Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

CHLORHEXIDINE GLUCONATE 0.12 % MT SOLN

Facility

OP

$0.03

Service Code	NDC 0116200116
Hospital Charge Code	0116200116
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.02
Rate for Payer: EmblemHealth Commercial	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.02

CHLORHEXIDINE GLUCONATE 0.12 % MT SOLN

Facility

IP

$0.02

Service Code	NDC 4887806201
Hospital Charge Code	4887806201
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

CHLORHEXIDINE GLUCONATE 0.12 % MT SOLN

Facility

IP

$0.15

Service Code	NDC 0121089340
Hospital Charge Code	0121089340
Hospital Revenue Code	250
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.08

CHLORHEXIDINE GLUCONATE 0.12 % MT SOLN

Facility

OP

$0.15

Service Code	NDC 0121089340
Hospital Charge Code	0121089340
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.08
Rate for Payer: Aetna Government	$0.08
Rate for Payer: Brighton Health Commercial	$0.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: EmblemHealth Commercial	$0.08
Rate for Payer: Group Health Inc Commercial	$0.08
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.08
Rate for Payer: Hamaspik Choice Inc Medicare	$0.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.10

CHLORHEXIDINE GLUCONATE 0.12 % MT SOLN

Facility

IP

$0.13

Service Code	NDC 0904703580
Hospital Charge Code	0904703580
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07

CHLORHEXIDINE GLUCONATE 0.12 % MT SOLN

Facility

IP

$0.15

Service Code	NDC 6933913817
Hospital Charge Code	6933913817
Hospital Revenue Code	250
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.08

CHLORHEXIDINE GLUCONATE 0.12 % MT SOLN

Facility

IP

$0.14

Service Code	NDC 1657112815
Hospital Charge Code	1657112815
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07

CHLORHEXIDINE GLUCONATE 0.12 % MT SOLN

Facility

OP

$0.02

Service Code	NDC 4887806201
Hospital Charge Code	4887806201
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: EmblemHealth Commercial	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

CHLORHEXIDINE GLUCONATE 0.12 % MT SOLN

Facility

IP

$0.14

Service Code	NDC 0904703587
Hospital Charge Code	0904703587
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07

CHLORHEXIDINE GLUCONATE 0.12 % MT SOLN

Facility

IP

$0.15

Service Code	NDC 6933913815
Hospital Charge Code	6933913815
Hospital Revenue Code	250
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.08

CHLORHEXIDINE GLUCONATE 0.12 % MT SOLN

Facility

OP

$0.09

Service Code	NDC 8103351250
Hospital Charge Code	8103351250
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Brighton Health Commercial	$0.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.06
Rate for Payer: EmblemHealth Commercial	$0.04
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.06

CHLORHEXIDINE GLUCONATE 0.12 % MT SOLN

Facility

IP

$0.14

Service Code	NDC 0121089300
Hospital Charge Code	0121089300
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07

CHLORHEXIDINE GLUCONATE 0.12 % MT SOLN

Facility

OP

$0.15

Service Code	NDC 6933913815
Hospital Charge Code	6933913815
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.08
Rate for Payer: Aetna Government	$0.08
Rate for Payer: Brighton Health Commercial	$0.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: EmblemHealth Commercial	$0.08
Rate for Payer: Group Health Inc Commercial	$0.08
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.08
Rate for Payer: Hamaspik Choice Inc Medicare	$0.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.10

CHLORHEXIDINE GLUCONATE 4 % EX SOLN

Facility

OP

$0.07

Service Code	NDC 0234057517
Hospital Charge Code	0234057517
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Brighton Health Commercial	$0.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: EmblemHealth Commercial	$0.04
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.05

CHLORHEXIDINE GLUCONATE 4 % EX SOLN

Facility

IP

$0.07

Service Code	NDC 0234057517
Hospital Charge Code	0234057517
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04

CHLORHEXIDINE GLUCONATE 4 % EX SOLN

Facility

OP

$0.03

Service Code	NDC 0234057504
Hospital Charge Code	0234057504
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

CHLORHEXIDINE GLUCONATE 4 % EX SOLN

Facility

IP

$0.03

Service Code	NDC 0234057504
Hospital Charge Code	0234057504
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

CHLOROPROCAINE HCL (PF) 3 % IJ SOLN

Facility

OP

$1.34

Service Code	HCPCS J2400
Hospital Charge Code	6332347801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$29.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.03
Rate for Payer: Aetna Government	$29.03
Rate for Payer: Brighton Health Commercial	$1.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.91
Rate for Payer: EmblemHealth Commercial	$0.67
Rate for Payer: Group Health Inc Commercial	$0.67
Rate for Payer: Group Health Inc Medicare	$0.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.67
Rate for Payer: Hamaspik Choice Inc Medicare	$0.67
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.87

CHLOROPROCAINE HCL (PF) 3 % IJ SOLN

Facility

OP

$1.34

Service Code	HCPCS J2400
Hospital Charge Code	6332347827
Hospital Revenue Code	250
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$29.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.03
Rate for Payer: Aetna Government	$29.03
Rate for Payer: Brighton Health Commercial	$1.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.91
Rate for Payer: EmblemHealth Commercial	$0.67
Rate for Payer: Group Health Inc Commercial	$0.67
Rate for Payer: Group Health Inc Medicare	$0.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.67
Rate for Payer: Hamaspik Choice Inc Medicare	$0.67
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.87

CHLOROPROCAINE HCL (PF) 3 % IJ SOLN

Facility

IP

$1.34

Service Code	HCPCS J2400
Hospital Charge Code	6332347801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$0.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.67

CHLOROPROCAINE HCL (PF) 3 % IJ SOLN

Facility

IP

$1.34

Service Code	HCPCS J2400
Hospital Charge Code	6332347827
Hospital Revenue Code	250
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$0.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.67

CHLORPHENIRAMINE MALEATE 4 MG PO TABS

Facility

OP

$0.04

Service Code	NDC 0904001259
Hospital Charge Code	0904001259
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	$0.03
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

CHLORPHENIRAMINE MALEATE 4 MG PO TABS

Facility

IP

$0.04

Service Code	NDC 0904001259
Hospital Charge Code	0904001259
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

CHLORPROMAZINE HCL 100 MG PO TABS

Facility

OP

$14.89

Service Code	NDC 0832030300
Hospital Charge Code	0832030300
Hospital Revenue Code	250
Min. Negotiated Rate	$5.21
Max. Negotiated Rate	$11.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.44
Rate for Payer: Aetna Government	$7.44
Rate for Payer: Brighton Health Commercial	$11.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.12
Rate for Payer: EmblemHealth Commercial	$7.44
Rate for Payer: Group Health Inc Commercial	$7.44
Rate for Payer: Group Health Inc Medicare	$5.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.44
Rate for Payer: Hamaspik Choice Inc Medicare	$7.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.68

CHLORPROMAZINE HCL 100 MG PO TABS

Facility

IP

$14.89

Service Code	NDC 0832030300
Hospital Charge Code	0832030300
Hospital Revenue Code	250
Min. Negotiated Rate	$7.44
Max. Negotiated Rate	$7.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.44

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