St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

TAMSULOSIN HCL 0.4 MG PO CAPS

Facility

$4.22

Service Code	NDC 6787745005
Hospital Charge Code	6787745005
Hospital Revenue Code	250
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$3.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.11
Rate for Payer: Aetna Government	$2.11
Rate for Payer: Brighton Health Commercial	$3.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.87
Rate for Payer: EmblemHealth Commercial	$2.11
Rate for Payer: Group Health Inc Commercial	$2.11
Rate for Payer: Group Health Inc Medicare	$1.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.11
Rate for Payer: Hamaspik Choice Inc Medicare	$2.11
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.74

TAMSULOSIN HCL 0.4 MG PO CAPS

Facility

$4.22

Service Code	NDC 6586259801
Hospital Charge Code	6586259801
Hospital Revenue Code	250
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$2.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.11

TAMSULOSIN HCL 0.4 MG PO CAPS

Facility

$0.53

Service Code	NDC 0904738361
Hospital Charge Code	0904738361
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.27
Rate for Payer: Aetna Government	$0.27
Rate for Payer: Brighton Health Commercial	$0.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.43
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.36
Rate for Payer: EmblemHealth Commercial	$0.27
Rate for Payer: Group Health Inc Commercial	$0.27
Rate for Payer: Group Health Inc Medicare	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$0.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.35

TAMSULOSIN HCL 0.4 MG PO CAPS

Facility

$0.48

Service Code	NDC 5026874011
Hospital Charge Code	5026874011
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.24
Rate for Payer: Aetna Government	$0.24
Rate for Payer: Brighton Health Commercial	$0.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.32
Rate for Payer: EmblemHealth Commercial	$0.24
Rate for Payer: Group Health Inc Commercial	$0.24
Rate for Payer: Group Health Inc Medicare	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.24
Rate for Payer: Hamaspik Choice Inc Medicare	$0.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.31

TAMSULOSIN HCL 0.4 MG PO CAPS

Facility

$0.48

Service Code	NDC 5026874011
Hospital Charge Code	5026874011
Hospital Revenue Code	250
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.24

TAMSULOSIN HCL 0.4 MG PO CAPS

Facility

$4.21

Service Code	NDC 6275616013
Hospital Charge Code	6275616013
Hospital Revenue Code	250
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$3.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.10
Rate for Payer: Aetna Government	$2.10
Rate for Payer: Brighton Health Commercial	$3.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.86
Rate for Payer: EmblemHealth Commercial	$2.10
Rate for Payer: Group Health Inc Commercial	$2.10
Rate for Payer: Group Health Inc Medicare	$1.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.10
Rate for Payer: Hamaspik Choice Inc Medicare	$2.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.74

TAMSULOSIN HCL 0.4 MG PO CAPS

Facility

$4.22

Service Code	NDC 6787745005
Hospital Charge Code	6787745005
Hospital Revenue Code	250
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$2.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.11

TAMSULOSIN HCL 0.4 MG PO CAPS

Facility

$4.21

Service Code	NDC 6808429901
Hospital Charge Code	6808429901
Hospital Revenue Code	250
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$2.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.11

TAMSULOSIN HCL 0.4 MG PO CAPS

Facility

$4.21

Service Code	NDC 6808429901
Hospital Charge Code	6808429901
Hospital Revenue Code	250
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$3.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.11
Rate for Payer: Aetna Government	$2.11
Rate for Payer: Brighton Health Commercial	$3.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.87
Rate for Payer: EmblemHealth Commercial	$2.11
Rate for Payer: Group Health Inc Commercial	$2.11
Rate for Payer: Group Health Inc Medicare	$1.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.11
Rate for Payer: Hamaspik Choice Inc Medicare	$2.11
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.74

TAMSULOSIN HCL 0.4 MG PO CAPS

Facility

$4.21

Service Code	NDC 6808429911
Hospital Charge Code	6808429911
Hospital Revenue Code	250
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$2.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.11

TAMSULOSIN HCL 0.4 MG PO CAPS

Facility

$4.21

Service Code	NDC 6808429911
Hospital Charge Code	6808429911
Hospital Revenue Code	250
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$3.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.11
Rate for Payer: Aetna Government	$2.11
Rate for Payer: Brighton Health Commercial	$3.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.87
Rate for Payer: EmblemHealth Commercial	$2.11
Rate for Payer: Group Health Inc Commercial	$2.11
Rate for Payer: Group Health Inc Medicare	$1.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.11
Rate for Payer: Hamaspik Choice Inc Medicare	$2.11
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.74

TAMSULOSIN HCL 0.4 MG PO CAPS

Facility

$4.21

Service Code	NDC 6275616013
Hospital Charge Code	6275616013
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.10

TAMSULOSIN HCL 0.4 MG PO CAPS

Facility

$0.48

Service Code	NDC 5026874015
Hospital Charge Code	5026874015
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.24
Rate for Payer: Aetna Government	$0.24
Rate for Payer: Brighton Health Commercial	$0.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.32
Rate for Payer: EmblemHealth Commercial	$0.24
Rate for Payer: Group Health Inc Commercial	$0.24
Rate for Payer: Group Health Inc Medicare	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.24
Rate for Payer: Hamaspik Choice Inc Medicare	$0.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.31

