Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

VALACYCLOVIR HCL 500 MG PO TABS

Facility

OP

$7.22

Service Code	NDC 5107909303
Hospital Charge Code	5107909303
Hospital Revenue Code	250
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$5.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.61
Rate for Payer: Aetna Government	$3.61
Rate for Payer: Brighton Health Commercial	$5.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.91
Rate for Payer: EmblemHealth Commercial	$3.61
Rate for Payer: Group Health Inc Commercial	$3.61
Rate for Payer: Group Health Inc Medicare	$2.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.61
Rate for Payer: Hamaspik Choice Inc Medicare	$3.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.70

VALACYCLOVIR HCL 500 MG PO TABS

Facility

IP

$7.22

Service Code	NDC 5723704230
Hospital Charge Code	5723704230
Hospital Revenue Code	250
Min. Negotiated Rate	$3.61
Max. Negotiated Rate	$3.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.61

VALGANCICLOVIR 60 MG/ML ORAL LIQUID - COMPOUNDED

Facility

OP

$7.92

Service Code	NDC 9999701486
Hospital Charge Code	9999701486
Hospital Revenue Code	250
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$6.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.96
Rate for Payer: Aetna Government	$3.96
Rate for Payer: Brighton Health Commercial	$5.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.33
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.38
Rate for Payer: EmblemHealth Commercial	$3.96
Rate for Payer: Group Health Inc Commercial	$3.96
Rate for Payer: Group Health Inc Medicare	$2.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.96
Rate for Payer: Hamaspik Choice Inc Medicare	$3.96
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.15

VALGANCICLOVIR 60 MG/ML ORAL LIQUID - COMPOUNDED

Facility

IP

$7.92

Service Code	NDC 9999701486
Hospital Charge Code	9999701486
Hospital Revenue Code	250
Min. Negotiated Rate	$3.96
Max. Negotiated Rate	$3.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.96

VALGANCICLOVIR HCL 450 MG PO TABS

Facility

OP

$64.40

Service Code	NDC 3172283260
Hospital Charge Code	3172283260
Hospital Revenue Code	250
Min. Negotiated Rate	$22.54
Max. Negotiated Rate	$51.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.20
Rate for Payer: Aetna Government	$32.20
Rate for Payer: Brighton Health Commercial	$48.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$43.79
Rate for Payer: EmblemHealth Commercial	$32.20
Rate for Payer: Group Health Inc Commercial	$32.20
Rate for Payer: Group Health Inc Medicare	$22.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.20
Rate for Payer: Hamaspik Choice Inc Medicare	$32.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$41.86

VALGANCICLOVIR HCL 450 MG PO TABS

Facility

IP

$64.40

Service Code	NDC 3172283260
Hospital Charge Code	3172283260
Hospital Revenue Code	250
Min. Negotiated Rate	$32.20
Max. Negotiated Rate	$32.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.20

VALGANCICLOVIR HCL 450 MG PO TABS

Facility

IP

$55.59

Service Code	NDC 0904679610
Hospital Charge Code	0904679610
Hospital Revenue Code	250
Min. Negotiated Rate	$27.80
Max. Negotiated Rate	$27.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.80

VALGANCICLOVIR HCL 450 MG PO TABS

Facility

OP

$106.08

Service Code	NDC 0004003822
Hospital Charge Code	0004003822
Hospital Revenue Code	250
Min. Negotiated Rate	$37.13
Max. Negotiated Rate	$84.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$53.04
Rate for Payer: Aetna Government	$53.04
Rate for Payer: Brighton Health Commercial	$79.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$84.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$72.14
Rate for Payer: EmblemHealth Commercial	$53.04
Rate for Payer: Group Health Inc Commercial	$53.04
Rate for Payer: Group Health Inc Medicare	$37.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.04
Rate for Payer: Hamaspik Choice Inc Medicare	$53.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$68.95

VALGANCICLOVIR HCL 450 MG PO TABS

Facility

OP

$149.43

Service Code	NDC 5026878711
Hospital Charge Code	5026878711
Hospital Revenue Code	250
Min. Negotiated Rate	$52.30
Max. Negotiated Rate	$119.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$74.71
Rate for Payer: Aetna Government	$74.71
Rate for Payer: Brighton Health Commercial	$112.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$119.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$101.61
Rate for Payer: EmblemHealth Commercial	$74.71
Rate for Payer: Group Health Inc Commercial	$74.71
Rate for Payer: Group Health Inc Medicare	$52.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.71
Rate for Payer: Hamaspik Choice Inc Medicare	$74.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$97.13

VALGANCICLOVIR HCL 450 MG PO TABS

Facility

OP

$149.43

Service Code	NDC 5026878712
Hospital Charge Code	5026878712
Hospital Revenue Code	250
Min. Negotiated Rate	$52.30
Max. Negotiated Rate	$119.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$74.71
Rate for Payer: Aetna Government	$74.71
Rate for Payer: Brighton Health Commercial	$112.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$119.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$101.61
Rate for Payer: EmblemHealth Commercial	$74.71
Rate for Payer: Group Health Inc Commercial	$74.71
Rate for Payer: Group Health Inc Medicare	$52.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.71
Rate for Payer: Hamaspik Choice Inc Medicare	$74.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$97.13

VALGANCICLOVIR HCL 450 MG PO TABS

Facility

IP

$149.43

Service Code	NDC 5026878711
Hospital Charge Code	5026878711
Hospital Revenue Code	250
Min. Negotiated Rate	$74.71
Max. Negotiated Rate	$74.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.71

