St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

RELOAD,LINEAR CUTR,BLU,75MM 75ST

Facility

$193.18

Hospital Charge Code	64902897
Hospital Revenue Code	270
Min. Negotiated Rate	$67.61
Max. Negotiated Rate	$154.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$106.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$96.59
Rate for Payer: Aetna Government	$96.59
Rate for Payer: Brighton Health Commercial	$144.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$154.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$131.36
Rate for Payer: Group Health Inc Commercial	$96.59
Rate for Payer: Group Health Inc Medicare	$67.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$96.59
Rate for Payer: Hamaspik Choice Inc Medicare	$96.59

RELOADS CONTOUR A

Facility

$632.76

Hospital Charge Code	64905451
Hospital Revenue Code	270
Min. Negotiated Rate	$221.47
Max. Negotiated Rate	$506.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$348.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$316.38
Rate for Payer: Aetna Government	$316.38
Rate for Payer: Brighton Health Commercial	$474.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$506.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$430.28
Rate for Payer: Group Health Inc Commercial	$316.38
Rate for Payer: Group Health Inc Medicare	$221.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$316.38
Rate for Payer: Hamaspik Choice Inc Medicare	$316.38

RELOADS CONTOUR B

Facility

$632.76

Hospital Charge Code	64905453
Hospital Revenue Code	270
Min. Negotiated Rate	$221.47
Max. Negotiated Rate	$506.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$348.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$316.38
Rate for Payer: Aetna Government	$316.38
Rate for Payer: Brighton Health Commercial	$474.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$506.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$430.28
Rate for Payer: Group Health Inc Commercial	$316.38
Rate for Payer: Group Health Inc Medicare	$221.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$316.38
Rate for Payer: Hamaspik Choice Inc Medicare	$316.38

RELOAD STAPLER 60MM ECHELON

Facility

$825.18

Hospital Charge Code	64904760
Hospital Revenue Code	270
Min. Negotiated Rate	$288.81
Max. Negotiated Rate	$660.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$453.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$412.59
Rate for Payer: Aetna Government	$412.59
Rate for Payer: Brighton Health Commercial	$618.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$660.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$561.12
Rate for Payer: Group Health Inc Commercial	$412.59
Rate for Payer: Group Health Inc Medicare	$288.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$412.59
Rate for Payer: Hamaspik Choice Inc Medicare	$412.59

RELOAD STAPLER 60MM ECHELON

Facility

$660.14

Hospital Charge Code	40205090
Hospital Revenue Code	279
Min. Negotiated Rate	$231.05
Max. Negotiated Rate	$528.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$363.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$330.07
Rate for Payer: Aetna Government	$330.07
Rate for Payer: Brighton Health Commercial	$495.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$528.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$448.90
Rate for Payer: Group Health Inc Commercial	$330.07
Rate for Payer: Group Health Inc Medicare	$231.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$330.07
Rate for Payer: Hamaspik Choice Inc Medicare	$330.07

RELOAD STAPLER C

Facility

$97.93

Hospital Charge Code	64907058
Hospital Revenue Code	270
Min. Negotiated Rate	$34.28
Max. Negotiated Rate	$78.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$53.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$48.96
Rate for Payer: Aetna Government	$48.96
Rate for Payer: Brighton Health Commercial	$73.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$78.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$66.59
Rate for Payer: Group Health Inc Commercial	$48.96
Rate for Payer: Group Health Inc Medicare	$34.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$48.96
Rate for Payer: Hamaspik Choice Inc Medicare	$48.96

RELOAD STAPLER GIA C

Facility

$166.10

Hospital Charge Code	64907041
Hospital Revenue Code	270
Min. Negotiated Rate	$58.14
Max. Negotiated Rate	$132.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$91.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$83.05
Rate for Payer: Aetna Government	$83.05
Rate for Payer: Brighton Health Commercial	$124.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$132.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.95
Rate for Payer: Group Health Inc Commercial	$83.05
Rate for Payer: Group Health Inc Medicare	$58.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$83.05
Rate for Payer: Hamaspik Choice Inc Medicare	$83.05

