St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

TRIHEXYPHENIDYL HCL 2 MG PO TABS

Facility

$0.37

Service Code	NDC 7095421210
Hospital Charge Code	7095421210
Hospital Revenue Code	250
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.18
Rate for Payer: Aetna Government	$0.18
Rate for Payer: Brighton Health Commercial	$0.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.25
Rate for Payer: EmblemHealth Commercial	$0.18
Rate for Payer: Group Health Inc Commercial	$0.18
Rate for Payer: Group Health Inc Medicare	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.18
Rate for Payer: Hamaspik Choice Inc Medicare	$0.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.24

TRIHEXYPHENIDYL HCL 2 MG PO TABS

Facility

$0.37

Service Code	NDC 7095421210
Hospital Charge Code	7095421210
Hospital Revenue Code	250
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.18

TRIHEXYPHENIDYL HCL 5 MG PO TABS

Facility

$0.34

Service Code	NDC 0591533710
Hospital Charge Code	0591533710
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.17
Rate for Payer: Aetna Government	$0.17
Rate for Payer: Brighton Health Commercial	$0.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.23
Rate for Payer: EmblemHealth Commercial	$0.17
Rate for Payer: Group Health Inc Commercial	$0.17
Rate for Payer: Group Health Inc Medicare	$0.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.17
Rate for Payer: Hamaspik Choice Inc Medicare	$0.17
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.22

TRIHEXYPHENIDYL HCL 5 MG PO TABS

Facility

$0.36

Service Code	NDC 0591533701
Hospital Charge Code	0591533701
Hospital Revenue Code	250
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.18

TRIHEXYPHENIDYL HCL 5 MG PO TABS

Facility

$0.34

Service Code	NDC 0591533710
Hospital Charge Code	0591533710
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.17

TRIHEXYPHENIDYL HCL 5 MG PO TABS

Facility

$0.36

Service Code	NDC 0591533701
Hospital Charge Code	0591533701
Hospital Revenue Code	250
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.18
Rate for Payer: Aetna Government	$0.18
Rate for Payer: Brighton Health Commercial	$0.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.25
Rate for Payer: EmblemHealth Commercial	$0.18
Rate for Payer: Group Health Inc Commercial	$0.18
Rate for Payer: Group Health Inc Medicare	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.18
Rate for Payer: Hamaspik Choice Inc Medicare	$0.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.24

TRIPLE DYE EX SWAB

Facility

$6.31

Service Code	NDC 6668971006
Hospital Charge Code	6668971006
Hospital Revenue Code	250
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.15

TRIPLE DYE EX SWAB

Facility

$6.31

Service Code	NDC 6668971006
Hospital Charge Code	6668971006
Hospital Revenue Code	250
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$5.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.15
Rate for Payer: Aetna Government	$3.15
Rate for Payer: Brighton Health Commercial	$4.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.29
Rate for Payer: EmblemHealth Commercial	$3.15
Rate for Payer: Group Health Inc Commercial	$3.15
Rate for Payer: Group Health Inc Medicare	$2.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.15
Rate for Payer: Hamaspik Choice Inc Medicare	$3.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.10

TROMETHAMINE 30 MEQ/100ML IV SOLN

Facility

$0.86

Service Code	NDC 0409159304
Hospital Charge Code	0409159304
Hospital Revenue Code	258
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.43
Rate for Payer: Aetna Government	$0.43
Rate for Payer: Brighton Health Commercial	$0.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.58
Rate for Payer: EmblemHealth Commercial	$0.43
Rate for Payer: Group Health Inc Commercial	$0.43
Rate for Payer: Group Health Inc Medicare	$0.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.43
Rate for Payer: Hamaspik Choice Inc Medicare	$0.43
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.56

TROMETHAMINE 30 MEQ/100ML IV SOLN

Facility

$0.86

Service Code	NDC 0409159304
Hospital Charge Code	0409159304
Hospital Revenue Code	258
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$0.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.43

TROPICAL LIQUID NUTRITION PO LIQD

Facility

$0.11

Service Code	NDC 1785650231
Hospital Charge Code	1785650231
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.05
Rate for Payer: Aetna Government	$0.05
Rate for Payer: Brighton Health Commercial	$0.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.07
Rate for Payer: EmblemHealth Commercial	$0.05
Rate for Payer: Group Health Inc Commercial	$0.05
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.07

TROPICAL LIQUID NUTRITION PO LIQD

Facility

$0.11

Service Code	NDC 1785650231
Hospital Charge Code	1785650231
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05

