St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

Cholecystectomy except laparoscopic

Facility

$138,484.12

Service Code	APR-DRG 2624
Min. Negotiated Rate	$54,072.00
Max. Negotiated Rate	$138,484.12
Rate for Payer: Affinity Essential Plan 1&2	$138,484.12
Rate for Payer: Affinity Essential Plan 3&4	$138,484.12
Rate for Payer: Affinity Medicaid/CHP/HARP	$61,548.50
Rate for Payer: Amida Care Medicaid	$61,548.50
Rate for Payer: EmblemHealth Essential Plan 1&2	$138,484.12
Rate for Payer: EmblemHealth Essential Plan 3&4	$61,548.50
Rate for Payer: Fidelis CHP/HARP/Medicaid	$61,548.50
Rate for Payer: Fidelis Qualified Health Plan	$73,858.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$61,548.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$61,548.50
Rate for Payer: Healthfirst Commercial	$87,198.00
Rate for Payer: Healthfirst Essential Plan	$138,484.12
Rate for Payer: Healthfirst QHP	$54,072.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$61,548.50
Rate for Payer: SOMOS Essential	$138,484.12
Rate for Payer: United Healthcare Essential Plan 1&2	$138,484.12
Rate for Payer: United Healthcare Essential Plan 3&4	$138,484.12
Rate for Payer: United Healthcare Medicaid	$61,548.50
Rate for Payer: Wellcare CHP/FHP/Medicaid	$61,548.50

Cholecystectomy except laparoscopic

Facility

$60,253.33

Service Code	APR-DRG 2622
Min. Negotiated Rate	$18,640.00
Max. Negotiated Rate	$60,253.33
Rate for Payer: Affinity Essential Plan 1&2	$60,253.33
Rate for Payer: Affinity Essential Plan 3&4	$60,253.33
Rate for Payer: Affinity Medicaid/CHP/HARP	$26,779.26
Rate for Payer: Amida Care Medicaid	$26,779.26
Rate for Payer: EmblemHealth Essential Plan 1&2	$60,253.33
Rate for Payer: EmblemHealth Essential Plan 3&4	$26,779.26
Rate for Payer: Fidelis CHP/HARP/Medicaid	$26,779.26
Rate for Payer: Fidelis Qualified Health Plan	$32,135.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$26,779.26
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$26,779.26
Rate for Payer: Healthfirst Commercial	$31,618.00
Rate for Payer: Healthfirst Essential Plan	$60,253.33
Rate for Payer: Healthfirst QHP	$18,640.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$26,779.26
Rate for Payer: SOMOS Essential	$60,253.33
Rate for Payer: United Healthcare Essential Plan 1&2	$60,253.33
Rate for Payer: United Healthcare Essential Plan 3&4	$60,253.33
Rate for Payer: United Healthcare Medicaid	$26,779.26
Rate for Payer: Wellcare CHP/FHP/Medicaid	$26,779.26

CHOLECYSTITIS

Facility

$200.07

Service Code	EAPG 00638
Min. Negotiated Rate	$145.80
Max. Negotiated Rate	$200.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$145.80
Rate for Payer: Healthfirst Commercial	$200.07

CHOLESTYRAMINE 4 GM/DOSE PO POWD

Facility

$0.35

Service Code	NDC 4988446566
Hospital Charge Code	4988446566
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.28
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	$0.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.24
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	$0.23

CHOLESTYRAMINE 4 GM/DOSE PO POWD

Facility

$0.35

Service Code	NDC 4988446566
Hospital Charge Code	4988446566
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.17

CHOLESTYRAMINE 4 GM/DOSE PO POWD

Facility

$0.35

Service Code	NDC 6838252842
Hospital Charge Code	6838252842
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.17

CHOLESTYRAMINE 4 GM/DOSE PO POWD

Facility

$0.35

Service Code	NDC 6838252842
Hospital Charge Code	6838252842
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.28
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	$0.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.24
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	$0.23

CHOLESTYRAMINE 4 G PO PACK

Facility

$3.37

Service Code	NDC 6838252860
Hospital Charge Code	6838252860
Hospital Revenue Code	250
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$2.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.68
Rate for Payer: Aetna Government	$1.68
Rate for Payer: Brighton Health Commercial	$2.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.29
Rate for Payer: EmblemHealth Commercial	$1.68
Rate for Payer: Group Health Inc Commercial	$1.68
Rate for Payer: Group Health Inc Medicare	$1.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.68
Rate for Payer: Hamaspik Choice Inc Medicare	$1.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.19

