St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CITALOPRAM HYDROBROMIDE 10 MG PO TABS

Facility

$2.43

Service Code	NDC 0904608461
Hospital Charge Code	0904608461
Hospital Revenue Code	250
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$1.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.21

CITALOPRAM HYDROBROMIDE 10 MG PO TABS

Facility

$2.43

Service Code	NDC 6586200501
Hospital Charge Code	6586200501
Hospital Revenue Code	250
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$1.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.22

CITALOPRAM HYDROBROMIDE 10 MG PO TABS

Facility

$2.43

Service Code	NDC 0904608461
Hospital Charge Code	0904608461
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$1.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.21
Rate for Payer: Aetna Government	$1.21
Rate for Payer: Brighton Health Commercial	$1.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.65
Rate for Payer: EmblemHealth Commercial	$1.21
Rate for Payer: Group Health Inc Commercial	$1.21
Rate for Payer: Group Health Inc Medicare	$0.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.21
Rate for Payer: Hamaspik Choice Inc Medicare	$1.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.58

CITALOPRAM HYDROBROMIDE 10 MG PO TABS

Facility

$2.45

Service Code	NDC 0378623101
Hospital Charge Code	0378623101
Hospital Revenue Code	250
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$1.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.22

CITALOPRAM HYDROBROMIDE 10 MG PO TABS

Facility

$2.58

Service Code	NDC 1366800901
Hospital Charge Code	1366800901
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$2.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.29
Rate for Payer: Aetna Government	$1.29
Rate for Payer: Brighton Health Commercial	$1.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.75
Rate for Payer: EmblemHealth Commercial	$1.29
Rate for Payer: Group Health Inc Commercial	$1.29
Rate for Payer: Group Health Inc Medicare	$0.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.29
Rate for Payer: Hamaspik Choice Inc Medicare	$1.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.68

CITALOPRAM HYDROBROMIDE 20 MG PO TABS

Facility

$2.56

Service Code	NDC 0378623201
Hospital Charge Code	0378623201
Hospital Revenue Code	250
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$1.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.28

CITALOPRAM HYDROBROMIDE 20 MG PO TABS

Facility

$2.69

Service Code	NDC 0904608561
Hospital Charge Code	0904608561
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.35

CITALOPRAM HYDROBROMIDE 20 MG PO TABS

Facility

$2.69

Service Code	NDC 1366801001
Hospital Charge Code	1366801001
Hospital Revenue Code	250
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$2.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.35
Rate for Payer: Aetna Government	$1.35
Rate for Payer: Brighton Health Commercial	$2.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.83
Rate for Payer: EmblemHealth Commercial	$1.35
Rate for Payer: Group Health Inc Commercial	$1.35
Rate for Payer: Group Health Inc Medicare	$0.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.35
Rate for Payer: Hamaspik Choice Inc Medicare	$1.35
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.75

CITALOPRAM HYDROBROMIDE 20 MG PO TABS

Facility

$2.69

Service Code	NDC 0904608561
Hospital Charge Code	0904608561
Hospital Revenue Code	250
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$2.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.35
Rate for Payer: Aetna Government	$1.35
Rate for Payer: Brighton Health Commercial	$2.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.83
Rate for Payer: EmblemHealth Commercial	$1.35
Rate for Payer: Group Health Inc Commercial	$1.35
Rate for Payer: Group Health Inc Medicare	$0.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.35
Rate for Payer: Hamaspik Choice Inc Medicare	$1.35
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.75

CITALOPRAM HYDROBROMIDE 20 MG PO TABS

Facility

$2.56

Service Code	NDC 0378623201
Hospital Charge Code	0378623201
Hospital Revenue Code	250
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$2.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.28
Rate for Payer: Aetna Government	$1.28
Rate for Payer: Brighton Health Commercial	$1.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.74
Rate for Payer: EmblemHealth Commercial	$1.28
Rate for Payer: Group Health Inc Commercial	$1.28
Rate for Payer: Group Health Inc Medicare	$0.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.28
Rate for Payer: Hamaspik Choice Inc Medicare	$1.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.66

CITALOPRAM HYDROBROMIDE 20 MG PO TABS

Facility

$2.69

Service Code	NDC 1366801001
Hospital Charge Code	1366801001
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.35

CITALOPRAM HYDROBROMIDE 40 MG PO TABS

Facility

$2.78

Service Code	NDC 1366801101
Hospital Charge Code	1366801101
Hospital Revenue Code	250
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$1.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.39

CITALOPRAM HYDROBROMIDE 40 MG PO TABS

Facility

$2.66

Service Code	NDC 0378623301
Hospital Charge Code	0378623301
Hospital Revenue Code	250
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$1.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.33

CITALOPRAM HYDROBROMIDE 40 MG PO TABS

Facility

$2.78

Service Code	NDC 1366801101
Hospital Charge Code	1366801101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$2.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.39
Rate for Payer: Aetna Government	$1.39
Rate for Payer: Brighton Health Commercial	$2.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.89
Rate for Payer: EmblemHealth Commercial	$1.39
Rate for Payer: Group Health Inc Commercial	$1.39
Rate for Payer: Group Health Inc Medicare	$0.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.39
Rate for Payer: Hamaspik Choice Inc Medicare	$1.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.81

