St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

FLUPHENAZINE DECANOATE 25 MG/ML IJ SOLN

Facility

$29.04

Service Code	HCPCS J2680
Hospital Charge Code	0143952901
Hospital Revenue Code	250
Min. Negotiated Rate	$14.52
Max. Negotiated Rate	$14.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.52

FLUPHENAZINE DECANOATE 25 MG/ML IJ SOLN

Facility

$37.19

Service Code	HCPCS J2680
Hospital Charge Code	6745735959
Hospital Revenue Code	250
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.60

FLUPHENAZINE HCL 10 MG PO TABS

Facility

$11.60

Service Code	NDC 0527179101
Hospital Charge Code	0527179101
Hospital Revenue Code	250
Min. Negotiated Rate	$4.06
Max. Negotiated Rate	$9.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.80
Rate for Payer: Aetna Government	$5.80
Rate for Payer: Brighton Health Commercial	$8.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.89
Rate for Payer: EmblemHealth Commercial	$5.80
Rate for Payer: Group Health Inc Commercial	$5.80
Rate for Payer: Group Health Inc Medicare	$4.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.80
Rate for Payer: Hamaspik Choice Inc Medicare	$5.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.54

FLUPHENAZINE HCL 10 MG PO TABS

Facility

$15.31

Service Code	NDC 0904716061
Hospital Charge Code	0904716061
Hospital Revenue Code	250
Min. Negotiated Rate	$7.66
Max. Negotiated Rate	$7.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.66

FLUPHENAZINE HCL 10 MG PO TABS

Facility

$15.31

Service Code	NDC 0904716061
Hospital Charge Code	0904716061
Hospital Revenue Code	250
Min. Negotiated Rate	$5.36
Max. Negotiated Rate	$12.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.66
Rate for Payer: Aetna Government	$7.66
Rate for Payer: Brighton Health Commercial	$11.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.41
Rate for Payer: EmblemHealth Commercial	$7.66
Rate for Payer: Group Health Inc Commercial	$7.66
Rate for Payer: Group Health Inc Medicare	$5.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.66
Rate for Payer: Hamaspik Choice Inc Medicare	$7.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.95

FLUPHENAZINE HCL 10 MG PO TABS

Facility

$2.19

Service Code	NDC 5167242361
Hospital Charge Code	5167242361
Hospital Revenue Code	250
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$1.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.10

FLUPHENAZINE HCL 10 MG PO TABS

Facility

$2.19

Service Code	NDC 5167242361
Hospital Charge Code	5167242361
Hospital Revenue Code	250
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$1.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.10
Rate for Payer: Aetna Government	$1.10
Rate for Payer: Brighton Health Commercial	$1.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.49
Rate for Payer: EmblemHealth Commercial	$1.10
Rate for Payer: Group Health Inc Commercial	$1.10
Rate for Payer: Group Health Inc Medicare	$0.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.42

FLUPHENAZINE HCL 10 MG PO TABS

Facility

$11.60

Service Code	NDC 4359803701
Hospital Charge Code	4359803701
Hospital Revenue Code	250
Min. Negotiated Rate	$4.06
Max. Negotiated Rate	$9.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.80
Rate for Payer: Aetna Government	$5.80
Rate for Payer: Brighton Health Commercial	$8.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.89
Rate for Payer: EmblemHealth Commercial	$5.80
Rate for Payer: Group Health Inc Commercial	$5.80
Rate for Payer: Group Health Inc Medicare	$4.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.80
Rate for Payer: Hamaspik Choice Inc Medicare	$5.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.54

FLUPHENAZINE HCL 10 MG PO TABS

Facility

$11.60

Service Code	NDC 0527179101
Hospital Charge Code	0527179101
Hospital Revenue Code	250
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$5.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.80

FLUPHENAZINE HCL 10 MG PO TABS

Facility

$11.60

Service Code	NDC 4359803701
Hospital Charge Code	4359803701
Hospital Revenue Code	250
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$5.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.80

FLUPHENAZINE HCL 1 MG PO TABS

Facility

$7.14

Service Code	NDC 0904715761
Hospital Charge Code	0904715761
Hospital Revenue Code	250
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$3.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.57

FLUPHENAZINE HCL 1 MG PO TABS

Facility

$7.14

Service Code	NDC 0904715761
Hospital Charge Code	0904715761
Hospital Revenue Code	250
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$5.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.57
Rate for Payer: Aetna Government	$3.57
Rate for Payer: Brighton Health Commercial	$5.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.86
Rate for Payer: EmblemHealth Commercial	$3.57
Rate for Payer: Group Health Inc Commercial	$3.57
Rate for Payer: Group Health Inc Medicare	$2.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.57
Rate for Payer: Hamaspik Choice Inc Medicare	$3.57
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.64

FLUPHENAZINE HCL 1 MG PO TABS

Facility

$4.39

Service Code	NDC 6923816781
Hospital Charge Code	6923816781
Hospital Revenue Code	250
Min. Negotiated Rate	$2.20
Max. Negotiated Rate	$2.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.20