CHOLESTYRAMINE 4 G PO PACK

Facility

$3.37

Service Code	NDC 6838252860
Hospital Charge Code	6838252860
Hospital Revenue Code	250
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$1.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.68

CHOLESTYRAMINE LIGHT 4 G PO PACK

Facility

$3.35

Service Code	NDC 5122400920
Hospital Charge Code	5122400920
Hospital Revenue Code	250
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$1.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.68

CHOLESTYRAMINE LIGHT 4 G PO PACK

Facility

$3.35

Service Code	NDC 5122400920
Hospital Charge Code	5122400920
Hospital Revenue Code	250
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$2.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.68
Rate for Payer: Aetna Government	$1.68
Rate for Payer: Brighton Health Commercial	$2.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.28
Rate for Payer: EmblemHealth Commercial	$1.68
Rate for Payer: Group Health Inc Commercial	$1.68
Rate for Payer: Group Health Inc Medicare	$1.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.68
Rate for Payer: Hamaspik Choice Inc Medicare	$1.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.18

CHROMIC CHLORIDE 40 MCG/10ML IV SOLN

Facility

$2.38

Service Code	NDC 0409409301
Hospital Charge Code	0409409301
Hospital Revenue Code	258
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$1.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.19
Rate for Payer: Aetna Government	$1.19
Rate for Payer: Brighton Health Commercial	$1.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.62
Rate for Payer: EmblemHealth Commercial	$1.19
Rate for Payer: Group Health Inc Commercial	$1.19
Rate for Payer: Group Health Inc Medicare	$0.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.19
Rate for Payer: Hamaspik Choice Inc Medicare	$1.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.55

CHROMIC CHLORIDE 40 MCG/10ML IV SOLN

Facility

$2.38

Service Code	NDC 0409409301
Hospital Charge Code	0409409301
Hospital Revenue Code	258
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.19

Chronic Kidney Disease #

Facility

$40,435.79

Service Code	APR-DRG 4701
Min. Negotiated Rate	$17,971.46
Max. Negotiated Rate	$40,435.79
Rate for Payer: Affinity Essential Plan 1&2	$40,435.79
Rate for Payer: Affinity Essential Plan 3&4	$40,435.79
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,971.46
Rate for Payer: Amida Care Medicaid	$17,971.46
Rate for Payer: EmblemHealth Essential Plan 1&2	$40,435.79
Rate for Payer: EmblemHealth Essential Plan 3&4	$17,971.46
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,971.46
Rate for Payer: Fidelis Qualified Health Plan	$21,565.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,971.46
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,971.46
Rate for Payer: Healthfirst Essential Plan	$40,435.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,971.46
Rate for Payer: SOMOS Essential	$40,435.79
Rate for Payer: United Healthcare Essential Plan 1&2	$40,435.79
Rate for Payer: United Healthcare Essential Plan 3&4	$40,435.79
Rate for Payer: United Healthcare Medicaid	$17,971.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,971.46

Chronic Kidney Disease #

Facility

$78,732.49

Service Code	APR-DRG 4704
Min. Negotiated Rate	$34,992.22
Max. Negotiated Rate	$78,732.49
Rate for Payer: Affinity Essential Plan 1&2	$78,732.49
Rate for Payer: Affinity Essential Plan 3&4	$78,732.49
Rate for Payer: Affinity Medicaid/CHP/HARP	$34,992.22
Rate for Payer: Amida Care Medicaid	$34,992.22
Rate for Payer: EmblemHealth Essential Plan 1&2	$78,732.49
Rate for Payer: EmblemHealth Essential Plan 3&4	$34,992.22
Rate for Payer: Fidelis CHP/HARP/Medicaid	$34,992.22
Rate for Payer: Fidelis Qualified Health Plan	$41,990.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$34,992.22
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34,992.22
Rate for Payer: Healthfirst Essential Plan	$78,732.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$34,992.22
Rate for Payer: SOMOS Essential	$78,732.49
Rate for Payer: United Healthcare Essential Plan 1&2	$78,732.49
Rate for Payer: United Healthcare Essential Plan 3&4	$78,732.49
Rate for Payer: United Healthcare Medicaid	$34,992.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34,992.22

