St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

FLUCONAZOLE IV SYRINGE 2 MG/ML (NEO/PED)

Facility

$0.22

Service Code	NDC 0338604648
Hospital Charge Code	0338604648
Hospital Revenue Code	258
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11

FLUCYTOSINE 250 MG PO CAPS

Facility

$82.07

Service Code	NDC 5965133101
Hospital Charge Code	5965133101
Hospital Revenue Code	250
Min. Negotiated Rate	$41.03
Max. Negotiated Rate	$41.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.03

FLUCYTOSINE 250 MG PO CAPS

Facility

$82.07

Service Code	NDC 4338677101
Hospital Charge Code	4338677101
Hospital Revenue Code	250
Min. Negotiated Rate	$41.03
Max. Negotiated Rate	$41.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.03

FLUCYTOSINE 250 MG PO CAPS

Facility

$82.07

Service Code	NDC 4338677101
Hospital Charge Code	4338677101
Hospital Revenue Code	250
Min. Negotiated Rate	$28.72
Max. Negotiated Rate	$65.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$41.03
Rate for Payer: Aetna Government	$41.03
Rate for Payer: Brighton Health Commercial	$61.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$65.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$55.81
Rate for Payer: EmblemHealth Commercial	$41.03
Rate for Payer: Group Health Inc Commercial	$41.03
Rate for Payer: Group Health Inc Medicare	$28.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.03
Rate for Payer: Hamaspik Choice Inc Medicare	$41.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$53.34

FLUCYTOSINE 250 MG PO CAPS

Facility

$82.07

Service Code	NDC 5965133101
Hospital Charge Code	5965133101
Hospital Revenue Code	250
Min. Negotiated Rate	$28.72
Max. Negotiated Rate	$65.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$41.03
Rate for Payer: Aetna Government	$41.03
Rate for Payer: Brighton Health Commercial	$61.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$65.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$55.81
Rate for Payer: EmblemHealth Commercial	$41.03
Rate for Payer: Group Health Inc Commercial	$41.03
Rate for Payer: Group Health Inc Medicare	$28.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.03
Rate for Payer: Hamaspik Choice Inc Medicare	$41.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$53.34

FLUCYTOSINE 500 MG PO CAPS

Facility

$158.81

Service Code	NDC 4338677001
Hospital Charge Code	4338677001
Hospital Revenue Code	250
Min. Negotiated Rate	$79.40
Max. Negotiated Rate	$79.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.40

FLUCYTOSINE 500 MG PO CAPS

Facility

$158.81

Service Code	NDC 5965133201
Hospital Charge Code	5965133201
Hospital Revenue Code	250
Min. Negotiated Rate	$55.58
Max. Negotiated Rate	$127.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$87.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$79.40
Rate for Payer: Aetna Government	$79.40
Rate for Payer: Brighton Health Commercial	$119.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$127.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$107.99
Rate for Payer: EmblemHealth Commercial	$79.40
Rate for Payer: Group Health Inc Commercial	$79.40
Rate for Payer: Group Health Inc Medicare	$55.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.40
Rate for Payer: Hamaspik Choice Inc Medicare	$79.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$103.22

FLUCYTOSINE 500 MG PO CAPS

Facility

$158.81

Service Code	NDC 4338677001
Hospital Charge Code	4338677001
Hospital Revenue Code	250
Min. Negotiated Rate	$55.58
Max. Negotiated Rate	$127.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$87.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$79.40
Rate for Payer: Aetna Government	$79.40
Rate for Payer: Brighton Health Commercial	$119.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$127.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$107.99
Rate for Payer: EmblemHealth Commercial	$79.40
Rate for Payer: Group Health Inc Commercial	$79.40
Rate for Payer: Group Health Inc Medicare	$55.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.40
Rate for Payer: Hamaspik Choice Inc Medicare	$79.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$103.22

FLUCYTOSINE 500 MG PO CAPS

Facility

$158.81

Service Code	NDC 5965133201
Hospital Charge Code	5965133201
Hospital Revenue Code	250
Min. Negotiated Rate	$79.40
Max. Negotiated Rate	$79.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.40

