St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

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	$0.89
Max. Negotiated Rate	$0.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.89

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

$1.63

Service Code	NDC 0143978401
Hospital Charge Code	0143978401
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 3600014801
Hospital Charge Code	3600014801
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	$1.28
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	$1.11

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

FLUMAZENIL 1 MG/10ML IV SOLN

Facility

$1.63

Service Code	NDC 0143978310
Hospital Charge Code	0143978310
Hospital Revenue Code	258
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$0.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.81

FLUMAZENIL 1 MG/10ML IV SOLN

Facility

$1.63

Service Code	NDC 0143978310
Hospital Charge Code	0143978310
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

FLUOCINONIDE 0.05 % EX CREA

Facility

$3.04

Service Code	NDC 5167213861
Hospital Charge Code	5167213861
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$2.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.52
Rate for Payer: Aetna Government	$1.52
Rate for Payer: Brighton Health Commercial	$2.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.43
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.07
Rate for Payer: EmblemHealth Commercial	$1.52
Rate for Payer: Group Health Inc Commercial	$1.52
Rate for Payer: Group Health Inc Medicare	$1.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.52
Rate for Payer: Hamaspik Choice Inc Medicare	$1.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.97

FLUOCINONIDE 0.05 % EX CREA

Facility

$3.04

Service Code	NDC 0093026292
Hospital Charge Code	0093026292
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$2.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.52
Rate for Payer: Aetna Government	$1.52
Rate for Payer: Brighton Health Commercial	$2.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.43
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.07
Rate for Payer: EmblemHealth Commercial	$1.52
Rate for Payer: Group Health Inc Commercial	$1.52
Rate for Payer: Group Health Inc Medicare	$1.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.52
Rate for Payer: Hamaspik Choice Inc Medicare	$1.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.97

FLUOCINONIDE 0.05 % EX CREA

Facility

$3.04

Service Code	NDC 5167213862
Hospital Charge Code	5167213862
Hospital Revenue Code	250
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$1.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.52

FLUOCINONIDE 0.05 % EX CREA

Facility

$3.04

Service Code	NDC 5167213863
Hospital Charge Code	5167213863
Hospital Revenue Code	250
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$1.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.52

FLUOCINONIDE 0.05 % EX CREA

Facility

$3.04

Service Code	NDC 0093026215
Hospital Charge Code	0093026215
Hospital Revenue Code	250
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$1.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.52

FLUOCINONIDE 0.05 % EX CREA

Facility

$3.04

Service Code	NDC 0093026230
Hospital Charge Code	0093026230
Hospital Revenue Code	250
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$1.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.52

FLUOCINONIDE 0.05 % EX CREA

Facility

$3.04

Service Code	NDC 5167213863
Hospital Charge Code	5167213863
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$2.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.52
Rate for Payer: Aetna Government	$1.52
Rate for Payer: Brighton Health Commercial	$2.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.43
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.07
Rate for Payer: EmblemHealth Commercial	$1.52
Rate for Payer: Group Health Inc Commercial	$1.52
Rate for Payer: Group Health Inc Medicare	$1.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.52
Rate for Payer: Hamaspik Choice Inc Medicare	$1.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.97

FLUOCINONIDE 0.05 % EX CREA

Facility

$3.04

Service Code	NDC 5167213862
Hospital Charge Code	5167213862
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$2.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.52
Rate for Payer: Aetna Government	$1.52
Rate for Payer: Brighton Health Commercial	$2.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.43
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.07
Rate for Payer: EmblemHealth Commercial	$1.52
Rate for Payer: Group Health Inc Commercial	$1.52
Rate for Payer: Group Health Inc Medicare	$1.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.52
Rate for Payer: Hamaspik Choice Inc Medicare	$1.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.97

FLUOCINONIDE 0.05 % EX CREA

Facility

$3.04

Service Code	NDC 0093026215
Hospital Charge Code	0093026215
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$2.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.52
Rate for Payer: Aetna Government	$1.52
Rate for Payer: Brighton Health Commercial	$2.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.43
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.07
Rate for Payer: EmblemHealth Commercial	$1.52
Rate for Payer: Group Health Inc Commercial	$1.52
Rate for Payer: Group Health Inc Medicare	$1.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.52
Rate for Payer: Hamaspik Choice Inc Medicare	$1.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.97

FLUOCINONIDE 0.05 % EX CREA

Facility

$3.04

Service Code	NDC 0093026292
Hospital Charge Code	0093026292
Hospital Revenue Code	250
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$1.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.52

FLUOCINONIDE 0.05 % EX CREA

Facility

$3.04

Service Code	NDC 5167213861
Hospital Charge Code	5167213861
Hospital Revenue Code	250
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$1.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.52

FLUOCINONIDE 0.05 % EX CREA

Facility

$3.04

Service Code	NDC 0093026230
Hospital Charge Code	0093026230
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$2.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.52
Rate for Payer: Aetna Government	$1.52
Rate for Payer: Brighton Health Commercial	$2.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.43
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.07
Rate for Payer: EmblemHealth Commercial	$1.52
Rate for Payer: Group Health Inc Commercial	$1.52
Rate for Payer: Group Health Inc Medicare	$1.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.52
Rate for Payer: Hamaspik Choice Inc Medicare	$1.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.97

FLUOCINONIDE 0.05 % EX OINT

Facility

$4.72

Service Code	NDC 5167212641
Hospital Charge Code	5167212641
Hospital Revenue Code	250
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$3.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.36
Rate for Payer: Aetna Government	$2.36
Rate for Payer: Brighton Health Commercial	$3.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.21
Rate for Payer: EmblemHealth Commercial	$2.36
Rate for Payer: Group Health Inc Commercial	$2.36
Rate for Payer: Group Health Inc Medicare	$1.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.36
Rate for Payer: Hamaspik Choice Inc Medicare	$2.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.07

FLUOCINONIDE 0.05 % EX OINT

Facility

$4.72

Service Code	NDC 5167212642
Hospital Charge Code	5167212642
Hospital Revenue Code	250
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$2.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.36

FLUOCINONIDE 0.05 % EX OINT

Facility

$4.72

Service Code	NDC 5167212643
Hospital Charge Code	5167212643
Hospital Revenue Code	250
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$2.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.36

FLUOCINONIDE 0.05 % EX OINT

Facility

$4.72

Service Code	NDC 5167212642
Hospital Charge Code	5167212642
Hospital Revenue Code	250
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$3.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.36
Rate for Payer: Aetna Government	$2.36
Rate for Payer: Brighton Health Commercial	$3.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.21
Rate for Payer: EmblemHealth Commercial	$2.36
Rate for Payer: Group Health Inc Commercial	$2.36
Rate for Payer: Group Health Inc Medicare	$1.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.36
Rate for Payer: Hamaspik Choice Inc Medicare	$2.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.07

FLUOCINONIDE 0.05 % EX OINT

Facility

$4.72

Service Code	NDC 5167212643
Hospital Charge Code	5167212643
Hospital Revenue Code	250
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$3.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.36
Rate for Payer: Aetna Government	$2.36
Rate for Payer: Brighton Health Commercial	$3.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.21
Rate for Payer: EmblemHealth Commercial	$2.36
Rate for Payer: Group Health Inc Commercial	$2.36
Rate for Payer: Group Health Inc Medicare	$1.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.36
Rate for Payer: Hamaspik Choice Inc Medicare	$2.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.07

Know your out-of-pocket cost for care.

All Charges