Chronic Kidney Disease #

Facility

$52,982.68

Service Code	APR-DRG 4703
Min. Negotiated Rate	$23,547.86
Max. Negotiated Rate	$52,982.68
Rate for Payer: Affinity Essential Plan 1&2	$52,982.68
Rate for Payer: Affinity Essential Plan 3&4	$52,982.68
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,547.86
Rate for Payer: Amida Care Medicaid	$23,547.86
Rate for Payer: EmblemHealth Essential Plan 1&2	$52,982.68
Rate for Payer: EmblemHealth Essential Plan 3&4	$23,547.86
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,547.86
Rate for Payer: Fidelis Qualified Health Plan	$28,257.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,547.86
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,547.86
Rate for Payer: Healthfirst Essential Plan	$52,982.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,547.86
Rate for Payer: SOMOS Essential	$52,982.68
Rate for Payer: United Healthcare Essential Plan 1&2	$52,982.68
Rate for Payer: United Healthcare Essential Plan 3&4	$52,982.68
Rate for Payer: United Healthcare Medicaid	$23,547.86
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,547.86

Chronic Kidney Disease #

Facility

$44,034.19

Service Code	APR-DRG 4702
Min. Negotiated Rate	$19,570.75
Max. Negotiated Rate	$44,034.19
Rate for Payer: Affinity Essential Plan 1&2	$44,034.19
Rate for Payer: Affinity Essential Plan 3&4	$44,034.19
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,570.75
Rate for Payer: Amida Care Medicaid	$19,570.75
Rate for Payer: EmblemHealth Essential Plan 1&2	$44,034.19
Rate for Payer: EmblemHealth Essential Plan 3&4	$19,570.75
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,570.75
Rate for Payer: Fidelis Qualified Health Plan	$23,484.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,570.75
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,570.75
Rate for Payer: Healthfirst Essential Plan	$44,034.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,570.75
Rate for Payer: SOMOS Essential	$44,034.19
Rate for Payer: United Healthcare Essential Plan 1&2	$44,034.19
Rate for Payer: United Healthcare Essential Plan 3&4	$44,034.19
Rate for Payer: United Healthcare Medicaid	$19,570.75
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,570.75

Chronic obstructive pulmonary disease

Facility

$42,131.23

Service Code	APR-DRG 1401
Min. Negotiated Rate	$6,814.00
Max. Negotiated Rate	$42,131.23
Rate for Payer: Affinity Essential Plan 1&2	$42,131.23
Rate for Payer: Affinity Essential Plan 3&4	$42,131.23
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,724.99
Rate for Payer: Amida Care Medicaid	$18,724.99
Rate for Payer: EmblemHealth Essential Plan 1&2	$42,131.23
Rate for Payer: EmblemHealth Essential Plan 3&4	$18,724.99
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,724.99
Rate for Payer: Fidelis Qualified Health Plan	$22,469.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,724.99
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,724.99
Rate for Payer: Healthfirst Commercial	$11,301.00
Rate for Payer: Healthfirst Essential Plan	$42,131.23
Rate for Payer: Healthfirst QHP	$6,814.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,724.99
Rate for Payer: SOMOS Essential	$42,131.23
Rate for Payer: United Healthcare Essential Plan 1&2	$42,131.23
Rate for Payer: United Healthcare Essential Plan 3&4	$42,131.23
Rate for Payer: United Healthcare Medicaid	$18,724.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,724.99

Chronic obstructive pulmonary disease

Facility

$44,714.81

Service Code	APR-DRG 1402
Min. Negotiated Rate	$8,324.00
Max. Negotiated Rate	$44,714.81
Rate for Payer: Affinity Essential Plan 1&2	$44,714.81
Rate for Payer: Affinity Essential Plan 3&4	$44,714.81
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,873.25
Rate for Payer: Amida Care Medicaid	$19,873.25
Rate for Payer: EmblemHealth Essential Plan 1&2	$44,714.81
Rate for Payer: EmblemHealth Essential Plan 3&4	$19,873.25
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,873.25
Rate for Payer: Fidelis Qualified Health Plan	$23,847.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,873.25
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,873.25
Rate for Payer: Healthfirst Commercial	$13,738.00
Rate for Payer: Healthfirst Essential Plan	$44,714.81
Rate for Payer: Healthfirst QHP	$8,324.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,873.25
Rate for Payer: SOMOS Essential	$44,714.81
Rate for Payer: United Healthcare Essential Plan 1&2	$44,714.81
Rate for Payer: United Healthcare Essential Plan 3&4	$44,714.81
Rate for Payer: United Healthcare Medicaid	$19,873.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,873.25