FLUDARABINE PHOSPHATE 50 MG/2ML IV SOLN

Facility

$163.13

Service Code	HCPCS J9185
Hospital Charge Code	6332319202
Hospital Revenue Code	258
Min. Negotiated Rate	$81.56
Max. Negotiated Rate	$81.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.56

FLUDARABINE PHOSPHATE 50 MG/2ML IV SOLN

Facility

$163.13

Service Code	HCPCS J9185
Hospital Charge Code	6332319202
Hospital Revenue Code	258
Min. Negotiated Rate	$47.74
Max. Negotiated Rate	$130.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$68.20
Rate for Payer: Aetna Government	$68.20
Rate for Payer: Affinity Essential Plan 1&2	$47.74
Rate for Payer: Affinity Essential Plan 3&4	$47.74
Rate for Payer: Affinity Medicaid/CHP/HARP	$47.74
Rate for Payer: Brighton Health Commercial	$122.35
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$68.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$130.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$110.93
Rate for Payer: Elderplan Medicare Advantage	$68.20
Rate for Payer: EmblemHealth Commercial	$68.20
Rate for Payer: Fidelis CHP/HARP/Medicaid	$61.38
Rate for Payer: Fidelis Essential Plan Aliesa	$57.97
Rate for Payer: Fidelis Essential Plan QHP	$60.70
Rate for Payer: Fidelis Medicare Advantage	$68.20
Rate for Payer: Fidelis Qualified Health Plan	$60.70
Rate for Payer: Group Health Inc Commercial	$68.20
Rate for Payer: Group Health Inc Medicare	$68.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$68.20
Rate for Payer: Hamaspik Choice Inc Medicare	$68.20
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$68.20
Rate for Payer: Healthfirst Medicare Advantage	$57.97
Rate for Payer: Healthfirst QHP	$68.20
Rate for Payer: Humana Medicare	$69.56
Rate for Payer: Senior Whole Health Medicare Advantage	$68.20
Rate for Payer: United Healthcare Medicare Advantage	$68.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$106.03
Rate for Payer: Wellcare CHP/FHP/Medicaid	$64.79
Rate for Payer: Wellcare Medicare	$64.79

FLUDEOXYGLUCOSE F 18 20-300 MCI/ML IV SOLN

Facility

$222.00

Service Code	HCPCS A9552
Hospital Charge Code	4960910101
Hospital Revenue Code	258
Min. Negotiated Rate	$111.00
Max. Negotiated Rate	$111.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.00

FLUDEOXYGLUCOSE F 18 20-300 MCI/ML IV SOLN

Facility

$222.00

Service Code	HCPCS A9552
Hospital Charge Code	4960910101
Hospital Revenue Code	258
Min. Negotiated Rate	$77.70
Max. Negotiated Rate	$260.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$260.79
Rate for Payer: Aetna Government	$260.79
Rate for Payer: Brighton Health Commercial	$166.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$177.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$150.96
Rate for Payer: EmblemHealth Commercial	$111.00
Rate for Payer: Group Health Inc Commercial	$111.00
Rate for Payer: Group Health Inc Medicare	$77.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.00
Rate for Payer: Hamaspik Choice Inc Medicare	$111.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$144.30

FLUDROCORTISONE ACETATE 0.1 MG PO TABS

Facility

$1.60

Service Code	NDC 5026833011
Hospital Charge Code	5026833011
Hospital Revenue Code	250
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.80

FLUDROCORTISONE ACETATE 0.1 MG PO TABS

Facility

$0.75

Service Code	NDC 0115703301
Hospital Charge Code	0115703301
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.37
Rate for Payer: Aetna Government	$0.37
Rate for Payer: Brighton Health Commercial	$0.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.51
Rate for Payer: EmblemHealth Commercial	$0.37
Rate for Payer: Group Health Inc Commercial	$0.37
Rate for Payer: Group Health Inc Medicare	$0.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.37
Rate for Payer: Hamaspik Choice Inc Medicare	$0.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.49

FLUDROCORTISONE ACETATE 0.1 MG PO TABS

Facility

$0.39

Service Code	NDC 0904731706
Hospital Charge Code	0904731706
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.20
Rate for Payer: Aetna Government	$0.20
Rate for Payer: Brighton Health Commercial	$0.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.27
Rate for Payer: EmblemHealth Commercial	$0.20
Rate for Payer: Group Health Inc Commercial	$0.20
Rate for Payer: Group Health Inc Medicare	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.20
Rate for Payer: Hamaspik Choice Inc Medicare	$0.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.25