VALGANCICLOVIR HCL 450 MG PO TABS

Facility

IP

$149.43

Service Code	NDC 5026878712
Hospital Charge Code	5026878712
Hospital Revenue Code	250
Min. Negotiated Rate	$74.71
Max. Negotiated Rate	$74.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.71

VALGANCICLOVIR HCL 450 MG PO TABS

Facility

IP

$106.08

Service Code	NDC 0004003822
Hospital Charge Code	0004003822
Hospital Revenue Code	250
Min. Negotiated Rate	$53.04
Max. Negotiated Rate	$53.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.04

VALGANCICLOVIR HCL 450 MG PO TABS

Facility

OP

$55.59

Service Code	NDC 0904679610
Hospital Charge Code	0904679610
Hospital Revenue Code	250
Min. Negotiated Rate	$19.46
Max. Negotiated Rate	$44.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$27.80
Rate for Payer: Aetna Government	$27.80
Rate for Payer: Brighton Health Commercial	$41.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$44.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$37.80
Rate for Payer: EmblemHealth Commercial	$27.80
Rate for Payer: Group Health Inc Commercial	$27.80
Rate for Payer: Group Health Inc Medicare	$19.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.80
Rate for Payer: Hamaspik Choice Inc Medicare	$27.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$36.13

VALGANCICLOVIR HCL 50 MG/ML PO SOLR

Facility

OP

$14.59

Service Code	NDC 0004003909
Hospital Charge Code	0004003909
Hospital Revenue Code	250
Min. Negotiated Rate	$5.11
Max. Negotiated Rate	$11.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.30
Rate for Payer: Aetna Government	$7.30
Rate for Payer: Brighton Health Commercial	$10.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.92
Rate for Payer: EmblemHealth Commercial	$7.30
Rate for Payer: Group Health Inc Commercial	$7.30
Rate for Payer: Group Health Inc Medicare	$5.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.30
Rate for Payer: Hamaspik Choice Inc Medicare	$7.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.49

VALGANCICLOVIR HCL 50 MG/ML PO SOLR

Facility

IP

$11.37

Service Code	NDC 0591257920
Hospital Charge Code	0591257920
Hospital Revenue Code	250
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$5.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.68

VALGANCICLOVIR HCL 50 MG/ML PO SOLR

Facility

IP

$11.37

Service Code	NDC 7220501901
Hospital Charge Code	7220501901
Hospital Revenue Code	250
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$5.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.68

VALGANCICLOVIR HCL 50 MG/ML PO SOLR

Facility

IP

$14.59

Service Code	NDC 0004003909
Hospital Charge Code	0004003909
Hospital Revenue Code	250
Min. Negotiated Rate	$7.30
Max. Negotiated Rate	$7.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.30

VALGANCICLOVIR HCL 50 MG/ML PO SOLR

Facility

OP

$11.37

Service Code	NDC 0591257920
Hospital Charge Code	0591257920
Hospital Revenue Code	250
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$9.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.68
Rate for Payer: Aetna Government	$5.68
Rate for Payer: Brighton Health Commercial	$8.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.73
Rate for Payer: EmblemHealth Commercial	$5.68
Rate for Payer: Group Health Inc Commercial	$5.68
Rate for Payer: Group Health Inc Medicare	$3.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.68
Rate for Payer: Hamaspik Choice Inc Medicare	$5.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.39

VALGANCICLOVIR HCL 50 MG/ML PO SOLR

Facility

OP

$11.37

Service Code	NDC 7220501901
Hospital Charge Code	7220501901
Hospital Revenue Code	250
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$9.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.68
Rate for Payer: Aetna Government	$5.68
Rate for Payer: Brighton Health Commercial	$8.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.73
Rate for Payer: EmblemHealth Commercial	$5.68
Rate for Payer: Group Health Inc Commercial	$5.68
Rate for Payer: Group Health Inc Medicare	$3.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.68
Rate for Payer: Hamaspik Choice Inc Medicare	$5.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.39

VALPROATE SODIUM 100 MG/ML IV SOLN

Facility

IP

$4.15

Service Code	NDC 0143978501
Hospital Charge Code	0143978501
Hospital Revenue Code	258
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$2.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.07

VALPROATE SODIUM 100 MG/ML IV SOLN

Facility

IP

$1.61

Service Code	NDC 6332349405
Hospital Charge Code	6332349405
Hospital Revenue Code	258
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.80

VALPROATE SODIUM 100 MG/ML IV SOLN

Facility

IP

$4.15

Service Code	NDC 0143978510
Hospital Charge Code	0143978510
Hospital Revenue Code	258
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$2.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.07

VALPROATE SODIUM 100 MG/ML IV SOLN

Facility

OP

$0.90

Service Code	NDC 2502179705
Hospital Charge Code	2502179705
Hospital Revenue Code	258
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$0.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.45
Rate for Payer: Aetna Government	$0.45
Rate for Payer: Brighton Health Commercial	$0.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.72
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	$0.32
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	$0.59

VALPROATE SODIUM 100 MG/ML IV SOLN

Facility

OP

$4.15

Service Code	NDC 0143978510
Hospital Charge Code	0143978510
Hospital Revenue Code	258
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$3.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.07
Rate for Payer: Aetna Government	$2.07
Rate for Payer: Brighton Health Commercial	$3.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.82
Rate for Payer: EmblemHealth Commercial	$2.07
Rate for Payer: Group Health Inc Commercial	$2.07
Rate for Payer: Group Health Inc Medicare	$1.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.07
Rate for Payer: Hamaspik Choice Inc Medicare	$2.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.70