$3.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.90
Rate for Payer: EmblemHealth Commercial	$2.13
Rate for Payer: Group Health Inc Commercial	$2.13
Rate for Payer: Group Health Inc Medicare	$1.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.13
Rate for Payer: Hamaspik Choice Inc Medicare	$2.13
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.77

METOLAZONE 5 MG PO TABS

Facility

IP

$3.73

Service Code	NDC 5107902401
Hospital Charge Code	5107902401
Hospital Revenue Code	250
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$1.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.86

METOPROLOL SUCCINATE ER 100 MG PO TB24

Facility

OP

$1.58

Service Code	NDC 6909740815
Hospital Charge Code	6909740815
Hospital Revenue Code	250
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$1.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.79
Rate for Payer: Aetna Government	$0.79
Rate for Payer: Brighton Health Commercial	$1.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.08
Rate for Payer: EmblemHealth Commercial	$0.79
Rate for Payer: Group Health Inc Commercial	$0.79
Rate for Payer: Group Health Inc Medicare	$0.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.79
Rate for Payer: Hamaspik Choice Inc Medicare	$0.79
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.03

METOPROLOL SUCCINATE ER 100 MG PO TB24

Facility

IP

$1.55

Service Code	NDC 7043616601
Hospital Charge Code	7043616601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$0.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.78

METOPROLOL SUCCINATE ER 100 MG PO TB24

Facility

OP

$1.76

Service Code	NDC 5107917103
Hospital Charge Code	5107917103
Hospital Revenue Code	250
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$1.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.88
Rate for Payer: Aetna Government	$0.88
Rate for Payer: Brighton Health Commercial	$1.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.20
Rate for Payer: EmblemHealth Commercial	$0.88
Rate for Payer: Group Health Inc Commercial	$0.88
Rate for Payer: Group Health Inc Medicare	$0.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.88
Rate for Payer: Hamaspik Choice Inc Medicare	$0.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.14

METOPROLOL SUCCINATE ER 100 MG PO TB24

Facility

IP

$1.68

Service Code	NDC 6068741301
Hospital Charge Code	6068741301
Hospital Revenue Code	250
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$0.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.84

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