Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR [27335]

Facility

IP

$3.74

Service Code	NDC 68084-603-11
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$2.99
Rate for Payer: Cash Price	$2.06
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$2.99
Rate for Payer: Health Smart Auto/Commercial	$2.24
Rate for Payer: LLUH Dept of Risk Management WC	$2.06
Rate for Payer: Multiplan Commercial	$2.81

NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR [27335]

Facility

IP

$1.04

Service Code	NDC 0904-7082-06
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$0.83
Rate for Payer: Cash Price	$0.57
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$0.83
Rate for Payer: Health Smart Auto/Commercial	$0.62
Rate for Payer: LLUH Dept of Risk Management WC	$0.57
Rate for Payer: Multiplan Commercial	$0.78

NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR [27335]

Facility

OP

$1.04

Service Code	NDC 0904-7082-06
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$0.83
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.62
Rate for Payer: Aetna of CA Government/Medicare	$0.62
Rate for Payer: Cash Price	$0.57
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$0.83
Rate for Payer: Health Smart Auto/Commercial	$0.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.62
Rate for Payer: LLUH Dept of Risk Management WC	$0.57
Rate for Payer: Multiplan Commercial	$0.78

NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR [27335]

Facility

OP

$0.78

Service Code	NDC 24979-009-01
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$0.62
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.47
Rate for Payer: Aetna of CA Government/Medicare	$0.47
Rate for Payer: Cash Price	$0.43
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$0.62
Rate for Payer: Health Smart Auto/Commercial	$0.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.47
Rate for Payer: LLUH Dept of Risk Management WC	$0.43
Rate for Payer: Multiplan Commercial	$0.59

NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR [27335]

Facility

IP

$2.70

Service Code	NDC 50268-599-11
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$2.16
Rate for Payer: Cash Price	$1.49
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$2.16
Rate for Payer: Health Smart Auto/Commercial	$1.62
Rate for Payer: LLUH Dept of Risk Management WC	$1.49
Rate for Payer: Multiplan Commercial	$2.02

NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR [27335]

Facility

IP

$0.78

Service Code	NDC 24979-009-01
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$0.62
Rate for Payer: Cash Price	$0.43
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$0.62
Rate for Payer: Health Smart Auto/Commercial	$0.47
Rate for Payer: LLUH Dept of Risk Management WC	$0.43
Rate for Payer: Multiplan Commercial	$0.59

NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR [27335]

Facility

IP

$2.56

Service Code	NDC 62175-262-37
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$2.05
Rate for Payer: Cash Price	$1.41
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$2.05
Rate for Payer: Health Smart Auto/Commercial	$1.54
Rate for Payer: LLUH Dept of Risk Management WC	$1.41
Rate for Payer: Multiplan Commercial	$1.92

NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR [27335]

Facility

OP

$3.74

Service Code	NDC 68084-603-21
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$2.99
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$2.24
Rate for Payer: Aetna of CA Government/Medicare	$2.24
Rate for Payer: Cash Price	$2.06
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$2.99
Rate for Payer: Health Smart Auto/Commercial	$2.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$2.24
Rate for Payer: LLUH Dept of Risk Management WC	$2.06
Rate for Payer: Multiplan Commercial	$2.81

NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR [27335]

Facility

OP

$3.74

Service Code	NDC 68084-603-11
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$2.99
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$2.24
Rate for Payer: Aetna of CA Government/Medicare	$2.24
Rate for Payer: Cash Price	$2.06
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$2.99
Rate for Payer: Health Smart Auto/Commercial	$2.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$2.24
Rate for Payer: LLUH Dept of Risk Management WC	$2.06
Rate for Payer: Multiplan Commercial	$2.81

NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR [27335]

Facility

OP

$2.70

Service Code	NDC 50268-599-15
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$2.16
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$1.62
Rate for Payer: Aetna of CA Government/Medicare	$1.62
Rate for Payer: Cash Price	$1.49
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$2.16
Rate for Payer: Health Smart Auto/Commercial	$1.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$1.62
Rate for Payer: LLUH Dept of Risk Management WC	$1.49
Rate for Payer: Multiplan Commercial	$2.02

NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR [27335]

Facility

IP

$2.70

Service Code	NDC 50268-599-15
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$2.16
Rate for Payer: Cash Price	$1.49
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$2.16
Rate for Payer: Health Smart Auto/Commercial	$1.62
Rate for Payer: LLUH Dept of Risk Management WC	$1.49
Rate for Payer: Multiplan Commercial	$2.02

NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR [27335]

Facility

OP

$2.70

Service Code	NDC 50268-599-11
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$2.16
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$1.62
Rate for Payer: Aetna of CA Government/Medicare	$1.62
Rate for Payer: Cash Price	$1.49
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$2.16
Rate for Payer: Health Smart Auto/Commercial	$1.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$1.62
Rate for Payer: LLUH Dept of Risk Management WC	$1.49
Rate for Payer: Multiplan Commercial	$2.02

NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE [37662]

Facility

OP

$0.67

Service Code	NDC 50742-622-01
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.54
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.40
Rate for Payer: Aetna of CA Government/Medicare	$0.40
Rate for Payer: Cash Price	$0.37
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$0.54
Rate for Payer: Health Smart Auto/Commercial	$0.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.40
Rate for Payer: LLUH Dept of Risk Management WC	$0.37
Rate for Payer: Multiplan Commercial	$0.50

NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE [37662]

