St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN

Facility

$1.23

Service Code	NDC 0143925010
Hospital Charge Code	0143925010
Hospital Revenue Code	258
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$0.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.62
Rate for Payer: Aetna Government	$0.62
Rate for Payer: Brighton Health Commercial	$0.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.84
Rate for Payer: EmblemHealth Commercial	$0.62
Rate for Payer: Group Health Inc Commercial	$0.62
Rate for Payer: Group Health Inc Medicare	$0.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.62
Rate for Payer: Hamaspik Choice Inc Medicare	$0.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.80

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN

Facility

$0.89

Service Code	NDC 4354753001
Hospital Charge Code	4354753001
Hospital Revenue Code	258
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.45

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN

Facility

$0.89

Service Code	NDC 4354753010
Hospital Charge Code	4354753010
Hospital Revenue Code	258
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.45

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN

Facility

$0.89

Service Code	NDC 4354753010
Hospital Charge Code	4354753010
Hospital Revenue Code	258
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.45
Rate for Payer: Aetna Government	$0.45
Rate for Payer: Brighton Health Commercial	$0.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.71
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	$0.31
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	$0.58

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN

Facility

$0.96

Service Code	NDC 7128870005
Hospital Charge Code	7128870005
Hospital Revenue Code	258
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.48

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN

Facility

$1.41

Service Code	NDC 7261175610
Hospital Charge Code	7261175610
Hospital Revenue Code	258
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$1.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.71
Rate for Payer: Aetna Government	$0.71
Rate for Payer: Brighton Health Commercial	$1.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.96
Rate for Payer: EmblemHealth Commercial	$0.71
Rate for Payer: Group Health Inc Commercial	$0.71
Rate for Payer: Group Health Inc Medicare	$0.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.71
Rate for Payer: Hamaspik Choice Inc Medicare	$0.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.92

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN

Facility

$1.15

Service Code	NDC 6679422841
Hospital Charge Code	6679422841
Hospital Revenue Code	258
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$0.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.58
Rate for Payer: Aetna Government	$0.58
Rate for Payer: Brighton Health Commercial	$0.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.78
Rate for Payer: EmblemHealth Commercial	$0.58
Rate for Payer: Group Health Inc Commercial	$0.58
Rate for Payer: Group Health Inc Medicare	$0.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.58
Rate for Payer: Hamaspik Choice Inc Medicare	$0.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.75

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN

Facility

$2.10

Service Code	NDC 5515022505
Hospital Charge Code	5515022505
Hospital Revenue Code	258
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$1.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.05
Rate for Payer: Aetna Government	$1.05
Rate for Payer: Brighton Health Commercial	$1.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.43
Rate for Payer: EmblemHealth Commercial	$1.05
Rate for Payer: Group Health Inc Commercial	$1.05
Rate for Payer: Group Health Inc Medicare	$0.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.05
Rate for Payer: Hamaspik Choice Inc Medicare	$1.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.36

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN

Facility

$2.10

Service Code	NDC 5515022505
Hospital Charge Code	5515022505
Hospital Revenue Code	258
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.05

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN

Facility

$1.15

Service Code	NDC 6679422841
Hospital Charge Code	6679422841
Hospital Revenue Code	258
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.58

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN

Facility

$0.59

Service Code	NDC 8156520402
Hospital Charge Code	8156520402
Hospital Revenue Code	258
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.30
Rate for Payer: Aetna Government	$0.30
Rate for Payer: Brighton Health Commercial	$0.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.40
Rate for Payer: EmblemHealth Commercial	$0.30
Rate for Payer: Group Health Inc Commercial	$0.30
Rate for Payer: Group Health Inc Medicare	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30
Rate for Payer: Hamaspik Choice Inc Medicare	$0.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.38

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN

Facility

$1.41

Service Code	NDC 7261175601
Hospital Charge Code	7261175601
Hospital Revenue Code	258
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$1.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.71
Rate for Payer: Aetna Government	$0.71
Rate for Payer: Brighton Health Commercial	$1.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.96
Rate for Payer: EmblemHealth Commercial	$0.71
Rate for Payer: Group Health Inc Commercial	$0.71
Rate for Payer: Group Health Inc Medicare	$0.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.71
Rate for Payer: Hamaspik Choice Inc Medicare	$0.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.92

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN

Facility

$1.21

Service Code	NDC 6745722805
Hospital Charge Code	6745722805
Hospital Revenue Code	258
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$0.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.61

ROFLUMILAST 250 MCG PO TABS

Facility

$15.56

Service Code	NDC 7220520111
Hospital Charge Code	7220520111
Hospital Revenue Code	250
Min. Negotiated Rate	$5.45
Max. Negotiated Rate	$12.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.78
Rate for Payer: Aetna Government	$7.78
Rate for Payer: Brighton Health Commercial	$11.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.58
Rate for Payer: EmblemHealth Commercial	$7.78
Rate for Payer: Group Health Inc Commercial	$7.78
Rate for Payer: Group Health Inc Medicare	$5.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.78
Rate for Payer: Hamaspik Choice Inc Medicare	$7.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10.11