RELOAD STAPLER TA C

Facility

$87.00

Hospital Charge Code	64907069
Hospital Revenue Code	270
Min. Negotiated Rate	$30.45
Max. Negotiated Rate	$69.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$47.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$43.50
Rate for Payer: Aetna Government	$43.50
Rate for Payer: Brighton Health Commercial	$65.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$69.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.16
Rate for Payer: Group Health Inc Commercial	$43.50
Rate for Payer: Group Health Inc Medicare	$30.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.50
Rate for Payer: Hamaspik Choice Inc Medicare	$43.50

RELOAD TRI 2.0 60MM XTCK(SIG60AXT

Facility

$1,188.66

Hospital Charge Code	64906570
Hospital Revenue Code	279
Min. Negotiated Rate	$416.03
Max. Negotiated Rate	$950.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$653.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$594.33
Rate for Payer: Aetna Government	$594.33
Rate for Payer: Brighton Health Commercial	$891.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$950.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$808.29
Rate for Payer: Group Health Inc Commercial	$594.33
Rate for Payer: Group Health Inc Medicare	$416.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$594.33
Rate for Payer: Hamaspik Choice Inc Medicare	$594.33

RELOAD TRI-STAPLE 2.0 (TRSB60AMT)

Facility

$1,701.72

Hospital Charge Code	64906573
Hospital Revenue Code	279
Min. Negotiated Rate	$595.60
Max. Negotiated Rate	$1,361.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$935.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$850.86
Rate for Payer: Aetna Government	$850.86
Rate for Payer: Brighton Health Commercial	$1,276.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,361.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,157.17
Rate for Payer: Group Health Inc Commercial	$850.86
Rate for Payer: Group Health Inc Medicare	$595.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$850.86
Rate for Payer: Hamaspik Choice Inc Medicare	$850.86

RELOAD TRI-STAPLER 2.0 XT THICK

Facility

$1,786.80

Hospital Charge Code	40004200
Hospital Revenue Code	272
Min. Negotiated Rate	$625.38
Max. Negotiated Rate	$1,429.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$982.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$893.40
Rate for Payer: Aetna Government	$893.40
Rate for Payer: Brighton Health Commercial	$1,340.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,429.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,215.02
Rate for Payer: Group Health Inc Commercial	$893.40
Rate for Payer: Group Health Inc Medicare	$625.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$893.40
Rate for Payer: Hamaspik Choice Inc Medicare	$893.40

RELOAD UNIT 60MM

Facility

$1,442.75

Hospital Charge Code	64905139
Hospital Revenue Code	270
Min. Negotiated Rate	$504.96
Max. Negotiated Rate	$1,154.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$793.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$721.38
Rate for Payer: Aetna Government	$721.38
Rate for Payer: Brighton Health Commercial	$1,082.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,154.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$981.07
Rate for Payer: Group Health Inc Commercial	$721.38
Rate for Payer: Group Health Inc Medicare	$504.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$721.38
Rate for Payer: Hamaspik Choice Inc Medicare	$721.38

RELOAD WHITE

Facility

$360.46

Hospital Charge Code	64905146
Hospital Revenue Code	270
Min. Negotiated Rate	$126.16
Max. Negotiated Rate	$288.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$198.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.23
Rate for Payer: Aetna Government	$180.23
Rate for Payer: Brighton Health Commercial	$270.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$288.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$245.11
Rate for Payer: Group Health Inc Commercial	$180.23
Rate for Payer: Group Health Inc Medicare	$126.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$180.23
Rate for Payer: Hamaspik Choice Inc Medicare	$180.23