Facility

IP

$0.67

Service Code	NDC 50742-622-01
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.54
Rate for Payer: Cash Price	$0.37
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$0.54
Rate for Payer: Health Smart Auto/Commercial	$0.40
Rate for Payer: LLUH Dept of Risk Management WC	$0.37
Rate for Payer: Multiplan Commercial	$0.50

NIFEDIPINE ORAL SUSPENSION COMPOUND 4 MG/ML [4080311]

Facility

IP

$0.41

Service Code	NDC 9994-0803-11
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.33
Rate for Payer: Cash Price	$0.23
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$0.33
Rate for Payer: Health Smart Auto/Commercial	$0.25
Rate for Payer: LLUH Dept of Risk Management WC	$0.23
Rate for Payer: Multiplan Commercial	$0.31

NIFEDIPINE ORAL SUSPENSION COMPOUND 4 MG/ML [4080311]

Facility

OP

$0.41

Service Code	NDC 9994-0803-11
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.33
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.25
Rate for Payer: Aetna of CA Government/Medicare	$0.25
Rate for Payer: Cash Price	$0.23
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$0.33
Rate for Payer: Health Smart Auto/Commercial	$0.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.25
Rate for Payer: LLUH Dept of Risk Management WC	$0.23
Rate for Payer: Multiplan Commercial	$0.31

NIFURTIMOX 120 MG TABLET [229005]

Facility

IP

$3.60

Service Code	NDC 50419-751-01
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$2.88
Rate for Payer: Cash Price	$1.98
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$2.88
Rate for Payer: Health Smart Auto/Commercial	$2.16
Rate for Payer: LLUH Dept of Risk Management WC	$1.98
Rate for Payer: Multiplan Commercial	$2.70

NIFURTIMOX 120 MG TABLET [229005]

Facility

OP

$3.60

Service Code	NDC 50419-751-01
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$2.88
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$2.16
Rate for Payer: Aetna of CA Government/Medicare	$2.16
Rate for Payer: Cash Price	$1.98
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$2.88
Rate for Payer: Health Smart Auto/Commercial	$2.16
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$2.16
Rate for Payer: LLUH Dept of Risk Management WC	$1.98
Rate for Payer: Multiplan Commercial	$2.70

NILOTINIB HCL 150 MG CAPSULE [105679]

Facility

OP

$231.91

Service Code	NDC 0078-0592-51
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$127.55
Max. Negotiated Rate	$185.53
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$139.15
Rate for Payer: Aetna of CA Government/Medicare	$139.15
Rate for Payer: Cash Price	$127.55
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$185.53
Rate for Payer: Health Smart Auto/Commercial	$139.15
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$139.15
Rate for Payer: LLUH Dept of Risk Management WC	$127.55
Rate for Payer: Multiplan Commercial	$173.93

NILOTINIB HCL 150 MG CAPSULE [105679]

Facility

IP

$231.91

Service Code	NDC 0078-0592-51
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$127.55
Max. Negotiated Rate	$185.53
Rate for Payer: Cash Price	$127.55
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$185.53
Rate for Payer: Health Smart Auto/Commercial	$139.15
Rate for Payer: LLUH Dept of Risk Management WC	$127.55
Rate for Payer: Multiplan Commercial	$173.93

NILOTINIB HCL 200 MG CAPSULE [88720]

Facility

IP

$231.91

Service Code	NDC 0078-0526-51
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$127.55
Max. Negotiated Rate	$185.53
Rate for Payer: Cash Price	$127.55
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$185.53
Rate for Payer: Health Smart Auto/Commercial	$139.15
Rate for Payer: LLUH Dept of Risk Management WC	$127.55
Rate for Payer: Multiplan Commercial	$173.93

NILOTINIB HCL 200 MG CAPSULE [88720]

Facility

OP

$231.91

Service Code	NDC 0078-0526-51
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$127.55
Max. Negotiated Rate	$185.53
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$139.15
Rate for Payer: Aetna of CA Government/Medicare	$139.15
Rate for Payer: Cash Price	$127.55
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$185.53
Rate for Payer: Health Smart Auto/Commercial	$139.15
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$139.15
Rate for Payer: LLUH Dept of Risk Management WC	$127.55
Rate for Payer: Multiplan Commercial	$173.93

NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY) [228034]

Facility

IP

$12.82

Service Code	NDC 24338-230-15
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$10.26
Rate for Payer: Cash Price	$7.05
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$10.26
Rate for Payer: Health Smart Auto/Commercial	$7.69
Rate for Payer: LLUH Dept of Risk Management WC	$7.05
Rate for Payer: Multiplan Commercial	$9.62

NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY) [228034]

Facility

IP

$12.82

Service Code	NDC 24338-230-12
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$10.26
Rate for Payer: Cash Price	$7.05
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$10.26
Rate for Payer: Health Smart Auto/Commercial	$7.69
Rate for Payer: LLUH Dept of Risk Management WC	$7.05
Rate for Payer: Multiplan Commercial	$9.62

NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY) [228034]

Facility

OP

$12.82

Service Code	NDC 24338-230-05
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$10.26
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$7.69
Rate for Payer: Aetna of CA Government/Medicare	$7.69
Rate for Payer: Cash Price	$7.05
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$10.26
Rate for Payer: Health Smart Auto/Commercial	$7.69
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$7.69
Rate for Payer: LLUH Dept of Risk Management WC	$7.05
Rate for Payer: Multiplan Commercial	$9.62

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