ROFLUMILAST 250 MCG PO TABS

Facility

$10.52

Service Code	NDC 4257136983
Hospital Charge Code	4257136983
Hospital Revenue Code	250
Min. Negotiated Rate	$3.68
Max. Negotiated Rate	$8.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.26
Rate for Payer: Aetna Government	$5.26
Rate for Payer: Brighton Health Commercial	$7.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.15
Rate for Payer: EmblemHealth Commercial	$5.26
Rate for Payer: Group Health Inc Commercial	$5.26
Rate for Payer: Group Health Inc Medicare	$3.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.26
Rate for Payer: Hamaspik Choice Inc Medicare	$5.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.84

ROFLUMILAST 250 MCG PO TABS

Facility

$10.52

Service Code	NDC 4257136983
Hospital Charge Code	4257136983
Hospital Revenue Code	250
Min. Negotiated Rate	$5.26
Max. Negotiated Rate	$5.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.26

ROFLUMILAST 250 MCG PO TABS

Facility

$15.56

Service Code	NDC 7220520111
Hospital Charge Code	7220520111
Hospital Revenue Code	250
Min. Negotiated Rate	$7.78
Max. Negotiated Rate	$7.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.78

ROFLUMILAST 250 MCG PO TABS

Facility

$15.56

Service Code	NDC 7220520124
Hospital Charge Code	7220520124
Hospital Revenue Code	250
Min. Negotiated Rate	$5.45
Max. Negotiated Rate	$12.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.78
Rate for Payer: Aetna Government	$7.78
Rate for Payer: Brighton Health Commercial	$11.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.58
Rate for Payer: EmblemHealth Commercial	$7.78
Rate for Payer: Group Health Inc Commercial	$7.78
Rate for Payer: Group Health Inc Medicare	$5.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.78
Rate for Payer: Hamaspik Choice Inc Medicare	$7.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10.11

ROFLUMILAST 250 MCG PO TABS

Facility

$17.75

Service Code	NDC 0310008828
Hospital Charge Code	0310008828
Hospital Revenue Code	250
Min. Negotiated Rate	$8.88
Max. Negotiated Rate	$8.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.88

ROFLUMILAST 250 MCG PO TABS

Facility

$15.56

Service Code	NDC 7220520124
Hospital Charge Code	7220520124
Hospital Revenue Code	250
Min. Negotiated Rate	$7.78
Max. Negotiated Rate	$7.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.78

ROFLUMILAST 250 MCG PO TABS

Facility

$17.75

Service Code	NDC 0310008839
Hospital Charge Code	0310008839
Hospital Revenue Code	250
Min. Negotiated Rate	$6.21
Max. Negotiated Rate	$14.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.87
Rate for Payer: Aetna Government	$8.87
Rate for Payer: Brighton Health Commercial	$13.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.07
Rate for Payer: EmblemHealth Commercial	$8.87
Rate for Payer: Group Health Inc Commercial	$8.87
Rate for Payer: Group Health Inc Medicare	$6.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.87
Rate for Payer: Hamaspik Choice Inc Medicare	$8.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.54

ROFLUMILAST 250 MCG PO TABS

Facility

$17.75

Service Code	NDC 0310008839
Hospital Charge Code	0310008839
Hospital Revenue Code	250
Min. Negotiated Rate	$8.87
Max. Negotiated Rate	$8.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.87

ROFLUMILAST 250 MCG PO TABS

Facility

$17.75

Service Code	NDC 0310008828
Hospital Charge Code	0310008828
Hospital Revenue Code	250
Min. Negotiated Rate	$6.21
Max. Negotiated Rate	$14.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.88
Rate for Payer: Aetna Government	$8.88
Rate for Payer: Brighton Health Commercial	$13.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.07
Rate for Payer: EmblemHealth Commercial	$8.88
Rate for Payer: Group Health Inc Commercial	$8.88
Rate for Payer: Group Health Inc Medicare	$6.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.88
Rate for Payer: Hamaspik Choice Inc Medicare	$8.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.54

ROFLUMILAST 500 MCG PO TABS

Facility

$17.75

Service Code	NDC 0310009530
Hospital Charge Code	0310009530
Hospital Revenue Code	250
Min. Negotiated Rate	$6.21
Max. Negotiated Rate	$14.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.88
Rate for Payer: Aetna Government	$8.88
Rate for Payer: Brighton Health Commercial	$13.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.07
Rate for Payer: EmblemHealth Commercial	$8.88
Rate for Payer: Group Health Inc Commercial	$8.88
Rate for Payer: Group Health Inc Medicare	$6.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.88
Rate for Payer: Hamaspik Choice Inc Medicare	$8.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.54

ROFLUMILAST 500 MCG PO TABS

Facility

$12.38

Service Code	NDC 7220520090
Hospital Charge Code	7220520090
Hospital Revenue Code	250
Min. Negotiated Rate	$6.19
Max. Negotiated Rate	$6.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.19

Know your out-of-pocket cost for care.

All Charges