St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

MEFLOQUINE 250 MG TAB

Facility

$6.95

Hospital Charge Code	41642841
Hospital Revenue Code	250
Min. Negotiated Rate	$2.43
Max. Negotiated Rate	$5.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.48
Rate for Payer: Aetna Government	$3.48
Rate for Payer: Brighton Health Commercial	$5.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.73
Rate for Payer: Group Health Inc Commercial	$3.48
Rate for Payer: Group Health Inc Medicare	$2.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.48
Rate for Payer: Hamaspik Choice Inc Medicare	$3.48
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.52

MEFLOQUINE 250 MG TAB

Facility

$6.95

Hospital Charge Code	41652841
Hospital Revenue Code	250
Min. Negotiated Rate	$2.43
Max. Negotiated Rate	$5.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.48
Rate for Payer: Aetna Government	$3.48
Rate for Payer: Brighton Health Commercial	$5.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.73
Rate for Payer: Group Health Inc Commercial	$3.48
Rate for Payer: Group Health Inc Medicare	$2.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.48
Rate for Payer: Hamaspik Choice Inc Medicare	$3.48
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.52

MEFLOQUINE HCL 250 MG PO TABS [10520]

Facility

$10.59

Service Code	NDC 00555017178
Hospital Charge Code	00555017178
Hospital Revenue Code	250
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$8.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.30
Rate for Payer: Aetna Government	$5.30
Rate for Payer: Brighton Health Commercial	$7.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.20
Rate for Payer: Group Health Inc Commercial	$5.30
Rate for Payer: Group Health Inc Medicare	$3.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.30
Rate for Payer: Hamaspik Choice Inc Medicare	$5.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.88

MEGA BED

Facility

$240.98

Hospital Charge Code	40209228
Hospital Revenue Code	270
Min. Negotiated Rate	$84.34
Max. Negotiated Rate	$192.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$120.49
Rate for Payer: Aetna Government	$120.49
Rate for Payer: Brighton Health Commercial	$180.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$192.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$163.87
Rate for Payer: Group Health Inc Commercial	$120.49
Rate for Payer: Group Health Inc Medicare	$84.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.49
Rate for Payer: Hamaspik Choice Inc Medicare	$120.49

MEGESTROL 20 MG TAB

Facility

$0.61

Service Code	HCPCS J8999
Hospital Charge Code	41640624
Hospital Revenue Code	636
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.31
Rate for Payer: Hamaspik Choice Inc Medicare	$0.31

MEGESTROL 20 MG TAB

Facility

$0.61

Service Code	HCPCS J8999
Hospital Charge Code	41640624
Hospital Revenue Code	636
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.31
Rate for Payer: Aetna Government	$0.31
Rate for Payer: Brighton Health Commercial	$0.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.35
Rate for Payer: Group Health Inc Commercial	$0.31
Rate for Payer: Group Health Inc Medicare	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.31
Rate for Payer: Hamaspik Choice Inc Medicare	$0.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.40

MEGESTROL 20 MG TAB

Facility

$0.61

Service Code	HCPCS J8999
Hospital Charge Code	41650624
Hospital Revenue Code	636
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.31
Rate for Payer: Aetna Government	$0.31
Rate for Payer: Brighton Health Commercial	$0.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.35
Rate for Payer: Group Health Inc Commercial	$0.31
Rate for Payer: Group Health Inc Medicare	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.31
Rate for Payer: Hamaspik Choice Inc Medicare	$0.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.40

MEGESTROL 20 MG TAB

Facility

$0.61

Service Code	HCPCS J8999
Hospital Charge Code	41650624
Hospital Revenue Code	636
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.31
Rate for Payer: Hamaspik Choice Inc Medicare	$0.31

MEGESTROL 40 MG/ML SUSP

Facility

$34.70

Service Code	HCPCS J8999
Hospital Charge Code	41640005
Hospital Revenue Code	636
Min. Negotiated Rate	$12.14
Max. Negotiated Rate	$22.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.35
Rate for Payer: Aetna Government	$17.35
Rate for Payer: Brighton Health Commercial	$20.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.95
Rate for Payer: Group Health Inc Commercial	$17.35
Rate for Payer: Group Health Inc Medicare	$12.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.35
Rate for Payer: Hamaspik Choice Inc Medicare	$17.35
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.56

MEGESTROL 40 MG/ML SUSP

Facility

$34.70

Service Code	HCPCS J8999
Hospital Charge Code	41650005
Hospital Revenue Code	636
Min. Negotiated Rate	$12.14
Max. Negotiated Rate	$22.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.35
Rate for Payer: Aetna Government	$17.35
Rate for Payer: Brighton Health Commercial	$20.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.95
Rate for Payer: Group Health Inc Commercial	$17.35
Rate for Payer: Group Health Inc Medicare	$12.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.35
Rate for Payer: Hamaspik Choice Inc Medicare	$17.35
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.56

MEGESTROL 40 MG/ML SUSP

Facility

$34.70

Service Code	HCPCS J8999
Hospital Charge Code	41650005
Hospital Revenue Code	636
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$17.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.35
Rate for Payer: Hamaspik Choice Inc Medicare	$17.35

MEGESTROL 40 MG/ML SUSP

Facility

$34.70

Service Code	HCPCS J8999
Hospital Charge Code	41640005
Hospital Revenue Code	636
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$17.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.35
Rate for Payer: Hamaspik Choice Inc Medicare	$17.35