REMDESIVIR 100MG/20ML

Facility

$13.00

Service Code	HCPCS J0248
Hospital Charge Code	41640232
Hospital Revenue Code	636
Min. Negotiated Rate	$4.24
Max. Negotiated Rate	$8.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.06
Rate for Payer: Aetna Government	$6.06
Rate for Payer: Affinity Essential Plan 1&2	$4.24
Rate for Payer: Affinity Essential Plan 3&4	$4.24
Rate for Payer: Affinity Medicaid/CHP/HARP	$4.24
Rate for Payer: Brighton Health Commercial	$7.80
Rate for Payer: Cash Price	$6.06
Rate for Payer: Cash Price	$6.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.48
Rate for Payer: Elderplan Medicare Advantage	$6.06
Rate for Payer: EmblemHealth Commercial	$6.06
Rate for Payer: Fidelis CHP/HARP/Medicaid	$6.06
Rate for Payer: Fidelis Essential Plan Aliesa	$6.06
Rate for Payer: Fidelis Essential Plan QHP	$6.36
Rate for Payer: Fidelis Medicare Advantage	$6.06
Rate for Payer: Fidelis Qualified Health Plan	$6.36
Rate for Payer: Group Health Inc Commercial	$6.06
Rate for Payer: Group Health Inc Medicare	$6.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6.50
Rate for Payer: Healthfirst Medicare Advantage	$5.15
Rate for Payer: Healthfirst QHP	$6.06
Rate for Payer: Humana Medicare	$6.18
Rate for Payer: Senior Whole Health Medicare Advantage	$6.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6.42
Rate for Payer: SOMOS Essential	$6.42
Rate for Payer: United Healthcare Commercial	$5.51
Rate for Payer: United Healthcare Medicare Advantage	$6.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.45
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.85
Rate for Payer: Wellcare Medicare	$5.76

REMDESIVIR 100MG/20ML

Facility

$13.00

Service Code	HCPCS J0248
Hospital Charge Code	41640232
Hospital Revenue Code	636
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$6.50
Rate for Payer: Cash Price	$6.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6.50

REMDESIVIR 100MG/20ML

Facility

$13.00

Service Code	HCPCS J0248
Hospital Charge Code	41650232
Hospital Revenue Code	636
Min. Negotiated Rate	$4.24
Max. Negotiated Rate	$8.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.06
Rate for Payer: Aetna Government	$6.06
Rate for Payer: Affinity Essential Plan 1&2	$4.24
Rate for Payer: Affinity Essential Plan 3&4	$4.24
Rate for Payer: Affinity Medicaid/CHP/HARP	$4.24
Rate for Payer: Brighton Health Commercial	$7.80
Rate for Payer: Cash Price	$6.06
Rate for Payer: Cash Price	$6.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.48
Rate for Payer: Elderplan Medicare Advantage	$6.06
Rate for Payer: EmblemHealth Commercial	$6.06
Rate for Payer: Fidelis CHP/HARP/Medicaid	$6.06
Rate for Payer: Fidelis Essential Plan Aliesa	$6.06
Rate for Payer: Fidelis Essential Plan QHP	$6.36
Rate for Payer: Fidelis Medicare Advantage	$6.06
Rate for Payer: Fidelis Qualified Health Plan	$6.36
Rate for Payer: Group Health Inc Commercial	$6.06
Rate for Payer: Group Health Inc Medicare	$6.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6.50
Rate for Payer: Healthfirst Medicare Advantage	$5.15
Rate for Payer: Healthfirst QHP	$6.06
Rate for Payer: Humana Medicare	$6.18
Rate for Payer: Senior Whole Health Medicare Advantage	$6.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6.42
Rate for Payer: SOMOS Essential	$6.42
Rate for Payer: United Healthcare Commercial	$5.51
Rate for Payer: United Healthcare Medicare Advantage	$6.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.45
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.85
Rate for Payer: Wellcare Medicare	$5.76

REMDESIVIR 100MG/20ML

Facility

$13.00

Service Code	HCPCS J0248
Hospital Charge Code	41650232
Hospital Revenue Code	636
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$6.50
Rate for Payer: Cash Price	$6.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6.50

