St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZIPRASIDONE HCL 20 MG PO CAPS

Facility

$8.96

Service Code	NDC 0904626908
Hospital Charge Code	0904626908
Hospital Revenue Code	250
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$7.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.48
Rate for Payer: Aetna Government	$4.48
Rate for Payer: Brighton Health Commercial	$6.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.10
Rate for Payer: EmblemHealth Commercial	$4.48
Rate for Payer: Group Health Inc Commercial	$4.48
Rate for Payer: Group Health Inc Medicare	$3.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.48
Rate for Payer: Hamaspik Choice Inc Medicare	$4.48
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.83

ZIPRASIDONE HCL 20 MG PO CAPS

Facility

$8.00

Service Code	NDC 3334214409
Hospital Charge Code	3334214409
Hospital Revenue Code	250
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$6.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.00
Rate for Payer: Aetna Government	$4.00
Rate for Payer: Brighton Health Commercial	$6.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.44
Rate for Payer: EmblemHealth Commercial	$4.00
Rate for Payer: Group Health Inc Commercial	$4.00
Rate for Payer: Group Health Inc Medicare	$2.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.20

ZIPRASIDONE HCL 20 MG PO CAPS

Facility

$3.34

Service Code	NDC 6373998832
Hospital Charge Code	6373998832
Hospital Revenue Code	250
Min. Negotiated Rate	$1.67
Max. Negotiated Rate	$1.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.67

ZIPRASIDONE HCL 20 MG PO CAPS

Facility

$8.96

Service Code	NDC 0904626908
Hospital Charge Code	0904626908
Hospital Revenue Code	250
Min. Negotiated Rate	$4.48
Max. Negotiated Rate	$4.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.48

ZIPRASIDONE HCL 20 MG PO CAPS

Facility

$3.34

Service Code	NDC 6373998832
Hospital Charge Code	6373998832
Hospital Revenue Code	250
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$2.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.67
Rate for Payer: Aetna Government	$1.67
Rate for Payer: Brighton Health Commercial	$2.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.27
Rate for Payer: EmblemHealth Commercial	$1.67
Rate for Payer: Group Health Inc Commercial	$1.67
Rate for Payer: Group Health Inc Medicare	$1.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.67
Rate for Payer: Hamaspik Choice Inc Medicare	$1.67
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.17

ZIPRASIDONE HCL 20 MG PO CAPS

Facility

$8.86

Service Code	NDC 5511125660
Hospital Charge Code	5511125660
Hospital Revenue Code	250
Min. Negotiated Rate	$4.43
Max. Negotiated Rate	$4.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.43

ZIPRASIDONE HCL 20 MG PO CAPS

Facility

$8.00

Service Code	NDC 3334214409
Hospital Charge Code	3334214409
Hospital Revenue Code	250
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$4.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.00

ZIPRASIDONE HCL 20 MG PO CAPS

Facility

$8.86

Service Code	NDC 5511125660
Hospital Charge Code	5511125660
Hospital Revenue Code	250
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$7.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.43
Rate for Payer: Aetna Government	$4.43
Rate for Payer: Brighton Health Commercial	$6.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.03
Rate for Payer: EmblemHealth Commercial	$4.43
Rate for Payer: Group Health Inc Commercial	$4.43
Rate for Payer: Group Health Inc Medicare	$3.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.43
Rate for Payer: Hamaspik Choice Inc Medicare	$4.43
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.76

ZIPRASIDONE HCL 40 MG PO CAPS

Facility

$3.34

Service Code	NDC 6373900532
Hospital Charge Code	6373900532
Hospital Revenue Code	250
Min. Negotiated Rate	$1.67
Max. Negotiated Rate	$1.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.67

ZIPRASIDONE HCL 40 MG PO CAPS

Facility

$8.00

Service Code	NDC 3334214509
Hospital Charge Code	3334214509
Hospital Revenue Code	250
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$6.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.00
Rate for Payer: Aetna Government	$4.00
Rate for Payer: Brighton Health Commercial	$6.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.44
Rate for Payer: EmblemHealth Commercial	$4.00
Rate for Payer: Group Health Inc Commercial	$4.00
Rate for Payer: Group Health Inc Medicare	$2.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.20

ZIPRASIDONE HCL 40 MG PO CAPS

Facility

$8.00

Service Code	NDC 3334214509
Hospital Charge Code	3334214509
Hospital Revenue Code	250
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$4.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.00

ZIPRASIDONE HCL 40 MG PO CAPS

Facility

$8.96

Service Code	NDC 0904627008
Hospital Charge Code	0904627008
Hospital Revenue Code	250
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$7.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.48
Rate for Payer: Aetna Government	$4.48
Rate for Payer: Brighton Health Commercial	$6.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.10
Rate for Payer: EmblemHealth Commercial	$4.48
Rate for Payer: Group Health Inc Commercial	$4.48
Rate for Payer: Group Health Inc Medicare	$3.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.48
Rate for Payer: Hamaspik Choice Inc Medicare	$4.48
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.83

ZIPRASIDONE HCL 40 MG PO CAPS

Facility

$3.34

Service Code	NDC 6373900532
Hospital Charge Code	6373900532
Hospital Revenue Code	250
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$2.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.67
Rate for Payer: Aetna Government	$1.67
Rate for Payer: Brighton Health Commercial	$2.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.27
Rate for Payer: EmblemHealth Commercial	$1.67
Rate for Payer: Group Health Inc Commercial	$1.67
Rate for Payer: Group Health Inc Medicare	$1.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.67
Rate for Payer: Hamaspik Choice Inc Medicare	$1.67
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.17