FLUPHENAZINE HCL 1 MG PO TABS

Facility

$4.39

Service Code	NDC 6923816781
Hospital Charge Code	6923816781
Hospital Revenue Code	250
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$3.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.20
Rate for Payer: Aetna Government	$2.20
Rate for Payer: Brighton Health Commercial	$3.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.99
Rate for Payer: EmblemHealth Commercial	$2.20
Rate for Payer: Group Health Inc Commercial	$2.20
Rate for Payer: Group Health Inc Medicare	$1.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.20
Rate for Payer: Hamaspik Choice Inc Medicare	$2.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.85

FLUPHENAZINE HCL 2.5 MG/ML IJ SOLN

Facility

$23.05

Service Code	NDC 6332328110
Hospital Charge Code	6332328110
Hospital Revenue Code	250
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$18.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.52
Rate for Payer: Aetna Government	$11.52
Rate for Payer: Brighton Health Commercial	$17.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.67
Rate for Payer: EmblemHealth Commercial	$11.52
Rate for Payer: Group Health Inc Commercial	$11.52
Rate for Payer: Group Health Inc Medicare	$8.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.52
Rate for Payer: Hamaspik Choice Inc Medicare	$11.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14.98

FLUPHENAZINE HCL 2.5 MG/ML IJ SOLN

Facility

$23.05

Service Code	NDC 6332328110
Hospital Charge Code	6332328110
Hospital Revenue Code	250
Min. Negotiated Rate	$11.52
Max. Negotiated Rate	$11.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.52

FLUPHENAZINE HCL 2.5 MG PO TABS

Facility

$8.89

Service Code	NDC 0904715861
Hospital Charge Code	0904715861
Hospital Revenue Code	250
Min. Negotiated Rate	$3.11
Max. Negotiated Rate	$7.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.44
Rate for Payer: Aetna Government	$4.44
Rate for Payer: Brighton Health Commercial	$6.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.04
Rate for Payer: EmblemHealth Commercial	$4.44
Rate for Payer: Group Health Inc Commercial	$4.44
Rate for Payer: Group Health Inc Medicare	$3.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.44
Rate for Payer: Hamaspik Choice Inc Medicare	$4.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.78

FLUPHENAZINE HCL 2.5 MG PO TABS

Facility

$6.80

Service Code	NDC 0527178901
Hospital Charge Code	0527178901
Hospital Revenue Code	250
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$5.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.40
Rate for Payer: Aetna Government	$3.40
Rate for Payer: Brighton Health Commercial	$5.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.62
Rate for Payer: EmblemHealth Commercial	$3.40
Rate for Payer: Group Health Inc Commercial	$3.40
Rate for Payer: Group Health Inc Medicare	$2.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.40
Rate for Payer: Hamaspik Choice Inc Medicare	$3.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.42

FLUPHENAZINE HCL 2.5 MG PO TABS

Facility

$6.80

Service Code	NDC 0527178901
Hospital Charge Code	0527178901
Hospital Revenue Code	250
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$3.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.40

FLUPHENAZINE HCL 2.5 MG PO TABS

Facility

$1.29

Service Code	NDC 5167242341
Hospital Charge Code	5167242341
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$1.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.64
Rate for Payer: Aetna Government	$0.64
Rate for Payer: Brighton Health Commercial	$0.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.87
Rate for Payer: EmblemHealth Commercial	$0.64
Rate for Payer: Group Health Inc Commercial	$0.64
Rate for Payer: Group Health Inc Medicare	$0.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.64
Rate for Payer: Hamaspik Choice Inc Medicare	$0.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.84

FLUPHENAZINE HCL 2.5 MG PO TABS

Facility

$1.29

Service Code	NDC 5167242341
Hospital Charge Code	5167242341
Hospital Revenue Code	250
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$0.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.64

FLUPHENAZINE HCL 2.5 MG PO TABS

Facility

$8.89

Service Code	NDC 0904715861
Hospital Charge Code	0904715861
Hospital Revenue Code	250
Min. Negotiated Rate	$4.44
Max. Negotiated Rate	$4.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.44

FLUPHENAZINE HCL 5 MG/ML PO CONC

Facility

$3.14

Service Code	NDC 0121065304
Hospital Charge Code	0121065304
Hospital Revenue Code	250
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$2.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.57
Rate for Payer: Aetna Government	$1.57
Rate for Payer: Brighton Health Commercial	$2.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.13
Rate for Payer: EmblemHealth Commercial	$1.57
Rate for Payer: Group Health Inc Commercial	$1.57
Rate for Payer: Group Health Inc Medicare	$1.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.57
Rate for Payer: Hamaspik Choice Inc Medicare	$1.57
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.04

FLUPHENAZINE HCL 5 MG/ML PO CONC

Facility

$3.14

Service Code	NDC 0121065304
Hospital Charge Code	0121065304
Hospital Revenue Code	250
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$1.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.57

FLUPHENAZINE HCL 5 MG PO TABS

Facility

$1.74

Service Code	NDC 5167242351
Hospital Charge Code	5167242351
Hospital Revenue Code	250
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$0.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.87

Know your out-of-pocket cost for care.

All Charges