Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

CHLORPROMAZINE HCL 50 MG/2ML IJ SOLN

Facility

IP

$12.60

Service Code	HCPCS J3230
Hospital Charge Code	6679425002
Hospital Revenue Code	250
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.30

CHLORPROMAZINE HCL 50 MG/2ML IJ SOLN

Facility

OP

$12.60

Service Code	HCPCS J3230
Hospital Charge Code	6679425002
Hospital Revenue Code	250
Min. Negotiated Rate	$4.41
Max. Negotiated Rate	$32.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.87
Rate for Payer: Aetna Government	$32.87
Rate for Payer: Brighton Health Commercial	$9.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.57
Rate for Payer: EmblemHealth Commercial	$6.30
Rate for Payer: Group Health Inc Commercial	$6.30
Rate for Payer: Group Health Inc Medicare	$4.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.30
Rate for Payer: Hamaspik Choice Inc Medicare	$6.30
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.19

CHLORPROMAZINE HCL 50 MG PO TABS

Facility

OP

$9.46

Service Code	NDC 0904713161
Hospital Charge Code	0904713161
Hospital Revenue Code	250
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$7.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.73
Rate for Payer: Aetna Government	$4.73
Rate for Payer: Brighton Health Commercial	$7.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.57
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.43
Rate for Payer: EmblemHealth Commercial	$4.73
Rate for Payer: Group Health Inc Commercial	$4.73
Rate for Payer: Group Health Inc Medicare	$3.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.73
Rate for Payer: Hamaspik Choice Inc Medicare	$4.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.15

CHLORPROMAZINE HCL 50 MG PO TABS

Facility

IP

$15.04

Service Code	NDC 0832030201
Hospital Charge Code	0832030201
Hospital Revenue Code	250
Min. Negotiated Rate	$7.52
Max. Negotiated Rate	$7.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.52

CHLORPROMAZINE HCL 50 MG PO TABS

Facility

OP

$15.04

Service Code	NDC 0832030201
Hospital Charge Code	0832030201
Hospital Revenue Code	250
Min. Negotiated Rate	$5.27
Max. Negotiated Rate	$12.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.52
Rate for Payer: Aetna Government	$7.52
Rate for Payer: Brighton Health Commercial	$11.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.23
Rate for Payer: EmblemHealth Commercial	$7.52
Rate for Payer: Group Health Inc Commercial	$7.52
Rate for Payer: Group Health Inc Medicare	$5.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.52
Rate for Payer: Hamaspik Choice Inc Medicare	$7.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.78

CHLORPROMAZINE HCL 50 MG PO TABS

Facility

IP

$10.83

Service Code	NDC 5026816411
Hospital Charge Code	5026816411
Hospital Revenue Code	250
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$5.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.42

CHLORPROMAZINE HCL 50 MG PO TABS

Facility

OP

$10.38

Service Code	NDC 0832601900
Hospital Charge Code	0832601900
Hospital Revenue Code	250
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$8.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.19
Rate for Payer: Aetna Government	$5.19
Rate for Payer: Brighton Health Commercial	$7.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.05
Rate for Payer: EmblemHealth Commercial	$5.19
Rate for Payer: Group Health Inc Commercial	$5.19
Rate for Payer: Group Health Inc Medicare	$3.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.19
Rate for Payer: Hamaspik Choice Inc Medicare	$5.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.74

CHLORPROMAZINE HCL 50 MG PO TABS

Facility

IP

$10.38

Service Code	NDC 0832030200
Hospital Charge Code	0832030200
Hospital Revenue Code	250
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$5.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.19

CHLORPROMAZINE HCL 50 MG PO TABS

Facility

IP

$10.38

Service Code	NDC 0832601900
Hospital Charge Code	0832601900
Hospital Revenue Code	250
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$5.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.19

CHLORPROMAZINE HCL 50 MG PO TABS

Facility

IP

$15.04

Service Code	NDC 0832601901
Hospital Charge Code	0832601901
Hospital Revenue Code	250
Min. Negotiated Rate	$7.52
Max. Negotiated Rate	$7.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.52

