St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ROSUVASTATIN CALCIUM 20 MG PO TABS

Facility

$8.95

Service Code	NDC 2780815701
Hospital Charge Code	2780815701
Hospital Revenue Code	250
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$7.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.47
Rate for Payer: Aetna Government	$4.47
Rate for Payer: Brighton Health Commercial	$6.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.08
Rate for Payer: EmblemHealth Commercial	$4.47
Rate for Payer: Group Health Inc Commercial	$4.47
Rate for Payer: Group Health Inc Medicare	$3.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47
Rate for Payer: Hamaspik Choice Inc Medicare	$4.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.81

ROSUVASTATIN CALCIUM 20 MG PO TABS

Facility

$8.95

Service Code	NDC 4733558481
Hospital Charge Code	4733558481
Hospital Revenue Code	250
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$4.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47

ROSUVASTATIN CALCIUM 20 MG PO TABS

Facility

$11.06

Service Code	NDC 0310758090
Hospital Charge Code	0310758090
Hospital Revenue Code	250
Min. Negotiated Rate	$5.53
Max. Negotiated Rate	$5.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.53

ROSUVASTATIN CALCIUM 20 MG PO TABS

Facility

$11.06

Service Code	NDC 0310758090
Hospital Charge Code	0310758090
Hospital Revenue Code	250
Min. Negotiated Rate	$3.87
Max. Negotiated Rate	$8.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.53
Rate for Payer: Aetna Government	$5.53
Rate for Payer: Brighton Health Commercial	$8.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.52
Rate for Payer: EmblemHealth Commercial	$5.53
Rate for Payer: Group Health Inc Commercial	$5.53
Rate for Payer: Group Health Inc Medicare	$3.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.53
Rate for Payer: Hamaspik Choice Inc Medicare	$5.53
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.19

ROSUVASTATIN CALCIUM 20 MG PO TABS

Facility

$1.48

Service Code	NDC 5026871011
Hospital Charge Code	5026871011
Hospital Revenue Code	250
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$0.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.74

ROSUVASTATIN CALCIUM 20 MG PO TABS

Facility

$1.48

Service Code	NDC 5026871011
Hospital Charge Code	5026871011
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$1.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.74
Rate for Payer: Aetna Government	$0.74
Rate for Payer: Brighton Health Commercial	$1.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.01
Rate for Payer: EmblemHealth Commercial	$0.74
Rate for Payer: Group Health Inc Commercial	$0.74
Rate for Payer: Group Health Inc Medicare	$0.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.74
Rate for Payer: Hamaspik Choice Inc Medicare	$0.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.96

ROSUVASTATIN CALCIUM 20 MG PO TABS

Facility

$7.14

Service Code	NDC 6068725611
Hospital Charge Code	6068725611
Hospital Revenue Code	250
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$3.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.57

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$1.59

Service Code	NDC 5026871111
Hospital Charge Code	5026871111
Hospital Revenue Code	250
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$0.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.79

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$8.95

Service Code	NDC 5723717105
Hospital Charge Code	5723717105
Hospital Revenue Code	250
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$4.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$8.95

Service Code	NDC 5723717105
Hospital Charge Code	5723717105
Hospital Revenue Code	250
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$7.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.47
Rate for Payer: Aetna Government	$4.47
Rate for Payer: Brighton Health Commercial	$6.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.08
Rate for Payer: EmblemHealth Commercial	$4.47
Rate for Payer: Group Health Inc Commercial	$4.47
Rate for Payer: Group Health Inc Medicare	$3.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47
Rate for Payer: Hamaspik Choice Inc Medicare	$4.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.81

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$8.95

Service Code	NDC 1672928715
Hospital Charge Code	1672928715
Hospital Revenue Code	250
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$4.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$8.94

Service Code	NDC 3172288530
Hospital Charge Code	3172288530
Hospital Revenue Code	250
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$4.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$8.95