TROPICAL LIQUID NUTRITION PO LIQD

Facility

$0.03

Service Code	NDC 5462980098
Hospital Charge Code	5462980098
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.02
Rate for Payer: EmblemHealth Commercial	$0.02
Rate for Payer: Group Health Inc Commercial	$0.02
Rate for Payer: Group Health Inc Medicare	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.02

TROPICAL LIQUID NUTRITION PO LIQD

Facility

$0.19

Service Code	NDC 6809412061
Hospital Charge Code	6809412061
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.10
Rate for Payer: Aetna Government	$0.10
Rate for Payer: Brighton Health Commercial	$0.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.13
Rate for Payer: EmblemHealth Commercial	$0.10
Rate for Payer: Group Health Inc Commercial	$0.10
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10
Rate for Payer: Hamaspik Choice Inc Medicare	$0.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.12

TROPICAL LIQUID NUTRITION PO LIQD

Facility

$0.19

Service Code	NDC 6809412061
Hospital Charge Code	6809412061
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10

TROPICAL LIQUID NUTRITION PO LIQD

Facility

$0.19

Service Code	NDC 6809412059
Hospital Charge Code	6809412059
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.10
Rate for Payer: Aetna Government	$0.10
Rate for Payer: Brighton Health Commercial	$0.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.13
Rate for Payer: EmblemHealth Commercial	$0.10
Rate for Payer: Group Health Inc Commercial	$0.10
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10
Rate for Payer: Hamaspik Choice Inc Medicare	$0.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.12

TROPICAL LIQUID NUTRITION PO LIQD

Facility

$0.19

Service Code	NDC 6809412059
Hospital Charge Code	6809412059
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10

TROPICAL LIQUID NUTRITION PO LIQD

Facility

$0.17

Service Code	NDC 8103350150
Hospital Charge Code	8103350150
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.09
Rate for Payer: Aetna Government	$0.09
Rate for Payer: Brighton Health Commercial	$0.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.12
Rate for Payer: EmblemHealth Commercial	$0.09
Rate for Payer: Group Health Inc Commercial	$0.09
Rate for Payer: Group Health Inc Medicare	$0.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.09
Rate for Payer: Hamaspik Choice Inc Medicare	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.11

TROPICAL LIQUID NUTRITION PO LIQD

Facility

$0.17

Service Code	NDC 8103350150
Hospital Charge Code	8103350150
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.09

TROPICAL LIQUID NUTRITION PO LIQD

Facility

$0.03

Service Code	NDC 5462980098
Hospital Charge Code	5462980098
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

TROPICAMIDE 0.5 % OP SOLN

Facility

$1.78

Service Code	NDC 6131435401
Hospital Charge Code	6131435401
Hospital Revenue Code	250
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$1.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.89
Rate for Payer: Aetna Government	$0.89
Rate for Payer: Brighton Health Commercial	$1.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.43
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.21
Rate for Payer: EmblemHealth Commercial	$0.89
Rate for Payer: Group Health Inc Commercial	$0.89
Rate for Payer: Group Health Inc Medicare	$0.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.89
Rate for Payer: Hamaspik Choice Inc Medicare	$0.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.16

TROPICAMIDE 0.5 % OP SOLN

Facility

$1.78

Service Code	NDC 6131435401
Hospital Charge Code	6131435401
Hospital Revenue Code	250
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$0.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.89

TROPICAMIDE 1 % OP SOLN

Facility

$4.67

Service Code	NDC 6131435501
Hospital Charge Code	6131435501
Hospital Revenue Code	250
Min. Negotiated Rate	$2.33
Max. Negotiated Rate	$2.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.33

TROPICAMIDE 1 % OP SOLN

Facility

$4.67

Service Code	NDC 6131435501
Hospital Charge Code	6131435501
Hospital Revenue Code	250
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$3.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.33
Rate for Payer: Aetna Government	$2.33
Rate for Payer: Brighton Health Commercial	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.17
Rate for Payer: EmblemHealth Commercial	$2.33
Rate for Payer: Group Health Inc Commercial	$2.33
Rate for Payer: Group Health Inc Medicare	$1.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.33
Rate for Payer: Hamaspik Choice Inc Medicare	$2.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.03

TROPICAMIDE 1 % OP SOLN

Facility

$3.17

Service Code	NDC 6131435502
Hospital Charge Code	6131435502
Hospital Revenue Code	250
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$1.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.59

Know your out-of-pocket cost for care.

All Charges