MEGESTROL 40 MG/ML SUSP 20 ML UDC

Facility

$12.68

Service Code	HCPCS J8999
Hospital Charge Code	41654701
Hospital Revenue Code	636
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$6.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.34
Rate for Payer: Hamaspik Choice Inc Medicare	$6.34

MEGESTROL 40 MG/ML SUSP 20 ML UDC

Facility

$12.68

Service Code	HCPCS J8999
Hospital Charge Code	41644701
Hospital Revenue Code	636
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$6.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.34
Rate for Payer: Hamaspik Choice Inc Medicare	$6.34

MEGESTROL 40 MG/ML SUSP 20 ML UDC

Facility

$12.68

Service Code	HCPCS J8999
Hospital Charge Code	41644701
Hospital Revenue Code	636
Min. Negotiated Rate	$4.44
Max. Negotiated Rate	$8.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.34
Rate for Payer: Aetna Government	$6.34
Rate for Payer: Brighton Health Commercial	$7.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.29
Rate for Payer: Group Health Inc Commercial	$6.34
Rate for Payer: Group Health Inc Medicare	$4.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.34
Rate for Payer: Hamaspik Choice Inc Medicare	$6.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.24

MEGESTROL 40 MG/ML SUSP 20 ML UDC

Facility

$12.68

Service Code	HCPCS J8999
Hospital Charge Code	41654701
Hospital Revenue Code	636
Min. Negotiated Rate	$4.44
Max. Negotiated Rate	$8.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.34
Rate for Payer: Aetna Government	$6.34
Rate for Payer: Brighton Health Commercial	$7.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.29
Rate for Payer: Group Health Inc Commercial	$6.34
Rate for Payer: Group Health Inc Medicare	$4.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.34
Rate for Payer: Hamaspik Choice Inc Medicare	$6.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.24

MEGESTROL 40 MG TAB

Facility

$0.40

Service Code	HCPCS J8999
Hospital Charge Code	41650223
Hospital Revenue Code	636
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.20
Rate for Payer: Hamaspik Choice Inc Medicare	$0.20

MEGESTROL 40 MG TAB

Facility

$0.40

Service Code	HCPCS J8999
Hospital Charge Code	41640223
Hospital Revenue Code	636
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.20
Rate for Payer: Aetna Government	$0.20
Rate for Payer: Brighton Health Commercial	$0.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.23
Rate for Payer: Group Health Inc Commercial	$0.20
Rate for Payer: Group Health Inc Medicare	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.20
Rate for Payer: Hamaspik Choice Inc Medicare	$0.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.26

MEGESTROL 40 MG TAB

Facility

$0.40

Service Code	HCPCS J8999
Hospital Charge Code	41650223
Hospital Revenue Code	636
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.20
Rate for Payer: Aetna Government	$0.20
Rate for Payer: Brighton Health Commercial	$0.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.23
Rate for Payer: Group Health Inc Commercial	$0.20
Rate for Payer: Group Health Inc Medicare	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.20
Rate for Payer: Hamaspik Choice Inc Medicare	$0.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.26

MEGESTROL 40 MG TAB

Facility

$0.40

Service Code	HCPCS J8999
Hospital Charge Code	41640223
Hospital Revenue Code	636
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.20
Rate for Payer: Hamaspik Choice Inc Medicare	$0.20

MEGESTROL ACETATE 20 MG PO TABS [4870]

Facility

$0.69

Service Code	NDC 64380015801
Hospital Charge Code	64380015801
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: 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

MEGESTROL ACETATE 40 MG/ML PO SUSP [10521]

Facility

$0.55

Service Code	NDC 68094017459
Hospital Charge Code	68094017459
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.28
Rate for Payer: Aetna Government	$0.28
Rate for Payer: Brighton Health Commercial	$0.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.38
Rate for Payer: Group Health Inc Commercial	$0.28
Rate for Payer: Group Health Inc Medicare	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.28
Rate for Payer: Hamaspik Choice Inc Medicare	$0.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.36

MEGESTROL ACETATE 40 MG PO TABS [4871]

Facility

$1.71

Service Code	NDC 00555060702
Hospital Charge Code	00555060702
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$1.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.85
Rate for Payer: Aetna Government	$0.85
Rate for Payer: Brighton Health Commercial	$1.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.16
Rate for Payer: Group Health Inc Commercial	$0.85
Rate for Payer: Group Health Inc Medicare	$0.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.85
Rate for Payer: Hamaspik Choice Inc Medicare	$0.85
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.11

MEGESTROL ACETATE 40 MG PO TABS [4871]

Facility

$0.28

Service Code	NDC 00904723661
Hospital Charge Code	00904723661
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.14
Rate for Payer: Aetna Government	$0.14
Rate for Payer: Brighton Health Commercial	$0.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.19
Rate for Payer: Group Health Inc Commercial	$0.14
Rate for Payer: Group Health Inc Medicare	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14
Rate for Payer: Hamaspik Choice Inc Medicare	$0.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.18

MEGESTROL ACETATE 800 MG/20ML PO SUSP [77979]

Facility

$0.55

Service Code	NDC 68094017459
Hospital Charge Code	68094017459
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.28
Rate for Payer: Aetna Government	$0.28
Rate for Payer: Brighton Health Commercial	$0.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.38
Rate for Payer: Group Health Inc Commercial	$0.28
Rate for Payer: Group Health Inc Medicare	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.28
Rate for Payer: Hamaspik Choice Inc Medicare	$0.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.36

Know your out-of-pocket cost for care.

All Charges