Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

FLUOROURACIL 1 GM/20ML IV SOLN

Facility

OP

$0.33

Service Code	HCPCS J9190
Hospital Charge Code	6332311728
Hospital Revenue Code	258
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$1.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
Rate for Payer: Brighton Health Commercial	$0.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.23
Rate for Payer: EmblemHealth Commercial	$0.17
Rate for Payer: Group Health Inc Commercial	$0.17
Rate for Payer: Group Health Inc Medicare	$0.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.17
Rate for Payer: Hamaspik Choice Inc Medicare	$0.17
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.22

FLUOROURACIL 1 GM/20ML IV SOLN

Facility

IP

$0.33

Service Code	HCPCS J9190
Hospital Charge Code	6332311741
Hospital Revenue Code	258
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.17

FLUOROURACIL 2.5 GM/50ML IV SOLN

Facility

IP

$0.66

Service Code	HCPCS J9190
Hospital Charge Code	2502121598
Hospital Revenue Code	258
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.33

FLUOROURACIL 2.5 GM/50ML IV SOLN

Facility

OP

$0.35

Service Code	HCPCS J9190
Hospital Charge Code	6332311751
Hospital Revenue Code	258
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$1.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
Rate for Payer: Brighton Health Commercial	$0.26
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: Healthfirst CHP/FHP/Medicaid	$1.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.23

FLUOROURACIL 2.5 GM/50ML IV SOLN

Facility

IP

$0.35

Service Code	HCPCS J9190
Hospital Charge Code	6332311751
Hospital Revenue Code	258
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.18

FLUOROURACIL 2.5 GM/50ML IV SOLN

Facility

IP

$0.69

Service Code	HCPCS J9190
Hospital Charge Code	7070018822
Hospital Revenue Code	258
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34

FLUOROURACIL 2.5 GM/50ML IV SOLN

Facility

OP

$0.66

Service Code	HCPCS J9190
Hospital Charge Code	2502121598
Hospital Revenue Code	258
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$1.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
Rate for Payer: Brighton Health Commercial	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.45
Rate for Payer: EmblemHealth Commercial	$0.33
Rate for Payer: Group Health Inc Commercial	$0.33
Rate for Payer: Group Health Inc Medicare	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.33
Rate for Payer: Hamaspik Choice Inc Medicare	$0.33
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.43

FLUOROURACIL 2.5 GM/50ML IV SOLN

Facility

IP

$0.69

Service Code	HCPCS J9190
Hospital Charge Code	1672927611
Hospital Revenue Code	258
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34

FLUOROURACIL 2.5 GM/50ML IV SOLN

Facility

OP

$0.69

Service Code	HCPCS J9190
Hospital Charge Code	7070018822
Hospital Revenue Code	258
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$1.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
Rate for Payer: Brighton Health Commercial	$0.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.47
Rate for Payer: EmblemHealth Commercial	$0.34
Rate for Payer: Group Health Inc Commercial	$0.34
Rate for Payer: Group Health Inc Medicare	$0.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34
Rate for Payer: Hamaspik Choice Inc Medicare	$0.34
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.45

FLUOROURACIL 2.5 GM/50ML IV SOLN

Facility

OP

$0.69

Service Code	HCPCS J9190
Hospital Charge Code	1672927611
Hospital Revenue Code	258
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$1.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
Rate for Payer: Brighton Health Commercial	$0.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.47
Rate for Payer: EmblemHealth Commercial	$0.34
Rate for Payer: Group Health Inc Commercial	$0.34
Rate for Payer: Group Health Inc Medicare	$0.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34
Rate for Payer: Hamaspik Choice Inc Medicare	$0.34
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.45

FLUOROURACIL 500 MG/10ML IV SOLN

Facility

OP

$1.59

Service Code	HCPCS J9190
Hospital Charge Code	7070018623
Hospital Revenue Code	258
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$1.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
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	$1.08
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: Healthfirst CHP/FHP/Medicaid	$1.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.04