TAMSULOSIN HCL 0.4 MG PO CAPS

Facility

$0.48

Service Code	NDC 5026874015
Hospital Charge Code	5026874015
Hospital Revenue Code	250
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.24

TAPENTADOL HCL 100 MG PO TABS

Facility

$19.78

Service Code	NDC 2451010010
Hospital Charge Code	2451010010
Hospital Revenue Code	250
Min. Negotiated Rate	$9.89
Max. Negotiated Rate	$9.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.89

TAPENTADOL HCL 100 MG PO TABS

Facility

$19.78

Service Code	NDC 2451010010
Hospital Charge Code	2451010010
Hospital Revenue Code	250
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$15.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.89
Rate for Payer: Aetna Government	$9.89
Rate for Payer: Brighton Health Commercial	$14.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.45
Rate for Payer: EmblemHealth Commercial	$9.89
Rate for Payer: Group Health Inc Commercial	$9.89
Rate for Payer: Group Health Inc Medicare	$6.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.89
Rate for Payer: Hamaspik Choice Inc Medicare	$9.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.86

TAPENTADOL HCL 50 MG PO TABS

Facility

$12.70

Service Code	NDC 2451005010
Hospital Charge Code	2451005010
Hospital Revenue Code	250
Min. Negotiated Rate	$6.35
Max. Negotiated Rate	$6.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.35

TAPENTADOL HCL 50 MG PO TABS

Facility

$12.70

Service Code	NDC 2451005010
Hospital Charge Code	2451005010
Hospital Revenue Code	250
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$10.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.35
Rate for Payer: Aetna Government	$6.35
Rate for Payer: Brighton Health Commercial	$9.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.64
Rate for Payer: EmblemHealth Commercial	$6.35
Rate for Payer: Group Health Inc Commercial	$6.35
Rate for Payer: Group Health Inc Medicare	$4.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.35
Rate for Payer: Hamaspik Choice Inc Medicare	$6.35
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.26

TAPENTADOL HCL 75 MG PO TABS

Facility

$14.84

Service Code	NDC 2451007510
Hospital Charge Code	2451007510
Hospital Revenue Code	250
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$11.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.42
Rate for Payer: Aetna Government	$7.42
Rate for Payer: Brighton Health Commercial	$11.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.09
Rate for Payer: EmblemHealth Commercial	$7.42
Rate for Payer: Group Health Inc Commercial	$7.42
Rate for Payer: Group Health Inc Medicare	$5.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.42
Rate for Payer: Hamaspik Choice Inc Medicare	$7.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.65

TAPENTADOL HCL 75 MG PO TABS

Facility

$14.84

Service Code	NDC 2451007510
Hospital Charge Code	2451007510
Hospital Revenue Code	250
Min. Negotiated Rate	$7.42
Max. Negotiated Rate	$7.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.42

TECHNETIUM TC 99M ALBUMIN AGGREGATED

Facility

$180.50

Service Code	HCPCS A9540
Hospital Charge Code	9999408443
Hospital Revenue Code	250
Min. Negotiated Rate	$90.25
Max. Negotiated Rate	$90.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$90.25

TECHNETIUM TC 99M ALBUMIN AGGREGATED

Facility

$180.50

Service Code	HCPCS A9540
Hospital Charge Code	9999408443
Hospital Revenue Code	250
Min. Negotiated Rate	$24.84
Max. Negotiated Rate	$144.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$99.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24.84
Rate for Payer: Aetna Government	$24.84
Rate for Payer: Brighton Health Commercial	$135.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$144.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$122.74
Rate for Payer: EmblemHealth Commercial	$90.25
Rate for Payer: Group Health Inc Commercial	$90.25
Rate for Payer: Group Health Inc Medicare	$63.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$90.25
Rate for Payer: Hamaspik Choice Inc Medicare	$90.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$117.33

TECHNETIUM TC 99M BICISATE IV KIT

Facility

$4.00

Service Code	HCPCS A9540
Hospital Charge Code	1199400602
Hospital Revenue Code	258
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$24.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24.84
Rate for Payer: Aetna Government	$24.84
Rate for Payer: Brighton Health Commercial	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.72
Rate for Payer: EmblemHealth Commercial	$2.00
Rate for Payer: Group Health Inc Commercial	$2.00
Rate for Payer: Group Health Inc Medicare	$1.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.60

TECHNETIUM TC 99M BICISATE IV KIT

Facility

$4.00

Service Code	HCPCS A9540
Hospital Charge Code	1199400602
Hospital Revenue Code	258
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$2.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00

TECHNETIUM TC 99M EXAMETAZIME IV KIT

Facility

$10.00

Service Code	NDC 1715602205
Hospital Charge Code	1715602205
Hospital Revenue Code	258
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$8.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.00
Rate for Payer: Aetna Government	$5.00
Rate for Payer: Brighton Health Commercial	$7.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.80
Rate for Payer: EmblemHealth Commercial	$5.00
Rate for Payer: Group Health Inc Commercial	$5.00
Rate for Payer: Group Health Inc Medicare	$3.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.50

Know your out-of-pocket cost for care.

All Charges