St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

AMIODARONE HCL 150 MG/3ML IV SOLN

Facility

$0.80

Service Code	NDC 0143987525
Hospital Charge Code	0143987525
Hospital Revenue Code	258
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$0.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.40

AMIODARONE HCL 150 MG/3ML IV SOLN

Facility

$0.83

Service Code	NDC 0143987501
Hospital Charge Code	0143987501
Hospital Revenue Code	258
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.42
Rate for Payer: Aetna Government	$0.42
Rate for Payer: Brighton Health Commercial	$0.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.57
Rate for Payer: EmblemHealth Commercial	$0.42
Rate for Payer: Group Health Inc Commercial	$0.42
Rate for Payer: Group Health Inc Medicare	$0.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42
Rate for Payer: Hamaspik Choice Inc Medicare	$0.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.54

AMIODARONE HCL 150 MG/3ML IV SOLN

Facility

$2.33

Service Code	NDC 7043623272
Hospital Charge Code	7043623272
Hospital Revenue Code	258
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$1.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.17

AMIODARONE HCL 150 MG/3ML IV SOLN

Facility

$1.53

Service Code	NDC 6745715303
Hospital Charge Code	6745715303
Hospital Revenue Code	258
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$0.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.77

AMIODARONE HCL 150 MG/3ML IV SOLN

Facility

$1.53

Service Code	NDC 6745715303
Hospital Charge Code	6745715303
Hospital Revenue Code	258
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$1.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.77
Rate for Payer: Aetna Government	$0.77
Rate for Payer: Brighton Health Commercial	$1.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.04
Rate for Payer: EmblemHealth Commercial	$0.77
Rate for Payer: Group Health Inc Commercial	$0.77
Rate for Payer: Group Health Inc Medicare	$0.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.77
Rate for Payer: Hamaspik Choice Inc Medicare	$0.77
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.00

AMIODARONE HCL 150 MG/3ML IV SOLN

Facility

$0.80

Service Code	NDC 0143987525
Hospital Charge Code	0143987525
Hospital Revenue Code	258
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$0.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.40
Rate for Payer: Aetna Government	$0.40
Rate for Payer: Brighton Health Commercial	$0.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.54
Rate for Payer: EmblemHealth Commercial	$0.40
Rate for Payer: Group Health Inc Commercial	$0.40
Rate for Payer: Group Health Inc Medicare	$0.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.40
Rate for Payer: Hamaspik Choice Inc Medicare	$0.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.52

AMIODARONE HCL 150 MG/3ML IV SOLN

Facility

$2.33

Service Code	NDC 7043623272
Hospital Charge Code	7043623272
Hospital Revenue Code	258
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$1.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.17
Rate for Payer: Aetna Government	$1.17
Rate for Payer: Brighton Health Commercial	$1.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.58
Rate for Payer: EmblemHealth Commercial	$1.17
Rate for Payer: Group Health Inc Commercial	$1.17
Rate for Payer: Group Health Inc Medicare	$0.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.17
Rate for Payer: Hamaspik Choice Inc Medicare	$1.17
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.51

AMIODARONE HCL 200 MG PO TABS

Facility

$0.61

Service Code	NDC 6068743711
Hospital Charge Code	6068743711
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.30
Rate for Payer: Aetna Government	$0.30
Rate for Payer: Brighton Health Commercial	$0.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.41
Rate for Payer: EmblemHealth Commercial	$0.30
Rate for Payer: Group Health Inc Commercial	$0.30
Rate for Payer: Group Health Inc Medicare	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30
Rate for Payer: Hamaspik Choice Inc Medicare	$0.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.39

AMIODARONE HCL 200 MG PO TABS

Facility

$7.94

Service Code	NDC 0245014789
Hospital Charge Code	0245014789
Hospital Revenue Code	250
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$6.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.97
Rate for Payer: Aetna Government	$3.97
Rate for Payer: Brighton Health Commercial	$5.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.40
Rate for Payer: EmblemHealth Commercial	$3.97
Rate for Payer: Group Health Inc Commercial	$3.97
Rate for Payer: Group Health Inc Medicare	$2.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.97
Rate for Payer: Hamaspik Choice Inc Medicare	$3.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.16

AMIODARONE HCL 200 MG PO TABS

Facility

$3.30

Service Code	NDC 5167240254
Hospital Charge Code	5167240254
Hospital Revenue Code	250
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.65

AMIODARONE HCL 200 MG PO TABS

Facility

$7.94

Service Code	NDC 0245014701
Hospital Charge Code	0245014701
Hospital Revenue Code	250
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$6.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.97
Rate for Payer: Aetna Government	$3.97
Rate for Payer: Brighton Health Commercial	$5.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.40
Rate for Payer: EmblemHealth Commercial	$3.97
Rate for Payer: Group Health Inc Commercial	$3.97
Rate for Payer: Group Health Inc Medicare	$2.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.97
Rate for Payer: Hamaspik Choice Inc Medicare	$3.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.16