Chronic obstructive pulmonary disease

Facility

$49,820.44

Service Code	APR-DRG 1403
Min. Negotiated Rate	$11,045.00
Max. Negotiated Rate	$49,820.44
Rate for Payer: Affinity Essential Plan 1&2	$49,820.44
Rate for Payer: Affinity Essential Plan 3&4	$49,820.44
Rate for Payer: Affinity Medicaid/CHP/HARP	$22,142.42
Rate for Payer: Amida Care Medicaid	$22,142.42
Rate for Payer: EmblemHealth Essential Plan 1&2	$49,820.44
Rate for Payer: EmblemHealth Essential Plan 3&4	$22,142.42
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,142.42
Rate for Payer: Fidelis Qualified Health Plan	$26,570.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,142.42
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,142.42
Rate for Payer: Healthfirst Commercial	$18,891.00
Rate for Payer: Healthfirst Essential Plan	$49,820.44
Rate for Payer: Healthfirst QHP	$11,045.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,142.42
Rate for Payer: SOMOS Essential	$49,820.44
Rate for Payer: United Healthcare Essential Plan 1&2	$49,820.44
Rate for Payer: United Healthcare Essential Plan 3&4	$49,820.44
Rate for Payer: United Healthcare Medicaid	$22,142.42
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,142.42

Chronic obstructive pulmonary disease

Facility

$66,671.01

Service Code	APR-DRG 1404
Min. Negotiated Rate	$20,067.00
Max. Negotiated Rate	$66,671.01
Rate for Payer: Affinity Essential Plan 1&2	$66,671.01
Rate for Payer: Affinity Essential Plan 3&4	$66,671.01
Rate for Payer: Affinity Medicaid/CHP/HARP	$29,631.56
Rate for Payer: Amida Care Medicaid	$29,631.56
Rate for Payer: EmblemHealth Essential Plan 1&2	$66,671.01
Rate for Payer: EmblemHealth Essential Plan 3&4	$29,631.56
Rate for Payer: Fidelis CHP/HARP/Medicaid	$29,631.56
Rate for Payer: Fidelis Qualified Health Plan	$35,557.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$29,631.56
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$29,631.56
Rate for Payer: Healthfirst Commercial	$35,384.00
Rate for Payer: Healthfirst Essential Plan	$66,671.01
Rate for Payer: Healthfirst QHP	$20,067.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$29,631.56
Rate for Payer: SOMOS Essential	$66,671.01
Rate for Payer: United Healthcare Essential Plan 1&2	$66,671.01
Rate for Payer: United Healthcare Essential Plan 3&4	$66,671.01
Rate for Payer: United Healthcare Medicaid	$29,631.56
Rate for Payer: Wellcare CHP/FHP/Medicaid	$29,631.56

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Facility

$211.41

Service Code	EAPG 00574
Min. Negotiated Rate	$152.74
Max. Negotiated Rate	$211.41
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$152.74
Rate for Payer: Healthfirst Commercial	$211.41

CILOSTAZOL 100 MG PO TABS

Facility

$2.25

Service Code	NDC 5026817715
Hospital Charge Code	5026817715
Hospital Revenue Code	250
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$1.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.12

CILOSTAZOL 100 MG PO TABS

Facility

$2.25

Service Code	NDC 5026817715
Hospital Charge Code	5026817715
Hospital Revenue Code	250
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$1.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.12
Rate for Payer: Aetna Government	$1.12
Rate for Payer: Brighton Health Commercial	$1.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.53
Rate for Payer: EmblemHealth Commercial	$1.12
Rate for Payer: Group Health Inc Commercial	$1.12
Rate for Payer: Group Health Inc Medicare	$0.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.46

CINACALCET HCL 30 MG PO TABS

Facility

$30.66

Service Code	NDC 4359836730
Hospital Charge Code	4359836730
Hospital Revenue Code	250
Min. Negotiated Rate	$15.33
Max. Negotiated Rate	$15.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.33

Know your out-of-pocket cost for care.

All Charges