CITALOPRAM HYDROBROMIDE 40 MG PO TABS

Facility

$2.66

Service Code	NDC 0378623301
Hospital Charge Code	0378623301
Hospital Revenue Code	250
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$2.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.33
Rate for Payer: Aetna Government	$1.33
Rate for Payer: Brighton Health Commercial	$1.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.81
Rate for Payer: EmblemHealth Commercial	$1.33
Rate for Payer: Group Health Inc Commercial	$1.33
Rate for Payer: Group Health Inc Medicare	$0.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.33
Rate for Payer: Hamaspik Choice Inc Medicare	$1.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.73

CLARITHROMYCIN 250 MG PO TABS

Facility

$6.02

Service Code	NDC 0527193106
Hospital Charge Code	0527193106
Hospital Revenue Code	250
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$4.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.01
Rate for Payer: Aetna Government	$3.01
Rate for Payer: Brighton Health Commercial	$4.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.09
Rate for Payer: EmblemHealth Commercial	$3.01
Rate for Payer: Group Health Inc Commercial	$3.01
Rate for Payer: Group Health Inc Medicare	$2.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.01
Rate for Payer: Hamaspik Choice Inc Medicare	$3.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.91

CLARITHROMYCIN 250 MG PO TABS

Facility

$6.02

Service Code	NDC 0527193106
Hospital Charge Code	0527193106
Hospital Revenue Code	250
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$3.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.01

CLARITHROMYCIN 500 MG PO TABS

Facility

$6.02

Service Code	NDC 6586222660
Hospital Charge Code	6586222660
Hospital Revenue Code	250
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$3.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.01

CLARITHROMYCIN 500 MG PO TABS

Facility

$6.02

Service Code	NDC 0781196260
Hospital Charge Code	0781196260
Hospital Revenue Code	250
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$4.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.01
Rate for Payer: Aetna Government	$3.01
Rate for Payer: Brighton Health Commercial	$4.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.09
Rate for Payer: EmblemHealth Commercial	$3.01
Rate for Payer: Group Health Inc Commercial	$3.01
Rate for Payer: Group Health Inc Medicare	$2.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.01
Rate for Payer: Hamaspik Choice Inc Medicare	$3.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.91

CLARITHROMYCIN 500 MG PO TABS

Facility

$4.52

Service Code	NDC 5723704560
Hospital Charge Code	5723704560
Hospital Revenue Code	250
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$3.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.26
Rate for Payer: Aetna Government	$2.26
Rate for Payer: Brighton Health Commercial	$3.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.07
Rate for Payer: EmblemHealth Commercial	$2.26
Rate for Payer: Group Health Inc Commercial	$2.26
Rate for Payer: Group Health Inc Medicare	$1.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.26
Rate for Payer: Hamaspik Choice Inc Medicare	$2.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.94

CLARITHROMYCIN 500 MG PO TABS

Facility

$6.02

Service Code	NDC 0527193206
Hospital Charge Code	0527193206
Hospital Revenue Code	250
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$3.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.01

CLARITHROMYCIN 500 MG PO TABS

Facility

$6.02

Service Code	NDC 0781196260
Hospital Charge Code	0781196260
Hospital Revenue Code	250
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$3.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.01

CLARITHROMYCIN 500 MG PO TABS

Facility

$4.52

Service Code	NDC 5723704560
Hospital Charge Code	5723704560
Hospital Revenue Code	250
Min. Negotiated Rate	$2.26
Max. Negotiated Rate	$2.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.26

CLARITHROMYCIN 500 MG PO TABS

Facility

$6.02

Service Code	NDC 6586222660
Hospital Charge Code	6586222660
Hospital Revenue Code	250
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$4.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.01
Rate for Payer: Aetna Government	$3.01
Rate for Payer: Brighton Health Commercial	$4.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.09
Rate for Payer: EmblemHealth Commercial	$3.01
Rate for Payer: Group Health Inc Commercial	$3.01
Rate for Payer: Group Health Inc Medicare	$2.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.01
Rate for Payer: Hamaspik Choice Inc Medicare	$3.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.91

CLARITHROMYCIN 500 MG PO TABS

Facility

$6.02

Service Code	NDC 0527193206
Hospital Charge Code	0527193206
Hospital Revenue Code	250
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$4.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.01
Rate for Payer: Aetna Government	$3.01
Rate for Payer: Brighton Health Commercial	$4.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.09
Rate for Payer: EmblemHealth Commercial	$3.01
Rate for Payer: Group Health Inc Commercial	$3.01
Rate for Payer: Group Health Inc Medicare	$2.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.01
Rate for Payer: Hamaspik Choice Inc Medicare	$3.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.91

Know your out-of-pocket cost for care.

All Charges