AMIODARONE HCL 200 MG PO TABS

Facility

$0.36

Service Code	NDC 0904699361
Hospital Charge Code	0904699361
Hospital Revenue Code	250
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.18

AMIODARONE HCL 200 MG PO TABS

Facility

$3.38

Service Code	NDC 6586273260
Hospital Charge Code	6586273260
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.69

AMIODARONE HCL 200 MG PO TABS

Facility

$7.94

Service Code	NDC 0245014701
Hospital Charge Code	0245014701
Hospital Revenue Code	250
Min. Negotiated Rate	$3.97
Max. Negotiated Rate	$3.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.97

AMIODARONE HCL 200 MG PO TABS

Facility

$3.38

Service Code	NDC 2930035916
Hospital Charge Code	2930035916
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.69

AMIODARONE HCL 200 MG PO TABS

Facility

$3.38

Service Code	NDC 6586273260
Hospital Charge Code	6586273260
Hospital Revenue Code	250
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$2.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.69
Rate for Payer: Aetna Government	$1.69
Rate for Payer: Brighton Health Commercial	$2.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.30
Rate for Payer: EmblemHealth Commercial	$1.69
Rate for Payer: Group Health Inc Commercial	$1.69
Rate for Payer: Group Health Inc Medicare	$1.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.69
Rate for Payer: Hamaspik Choice Inc Medicare	$1.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.20

AMIODARONE HCL 200 MG PO TABS

Facility

$3.38

Service Code	NDC 2930035916
Hospital Charge Code	2930035916
Hospital Revenue Code	250
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$2.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.69
Rate for Payer: Aetna Government	$1.69
Rate for Payer: Brighton Health Commercial	$2.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.30
Rate for Payer: EmblemHealth Commercial	$1.69
Rate for Payer: Group Health Inc Commercial	$1.69
Rate for Payer: Group Health Inc Medicare	$1.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.69
Rate for Payer: Hamaspik Choice Inc Medicare	$1.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.20

AMIODARONE HCL 200 MG PO TABS

Facility

$0.36

Service Code	NDC 0904699361
Hospital Charge Code	0904699361
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.18
Rate for Payer: Aetna Government	$0.18
Rate for Payer: Brighton Health Commercial	$0.27
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	$0.18
Rate for Payer: Group Health Inc Commercial	$0.18
Rate for Payer: Group Health Inc Medicare	$0.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.18
Rate for Payer: Hamaspik Choice Inc Medicare	$0.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.23

AMIODARONE HCL 200 MG PO TABS

Facility

$3.30

Service Code	NDC 5167240254
Hospital Charge Code	5167240254
Hospital Revenue Code	250
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$2.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.65
Rate for Payer: Aetna Government	$1.65
Rate for Payer: Brighton Health Commercial	$2.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.25
Rate for Payer: EmblemHealth Commercial	$1.65
Rate for Payer: Group Health Inc Commercial	$1.65
Rate for Payer: Group Health Inc Medicare	$1.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.65
Rate for Payer: Hamaspik Choice Inc Medicare	$1.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.15

AMIODARONE HCL 200 MG PO TABS

Facility

$7.94

Service Code	NDC 0245014789
Hospital Charge Code	0245014789
Hospital Revenue Code	250
Min. Negotiated Rate	$3.97
Max. Negotiated Rate	$3.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.97

AMIODARONE HCL 200 MG PO TABS

Facility

$0.61

Service Code	NDC 6068743711
Hospital Charge Code	6068743711
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30

AMIODARONE HCL 900 MG/18ML IV SOLN

Facility

$1.00

Service Code	NDC 6745715318
Hospital Charge Code	6745715318
Hospital Revenue Code	258
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$0.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50

AMIODARONE HCL 900 MG/18ML IV SOLN

Facility

$1.00

Service Code	NDC 6745715318
Hospital Charge Code	6745715318
Hospital Revenue Code	258
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Brighton Health Commercial	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: EmblemHealth Commercial	$0.50
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65

AMIODARONE HCL IN DEXTROSE 150-4.21 MG/100ML-% IV SOLN

Facility

$0.42

Service Code	NDC 4306615010
Hospital Charge Code	4306615010
Hospital Revenue Code	258
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21

AMIODARONE HCL IN DEXTROSE 150-4.21 MG/100ML-% IV SOLN

Facility

$0.42

Service Code	NDC 4306615010
Hospital Charge Code	4306615010
Hospital Revenue Code	258
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.21
Rate for Payer: Aetna Government	$0.21
Rate for Payer: Brighton Health Commercial	$0.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.33
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.28
Rate for Payer: EmblemHealth Commercial	$0.21
Rate for Payer: Group Health Inc Commercial	$0.21
Rate for Payer: Group Health Inc Medicare	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.27

Know your out-of-pocket cost for care.

All Charges