REMDESIVIR 100MG IN NS 250ML

Facility

$6.24

Service Code	HCPCS J0248
Hospital Charge Code	41650321
Hospital Revenue Code	636
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$3.12
Rate for Payer: Cash Price	$6.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.12
Rate for Payer: Hamaspik Choice Inc Medicare	$3.12

REMDESIVIR 100MG IN NS 250ML

Facility

$6.24

Service Code	HCPCS J0248
Hospital Charge Code	41640321
Hospital Revenue Code	636
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$3.12
Rate for Payer: Cash Price	$6.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.12
Rate for Payer: Hamaspik Choice Inc Medicare	$3.12

REMDESIVIR 100MG IN NS 250ML

Facility

$6.24

Service Code	HCPCS J0248
Hospital Charge Code	41650321
Hospital Revenue Code	636
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$6.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.06
Rate for Payer: Aetna Government	$6.06
Rate for Payer: Affinity Essential Plan 1&2	$4.24
Rate for Payer: Affinity Essential Plan 3&4	$4.24
Rate for Payer: Affinity Medicaid/CHP/HARP	$4.24
Rate for Payer: Brighton Health Commercial	$3.74
Rate for Payer: Cash Price	$6.06
Rate for Payer: Cash Price	$6.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.59
Rate for Payer: Elderplan Medicare Advantage	$6.06
Rate for Payer: EmblemHealth Commercial	$6.06
Rate for Payer: Fidelis CHP/HARP/Medicaid	$6.06
Rate for Payer: Fidelis Essential Plan Aliesa	$6.06
Rate for Payer: Fidelis Essential Plan QHP	$6.36
Rate for Payer: Fidelis Medicare Advantage	$6.06
Rate for Payer: Fidelis Qualified Health Plan	$6.36
Rate for Payer: Group Health Inc Commercial	$6.06
Rate for Payer: Group Health Inc Medicare	$6.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.12
Rate for Payer: Hamaspik Choice Inc Medicare	$3.12
Rate for Payer: Healthfirst Medicare Advantage	$5.15
Rate for Payer: Healthfirst QHP	$6.06
Rate for Payer: Humana Medicare	$6.18
Rate for Payer: Senior Whole Health Medicare Advantage	$6.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6.42
Rate for Payer: SOMOS Essential	$6.42
Rate for Payer: United Healthcare Commercial	$5.51
Rate for Payer: United Healthcare Medicare Advantage	$6.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.85
Rate for Payer: Wellcare Medicare	$5.76

REMDESIVIR 100MG IN NS 250ML

Facility

$6.24

Service Code	HCPCS J0248
Hospital Charge Code	41640321
Hospital Revenue Code	636
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$6.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.06
Rate for Payer: Aetna Government	$6.06
Rate for Payer: Affinity Essential Plan 1&2	$4.24
Rate for Payer: Affinity Essential Plan 3&4	$4.24
Rate for Payer: Affinity Medicaid/CHP/HARP	$4.24
Rate for Payer: Brighton Health Commercial	$3.74
Rate for Payer: Cash Price	$6.06
Rate for Payer: Cash Price	$6.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.59
Rate for Payer: Elderplan Medicare Advantage	$6.06
Rate for Payer: EmblemHealth Commercial	$6.06
Rate for Payer: Fidelis CHP/HARP/Medicaid	$6.06
Rate for Payer: Fidelis Essential Plan Aliesa	$6.06
Rate for Payer: Fidelis Essential Plan QHP	$6.36
Rate for Payer: Fidelis Medicare Advantage	$6.06
Rate for Payer: Fidelis Qualified Health Plan	$6.36
Rate for Payer: Group Health Inc Commercial	$6.06
Rate for Payer: Group Health Inc Medicare	$6.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.12
Rate for Payer: Hamaspik Choice Inc Medicare	$3.12
Rate for Payer: Healthfirst Medicare Advantage	$5.15
Rate for Payer: Healthfirst QHP	$6.06
Rate for Payer: Humana Medicare	$6.18
Rate for Payer: Senior Whole Health Medicare Advantage	$6.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6.42
Rate for Payer: SOMOS Essential	$6.42
Rate for Payer: United Healthcare Commercial	$5.51
Rate for Payer: United Healthcare Medicare Advantage	$6.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.85
Rate for Payer: Wellcare Medicare	$5.76