CHLORPROMAZINE HCL 50 MG PO TABS

Facility

OP

$10.38

Service Code	NDC 0832030200
Hospital Charge Code	0832030200
Hospital Revenue Code	250
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$8.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.19
Rate for Payer: Aetna Government	$5.19
Rate for Payer: Brighton Health Commercial	$7.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.05
Rate for Payer: EmblemHealth Commercial	$5.19
Rate for Payer: Group Health Inc Commercial	$5.19
Rate for Payer: Group Health Inc Medicare	$3.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.19
Rate for Payer: Hamaspik Choice Inc Medicare	$5.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.74

CHLORPROMAZINE HCL 50 MG PO TABS

Facility

IP

$9.46

Service Code	NDC 0904713161
Hospital Charge Code	0904713161
Hospital Revenue Code	250
Min. Negotiated Rate	$4.73
Max. Negotiated Rate	$4.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.73

CHLORPROMAZINE HCL 50 MG PO TABS

Facility

OP

$15.04

Service Code	NDC 0832601901
Hospital Charge Code	0832601901
Hospital Revenue Code	250
Min. Negotiated Rate	$5.27
Max. Negotiated Rate	$12.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.52
Rate for Payer: Aetna Government	$7.52
Rate for Payer: Brighton Health Commercial	$11.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.23
Rate for Payer: EmblemHealth Commercial	$7.52
Rate for Payer: Group Health Inc Commercial	$7.52
Rate for Payer: Group Health Inc Medicare	$5.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.52
Rate for Payer: Hamaspik Choice Inc Medicare	$7.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.78

CHLORPROMAZINE HCL 50 MG PO TABS

Facility

OP

$10.83

Service Code	NDC 5026816411
Hospital Charge Code	5026816411
Hospital Revenue Code	250
Min. Negotiated Rate	$3.79
Max. Negotiated Rate	$8.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.42
Rate for Payer: Aetna Government	$5.42
Rate for Payer: Brighton Health Commercial	$8.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.36
Rate for Payer: EmblemHealth Commercial	$5.42
Rate for Payer: Group Health Inc Commercial	$5.42
Rate for Payer: Group Health Inc Medicare	$3.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.42
Rate for Payer: Hamaspik Choice Inc Medicare	$5.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.04

CHLORTHALIDONE 25 MG PO TABS

Facility

IP

$2.62

Service Code	NDC 0904690061
Hospital Charge Code	0904690061
Hospital Revenue Code	250
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$1.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.31

CHLORTHALIDONE 25 MG PO TABS

Facility

IP

$2.30

Service Code	NDC 5107905801
Hospital Charge Code	5107905801
Hospital Revenue Code	250
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$1.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.15

CHLORTHALIDONE 25 MG PO TABS

Facility

OP

$2.30

Service Code	NDC 5107905801
Hospital Charge Code	5107905801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$1.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.15
Rate for Payer: Aetna Government	$1.15
Rate for Payer: Brighton Health Commercial	$1.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.56
Rate for Payer: EmblemHealth Commercial	$1.15
Rate for Payer: Group Health Inc Commercial	$1.15
Rate for Payer: Group Health Inc Medicare	$0.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.15
Rate for Payer: Hamaspik Choice Inc Medicare	$1.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.50

CHLORTHALIDONE 25 MG PO TABS

Facility

OP

$2.62

Service Code	NDC 0904690061
Hospital Charge Code	0904690061
Hospital Revenue Code	250
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$2.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.31
Rate for Payer: Aetna Government	$1.31
Rate for Payer: Brighton Health Commercial	$1.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.78
Rate for Payer: EmblemHealth Commercial	$1.31
Rate for Payer: Group Health Inc Commercial	$1.31
Rate for Payer: Group Health Inc Medicare	$0.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.31
Rate for Payer: Hamaspik Choice Inc Medicare	$1.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.70