FLUDROCORTISONE ACETATE 0.1 MG PO TABS

Facility

$1.60

Service Code	NDC 5026833015
Hospital Charge Code	5026833015
Hospital Revenue Code	250
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$1.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.80
Rate for Payer: Aetna Government	$0.80
Rate for Payer: Brighton Health Commercial	$1.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.09
Rate for Payer: EmblemHealth Commercial	$0.80
Rate for Payer: Group Health Inc Commercial	$0.80
Rate for Payer: Group Health Inc Medicare	$0.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.80
Rate for Payer: Hamaspik Choice Inc Medicare	$0.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.04

FLUDROCORTISONE ACETATE 0.1 MG PO TABS

Facility

$1.60

Service Code	NDC 5026833015
Hospital Charge Code	5026833015
Hospital Revenue Code	250
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.80

FLUDROCORTISONE ACETATE 0.1 MG PO TABS

Facility

$0.39

Service Code	NDC 0904731706
Hospital Charge Code	0904731706
Hospital Revenue Code	250
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.20

FLUDROCORTISONE ACETATE 0.1 MG PO TABS

Facility

$1.60

Service Code	NDC 5026833011
Hospital Charge Code	5026833011
Hospital Revenue Code	250
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$1.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.80
Rate for Payer: Aetna Government	$0.80
Rate for Payer: Brighton Health Commercial	$1.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.09
Rate for Payer: EmblemHealth Commercial	$0.80
Rate for Payer: Group Health Inc Commercial	$0.80
Rate for Payer: Group Health Inc Medicare	$0.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.80
Rate for Payer: Hamaspik Choice Inc Medicare	$0.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.04

FLUDROCORTISONE ACETATE 0.1 MG PO TABS

Facility

$0.75

Service Code	NDC 0115703301
Hospital Charge Code	0115703301
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.37

FLUMAZENIL 0.5 MG/5ML IV SOLN

Facility

$1.63

Service Code	NDC 0143978410
Hospital Charge Code	0143978410
Hospital Revenue Code	258
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$1.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.81
Rate for Payer: Aetna Government	$0.81
Rate for Payer: Brighton Health Commercial	$1.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.10
Rate for Payer: EmblemHealth Commercial	$0.81
Rate for Payer: Group Health Inc Commercial	$0.81
Rate for Payer: Group Health Inc Medicare	$0.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.81
Rate for Payer: Hamaspik Choice Inc Medicare	$0.81
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.06

FLUMAZENIL 0.5 MG/5ML IV SOLN

Facility

$1.70

Service Code	NDC 3600014810
Hospital Charge Code	3600014810
Hospital Revenue Code	258
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$1.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.85
Rate for Payer: Aetna Government	$0.85
Rate for Payer: Brighton Health Commercial	$1.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.16
Rate for Payer: EmblemHealth Commercial	$0.85
Rate for Payer: Group Health Inc Commercial	$0.85
Rate for Payer: Group Health Inc Medicare	$0.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.85
Rate for Payer: Hamaspik Choice Inc Medicare	$0.85
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.10

FLUMAZENIL 0.5 MG/5ML IV SOLN

Facility

$1.70

Service Code	NDC 3600014801
Hospital Charge Code	3600014801
Hospital Revenue Code	258
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.85

FLUMAZENIL 0.5 MG/5ML IV SOLN

Facility

$1.78

Service Code	NDC 6332342405
Hospital Charge Code	6332342405
Hospital Revenue Code	258
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$1.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.89
Rate for Payer: Aetna Government	$0.89
Rate for Payer: Brighton Health Commercial	$1.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.21
Rate for Payer: EmblemHealth Commercial	$0.89
Rate for Payer: Group Health Inc Commercial	$0.89
Rate for Payer: Group Health Inc Medicare	$0.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.89
Rate for Payer: Hamaspik Choice Inc Medicare	$0.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.16

Know your out-of-pocket cost for care.

All Charges