REMDESIVIR 100 MG IV SOLR [400829]

Facility

$719.38

Service Code	HCPCS J0248
Hospital Charge Code	61958290102
Hospital Revenue Code	278
Min. Negotiated Rate	$4.85
Max. Negotiated Rate	$467.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$395.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.06
Rate for Payer: Aetna Government	$6.06
Rate for Payer: Brighton Health Commercial	$431.63
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$359.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$413.64
Rate for Payer: Elderplan Medicare Advantage	$6.06
Rate for Payer: EmblemHealth Commercial	$359.69
Rate for Payer: Fidelis Medicare Advantage	$6.06
Rate for Payer: Group Health Inc Commercial	$6.06
Rate for Payer: Group Health Inc Medicare	$6.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$359.69
Rate for Payer: Hamaspik Choice Inc Medicare	$359.69
Rate for Payer: Healthfirst Medicare Advantage	$5.15
Rate for Payer: Healthfirst QHP	$6.06
Rate for Payer: Humana Medicare	$6.18
Rate for Payer: Senior Whole Health Medicare Advantage	$6.06
Rate for Payer: United Healthcare Medicare Advantage	$6.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$467.60
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.85

REMDESIVIR 100 MG IV SOLR [400829]

Facility

$719.38

Service Code	HCPCS J0248
Hospital Charge Code	61958290102
Hospital Revenue Code	278
Min. Negotiated Rate	$359.69
Max. Negotiated Rate	$359.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$359.69
Rate for Payer: Hamaspik Choice Inc Medicare	$359.69

REMDESIVIR 200MG IN NS 250ML

Facility

$6.24

Service Code	HCPCS J0248
Hospital Charge Code	41640319
Hospital Revenue Code	636
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$6.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.06
Rate for Payer: Aetna Government	$6.06
Rate for Payer: Affinity Essential Plan 1&2	$4.24
Rate for Payer: Affinity Essential Plan 3&4	$4.24
Rate for Payer: Affinity Medicaid/CHP/HARP	$4.24
Rate for Payer: Brighton Health Commercial	$3.74
Rate for Payer: Cash Price	$6.06
Rate for Payer: Cash Price	$6.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.59
Rate for Payer: Elderplan Medicare Advantage	$6.06
Rate for Payer: EmblemHealth Commercial	$6.06
Rate for Payer: Fidelis CHP/HARP/Medicaid	$6.06
Rate for Payer: Fidelis Essential Plan Aliesa	$6.06
Rate for Payer: Fidelis Essential Plan QHP	$6.36
Rate for Payer: Fidelis Medicare Advantage	$6.06
Rate for Payer: Fidelis Qualified Health Plan	$6.36
Rate for Payer: Group Health Inc Commercial	$6.06
Rate for Payer: Group Health Inc Medicare	$6.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.12
Rate for Payer: Hamaspik Choice Inc Medicare	$3.12
Rate for Payer: Healthfirst Medicare Advantage	$5.15
Rate for Payer: Healthfirst QHP	$6.06
Rate for Payer: Humana Medicare	$6.18
Rate for Payer: Senior Whole Health Medicare Advantage	$6.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6.42
Rate for Payer: SOMOS Essential	$6.42
Rate for Payer: United Healthcare Commercial	$5.51
Rate for Payer: United Healthcare Medicare Advantage	$6.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.85
Rate for Payer: Wellcare Medicare	$5.76

REMDESIVIR 200MG IN NS 250ML

Facility

$6.24

Service Code	HCPCS J0248
Hospital Charge Code	41650319
Hospital Revenue Code	636
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$3.12
Rate for Payer: Cash Price	$6.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.12
Rate for Payer: Hamaspik Choice Inc Medicare	$3.12

Know your out-of-pocket cost for care.

All Charges