Service Code	NDC 4733558583
Hospital Charge Code	4733558583
Hospital Revenue Code	250
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$7.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.47
Rate for Payer: Aetna Government	$4.47
Rate for Payer: Brighton Health Commercial	$6.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.08
Rate for Payer: EmblemHealth Commercial	$4.47
Rate for Payer: Group Health Inc Commercial	$4.47
Rate for Payer: Group Health Inc Medicare	$3.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47
Rate for Payer: Hamaspik Choice Inc Medicare	$4.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.81

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$8.94

Service Code	NDC 3172288530
Hospital Charge Code	3172288530
Hospital Revenue Code	250
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$7.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.47
Rate for Payer: Aetna Government	$4.47
Rate for Payer: Brighton Health Commercial	$6.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.08
Rate for Payer: EmblemHealth Commercial	$4.47
Rate for Payer: Group Health Inc Commercial	$4.47
Rate for Payer: Group Health Inc Medicare	$3.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47
Rate for Payer: Hamaspik Choice Inc Medicare	$4.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.81

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$8.95

Service Code	NDC 1672928715
Hospital Charge Code	1672928715
Hospital Revenue Code	250
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$7.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.47
Rate for Payer: Aetna Government	$4.47
Rate for Payer: Brighton Health Commercial	$6.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.08
Rate for Payer: EmblemHealth Commercial	$4.47
Rate for Payer: Group Health Inc Commercial	$4.47
Rate for Payer: Group Health Inc Medicare	$3.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47
Rate for Payer: Hamaspik Choice Inc Medicare	$4.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.81

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$8.95

Service Code	NDC 5723717190
Hospital Charge Code	5723717190
Hospital Revenue Code	250
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$7.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.47
Rate for Payer: Aetna Government	$4.47
Rate for Payer: Brighton Health Commercial	$6.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.08
Rate for Payer: EmblemHealth Commercial	$4.47
Rate for Payer: Group Health Inc Commercial	$4.47
Rate for Payer: Group Health Inc Medicare	$3.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47
Rate for Payer: Hamaspik Choice Inc Medicare	$4.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.81

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$8.95

Service Code	NDC 5723717190
Hospital Charge Code	5723717190
Hospital Revenue Code	250
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$4.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$1.59

Service Code	NDC 5026871115
Hospital Charge Code	5026871115
Hospital Revenue Code	250
Min. Negotiated Rate	$0.56
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	$0.56
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

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$8.95

Service Code	NDC 4733558583
Hospital Charge Code	4733558583
Hospital Revenue Code	250
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$4.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$8.95

Service Code	NDC 6846226430
Hospital Charge Code	6846226430
Hospital Revenue Code	250
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$7.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.47
Rate for Payer: Aetna Government	$4.47
Rate for Payer: Brighton Health Commercial	$6.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.08
Rate for Payer: EmblemHealth Commercial	$4.47
Rate for Payer: Group Health Inc Commercial	$4.47
Rate for Payer: Group Health Inc Medicare	$3.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47
Rate for Payer: Hamaspik Choice Inc Medicare	$4.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.81

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$8.95

Service Code	NDC 7220500590
Hospital Charge Code	7220500590
Hospital Revenue Code	250
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$7.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.47
Rate for Payer: Aetna Government	$4.47
Rate for Payer: Brighton Health Commercial	$6.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.08
Rate for Payer: EmblemHealth Commercial	$4.47
Rate for Payer: Group Health Inc Commercial	$4.47
Rate for Payer: Group Health Inc Medicare	$3.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47
Rate for Payer: Hamaspik Choice Inc Medicare	$4.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.81

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$8.95

Service Code	NDC 7220500590
Hospital Charge Code	7220500590
Hospital Revenue Code	250
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$4.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$1.59

Service Code	NDC 5026871115
Hospital Charge Code	5026871115
Hospital Revenue Code	250
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$0.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.79

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$1.59

Service Code	NDC 5026871111
Hospital Charge Code	5026871111
Hospital Revenue Code	250
Min. Negotiated Rate	$0.56
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	$0.56
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

ROSUVASTATIN CALCIUM 40 MG PO TABS

Facility

$8.95

Service Code	NDC 6846226430
Hospital Charge Code	6846226430
Hospital Revenue Code	250
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$4.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47

Know your out-of-pocket cost for care.

All Charges