ZIPRASIDONE HCL 40 MG PO CAPS

Facility

$8.96

Service Code	NDC 0904627008
Hospital Charge Code	0904627008
Hospital Revenue Code	250
Min. Negotiated Rate	$4.48
Max. Negotiated Rate	$4.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.48

ZIPRASIDONE HCL 60 MG PO CAPS

Facility

$10.88

Service Code	NDC 0904627108
Hospital Charge Code	0904627108
Hospital Revenue Code	250
Min. Negotiated Rate	$3.81
Max. Negotiated Rate	$8.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.44
Rate for Payer: Aetna Government	$5.44
Rate for Payer: Brighton Health Commercial	$8.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.40
Rate for Payer: EmblemHealth Commercial	$5.44
Rate for Payer: Group Health Inc Commercial	$5.44
Rate for Payer: Group Health Inc Medicare	$3.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.44
Rate for Payer: Hamaspik Choice Inc Medicare	$5.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.07

ZIPRASIDONE HCL 60 MG PO CAPS

Facility

$10.76

Service Code	NDC 5511125860
Hospital Charge Code	5511125860
Hospital Revenue Code	250
Min. Negotiated Rate	$3.76
Max. Negotiated Rate	$8.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.38
Rate for Payer: Aetna Government	$5.38
Rate for Payer: Brighton Health Commercial	$8.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.31
Rate for Payer: EmblemHealth Commercial	$5.38
Rate for Payer: Group Health Inc Commercial	$5.38
Rate for Payer: Group Health Inc Medicare	$3.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.38
Rate for Payer: Hamaspik Choice Inc Medicare	$5.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.99

ZIPRASIDONE HCL 60 MG PO CAPS

Facility

$10.88

Service Code	NDC 0904627108
Hospital Charge Code	0904627108
Hospital Revenue Code	250
Min. Negotiated Rate	$5.44
Max. Negotiated Rate	$5.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.44

ZIPRASIDONE HCL 60 MG PO CAPS

Facility

$10.76

Service Code	NDC 5511125860
Hospital Charge Code	5511125860
Hospital Revenue Code	250
Min. Negotiated Rate	$5.38
Max. Negotiated Rate	$5.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.38

ZIPRASIDONE HCL 80 MG PO CAPS

Facility

$10.88

Service Code	NDC 0904627208
Hospital Charge Code	0904627208
Hospital Revenue Code	250
Min. Negotiated Rate	$3.81
Max. Negotiated Rate	$8.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.44
Rate for Payer: Aetna Government	$5.44
Rate for Payer: Brighton Health Commercial	$8.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.40
Rate for Payer: EmblemHealth Commercial	$5.44
Rate for Payer: Group Health Inc Commercial	$5.44
Rate for Payer: Group Health Inc Medicare	$3.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.44
Rate for Payer: Hamaspik Choice Inc Medicare	$5.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.07

ZIPRASIDONE HCL 80 MG PO CAPS

Facility

$10.88

Service Code	NDC 0904627208
Hospital Charge Code	0904627208
Hospital Revenue Code	250
Min. Negotiated Rate	$5.44
Max. Negotiated Rate	$5.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.44

ZIPRASIDONE HCL 80 MG PO CAPS

Facility

$3.23

Service Code	NDC 5026881412
Hospital Charge Code	5026881412
Hospital Revenue Code	250
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$1.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.61

ZIPRASIDONE HCL 80 MG PO CAPS

Facility

$10.76

Service Code	NDC 5511125960
Hospital Charge Code	5511125960
Hospital Revenue Code	250
Min. Negotiated Rate	$3.76
Max. Negotiated Rate	$8.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.38
Rate for Payer: Aetna Government	$5.38
Rate for Payer: Brighton Health Commercial	$8.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.31
Rate for Payer: EmblemHealth Commercial	$5.38
Rate for Payer: Group Health Inc Commercial	$5.38
Rate for Payer: Group Health Inc Medicare	$3.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.38
Rate for Payer: Hamaspik Choice Inc Medicare	$5.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.99

ZIPRASIDONE HCL 80 MG PO CAPS

Facility

$3.23

Service Code	NDC 5026881412
Hospital Charge Code	5026881412
Hospital Revenue Code	250
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$2.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.61
Rate for Payer: Aetna Government	$1.61
Rate for Payer: Brighton Health Commercial	$2.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.20
Rate for Payer: EmblemHealth Commercial	$1.61
Rate for Payer: Group Health Inc Commercial	$1.61
Rate for Payer: Group Health Inc Medicare	$1.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.61
Rate for Payer: Hamaspik Choice Inc Medicare	$1.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.10

ZIPRASIDONE HCL 80 MG PO CAPS

Facility

$3.23

Service Code	NDC 5026881411
Hospital Charge Code	5026881411
Hospital Revenue Code	250
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$1.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.61

ZIPRASIDONE HCL 80 MG PO CAPS

Facility

$3.23

Service Code	NDC 5026881411
Hospital Charge Code	5026881411
Hospital Revenue Code	250
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$2.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.61
Rate for Payer: Aetna Government	$1.61
Rate for Payer: Brighton Health Commercial	$2.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.20
Rate for Payer: EmblemHealth Commercial	$1.61
Rate for Payer: Group Health Inc Commercial	$1.61
Rate for Payer: Group Health Inc Medicare	$1.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.61
Rate for Payer: Hamaspik Choice Inc Medicare	$1.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.10

Know your out-of-pocket cost for care.

All Charges