FLUOROURACIL 500 MG/10ML IV SOLN

Facility

IP

$1.59

Service Code	HCPCS J9190
Hospital Charge Code	7070018623
Hospital Revenue Code	258
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.80

FLUOROURACIL 500 MG/10ML IV SOLN

Facility

IP

$0.41

Service Code	HCPCS J9190
Hospital Charge Code	6332311710
Hospital Revenue Code	258
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21

FLUOROURACIL 500 MG/10ML IV SOLN

Facility

OP

$1.59

Service Code	HCPCS J9190
Hospital Charge Code	1672927603
Hospital Revenue Code	258
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$1.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
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	$1.08
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: Healthfirst CHP/FHP/Medicaid	$1.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.04

FLUOROURACIL 500 MG/10ML IV SOLN

Facility

IP

$1.59

Service Code	HCPCS J9190
Hospital Charge Code	1672927603
Hospital Revenue Code	258
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.80

FLUOROURACIL 500 MG/10ML IV SOLN

Facility

OP

$0.41

Service Code	HCPCS J9190
Hospital Charge Code	6332311710
Hospital Revenue Code	258
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$1.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
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	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.27

FLUOROURACIL 500 MG/10ML IV SOLN

Facility

IP

$1.59

Service Code	HCPCS J9190
Hospital Charge Code	7070018622
Hospital Revenue Code	258
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.80

FLUOROURACIL 500 MG/10ML IV SOLN

Facility

OP

$1.59

Service Code	HCPCS J9190
Hospital Charge Code	7070018622
Hospital Revenue Code	258
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$1.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
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	$1.08
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: Healthfirst CHP/FHP/Medicaid	$1.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.04

FLUOROURACIL 5 % EX CREA

Facility

OP

$7.10

Service Code	NDC 0378479106
Hospital Charge Code	0378479106
Hospital Revenue Code	250
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$5.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.55
Rate for Payer: Aetna Government	$3.55
Rate for Payer: Brighton Health Commercial	$5.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.83
Rate for Payer: EmblemHealth Commercial	$3.55
Rate for Payer: Group Health Inc Commercial	$3.55
Rate for Payer: Group Health Inc Medicare	$2.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.55
Rate for Payer: Hamaspik Choice Inc Medicare	$3.55
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.62

FLUOROURACIL 5 % EX CREA

Facility

IP

$7.10

Service Code	NDC 0378479106
Hospital Charge Code	0378479106
Hospital Revenue Code	250
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$3.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.55

FLUOROURACIL 5 GM/100ML IV SOLN

Facility

OP

$0.69

Service Code	HCPCS J9190
Hospital Charge Code	1672927638
Hospital Revenue Code	258
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$1.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
Rate for Payer: Brighton Health Commercial	$0.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.47
Rate for Payer: EmblemHealth Commercial	$0.34
Rate for Payer: Group Health Inc Commercial	$0.34
Rate for Payer: Group Health Inc Medicare	$0.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34
Rate for Payer: Hamaspik Choice Inc Medicare	$0.34
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.45

FLUOROURACIL 5 GM/100ML IV SOLN

Facility

IP

$0.35

Service Code	HCPCS J9190
Hospital Charge Code	6332311761
Hospital Revenue Code	258
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.18

FLUOROURACIL 5 GM/100ML IV SOLN

Facility

IP

$0.69

Service Code	HCPCS J9190
Hospital Charge Code	1672927638
Hospital Revenue Code	258
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34

FLUOROURACIL 5 GM/100ML IV SOLN

Facility

OP

$0.35

Service Code	HCPCS J9190
Hospital Charge Code	6332311761
Hospital Revenue Code	258
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$1.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
Rate for Payer: Brighton Health Commercial	$0.26
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: Healthfirst CHP/FHP/Medicaid	$1.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.23

FLUOXETINE HCL 10 MG PO CAPS

Facility

IP

$0.14

Service Code	NDC 0904734561
Hospital Charge Code	0904734561
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07

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