CHOLECALCIFEROL 10 MCG (400 UNIT) PO TABS

Facility

IP

$0.03

Service Code	NDC 0761005820
Hospital Charge Code	0761005820
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

CHOLECALCIFEROL 10 MCG (400 UNIT) PO TABS

Facility

OP

$0.03

Service Code	NDC 0761005820
Hospital Charge Code	0761005820
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.02
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	$0.02
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

CHOLECALCIFEROL 25 MCG (1000 UT) PO TBDP

Facility

IP

$0.11

Service Code	NDC 3160402877
Hospital Charge Code	3160402877
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05

CHOLECALCIFEROL 25 MCG (1000 UT) PO TBDP

Facility

OP

$0.11

Service Code	NDC 3160402877
Hospital Charge Code	3160402877
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.09
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	$0.09
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

CHOLECYSTECTOMY AND RELATED BILIARY PROCEDURES

Facility

OP

$3,404.34

Service Code	EAPG 00107
Min. Negotiated Rate	$3,404.34
Max. Negotiated Rate	$3,404.34
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3,404.34

Cholecystectomy except laparoscopic

Facility

IP

$55,121.31

Service Code	APR-DRG 2621
Min. Negotiated Rate	$15,053.00
Max. Negotiated Rate	$55,121.31
Rate for Payer: Affinity Essential Plan 1&2	$55,121.31
Rate for Payer: Affinity Essential Plan 3&4	$55,121.31
Rate for Payer: Affinity Medicaid/CHP/HARP	$24,498.36
Rate for Payer: Amida Care Medicaid	$24,498.36
Rate for Payer: EmblemHealth Essential Plan 1&2	$55,121.31
Rate for Payer: EmblemHealth Essential Plan 3&4	$24,498.36
Rate for Payer: Fidelis CHP/HARP/Medicaid	$24,498.36
Rate for Payer: Fidelis Qualified Health Plan	$29,398.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$24,498.36
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$24,498.36
Rate for Payer: Healthfirst Commercial	$25,071.00
Rate for Payer: Healthfirst Essential Plan	$55,121.31
Rate for Payer: Healthfirst QHP	$15,053.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24,498.36
Rate for Payer: SOMOS Essential	$55,121.31
Rate for Payer: United Healthcare Essential Plan 1&2	$55,121.31
Rate for Payer: United Healthcare Essential Plan 3&4	$55,121.31
Rate for Payer: United Healthcare Medicaid	$24,498.36
Rate for Payer: Wellcare CHP/FHP/Medicaid	$24,498.36

Cholecystectomy except laparoscopic

Facility

IP

$80,153.55

Service Code	APR-DRG 2623
Min. Negotiated Rate	$28,410.00
Max. Negotiated Rate	$80,153.55
Rate for Payer: Affinity Essential Plan 1&2	$80,153.55
Rate for Payer: Affinity Essential Plan 3&4	$80,153.55
Rate for Payer: Affinity Medicaid/CHP/HARP	$35,623.80
Rate for Payer: Amida Care Medicaid	$35,623.80
Rate for Payer: EmblemHealth Essential Plan 1&2	$80,153.55
Rate for Payer: EmblemHealth Essential Plan 3&4	$35,623.80
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35,623.80
Rate for Payer: Fidelis Qualified Health Plan	$42,748.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$35,623.80
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35,623.80
Rate for Payer: Healthfirst Commercial	$45,651.00
Rate for Payer: Healthfirst Essential Plan	$80,153.55
Rate for Payer: Healthfirst QHP	$28,410.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35,623.80
Rate for Payer: SOMOS Essential	$80,153.55
Rate for Payer: United Healthcare Essential Plan 1&2	$80,153.55
Rate for Payer: United Healthcare Essential Plan 3&4	$80,153.55
Rate for Payer: United Healthcare Medicaid	$35,623.80
Rate for Payer: Wellcare CHP/FHP/Medicaid	$35,623.80

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