St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

FUROSEMIDE 10 MG/ML IJ SOLN

Facility

$0.37

Service Code	HCPCS J1938
Hospital Charge Code	3600028425
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.19
Rate for Payer: Aetna Government	$0.19
Rate for Payer: Brighton Health Commercial	$0.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.25
Rate for Payer: EmblemHealth Commercial	$0.19
Rate for Payer: Group Health Inc Commercial	$0.19
Rate for Payer: Group Health Inc Medicare	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.19
Rate for Payer: Hamaspik Choice Inc Medicare	$0.19
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.24

FUROSEMIDE 10 MG/ML IJ SOLN

Facility

$0.38

Service Code	HCPCS J1938
Hospital Charge Code	6332328010
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.19
Rate for Payer: Aetna Government	$0.19
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	$0.26
Rate for Payer: EmblemHealth Commercial	$0.19
Rate for Payer: Group Health Inc Commercial	$0.19
Rate for Payer: Group Health Inc Medicare	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.19
Rate for Payer: Hamaspik Choice Inc Medicare	$0.19
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.25

FUROSEMIDE 10 MG/ML IJ SOLN

Facility

$1.43

Service Code	HCPCS J1938
Hospital Charge Code	1672950008
Hospital Revenue Code	250
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$0.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.72

FUROSEMIDE 10 MG/ML IJ SOLN

Facility

$0.60

Service Code	HCPCS J1938
Hospital Charge Code	7128820302
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
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: Healthfirst CHP/FHP/Medicaid	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.39

FUROSEMIDE 10 MG/ML IJ SOLN

Facility

$1.26

Service Code	HCPCS J1938
Hospital Charge Code	6332328002
Hospital Revenue Code	250
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$0.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.63

FUROSEMIDE 10 MG/ML IJ SOLN

Facility

$2.51

Service Code	HCPCS J1938
Hospital Charge Code	0409610219
Hospital Revenue Code	250
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$1.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.25

FUROSEMIDE 10 MG/ML IJ SOLN

Facility

$1.26

Service Code	HCPCS J1938
Hospital Charge Code	6332328002
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$1.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.63
Rate for Payer: Aetna Government	$0.63
Rate for Payer: Brighton Health Commercial	$0.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.86
Rate for Payer: EmblemHealth Commercial	$0.63
Rate for Payer: Group Health Inc Commercial	$0.63
Rate for Payer: Group Health Inc Medicare	$0.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.63
Rate for Payer: Hamaspik Choice Inc Medicare	$0.63
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.82

FUROSEMIDE 10 MG/ML IJ SOLN

Facility

$0.60

Service Code	HCPCS J1938
Hospital Charge Code	7128820302
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30

FUROSEMIDE 10 MG/ML IJ SOLN

Facility

$0.84

Service Code	HCPCS J1938
Hospital Charge Code	6332328003
Hospital Revenue Code	250
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$0.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42

FUROSEMIDE 10 MG/ML IJ SOLN

Facility

$0.38

Service Code	HCPCS J1938
Hospital Charge Code	6332328005
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.19

FUROSEMIDE 10 MG/ML IJ SOLN

Facility

$0.37

Service Code	HCPCS J1938
Hospital Charge Code	3600028425
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.19

FUROSEMIDE 10 MG/ML IJ SOLN

Facility

$0.88

Service Code	HCPCS J1938
Hospital Charge Code	0409610218
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.44
Rate for Payer: Aetna Government	$0.44
Rate for Payer: Brighton Health Commercial	$0.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.60
Rate for Payer: EmblemHealth Commercial	$0.44
Rate for Payer: Group Health Inc Commercial	$0.44
Rate for Payer: Group Health Inc Medicare	$0.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.44
Rate for Payer: Hamaspik Choice Inc Medicare	$0.44
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.57

FUROSEMIDE 10 MG/ML IJ SOLN

Facility

$0.41

Service Code	HCPCS J1938
Hospital Charge Code	7128820304
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.20
Rate for Payer: Aetna Government	$0.20
Rate for Payer: Brighton Health Commercial	$0.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.28
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: Healthfirst CHP/FHP/Medicaid	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.26

FUROSEMIDE 20 MG PO TABS

Facility

$0.14

Service Code	NDC 4354740110
Hospital Charge Code	4354740110
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07

FUROSEMIDE 20 MG PO TABS

Facility

$0.14

Service Code	NDC 6931511601
Hospital Charge Code	6931511601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07

FUROSEMIDE 20 MG PO TABS

Facility

$0.14

Service Code	NDC 4354740110
Hospital Charge Code	4354740110
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.07
Rate for Payer: Aetna Government	$0.07
Rate for Payer: Brighton Health Commercial	$0.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: EmblemHealth Commercial	$0.07
Rate for Payer: Group Health Inc Commercial	$0.07
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.09

FUROSEMIDE 20 MG PO TABS

Facility

$0.15

Service Code	NDC 5107907201
Hospital Charge Code	5107907201
Hospital Revenue Code	250
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.08

FUROSEMIDE 20 MG PO TABS

Facility

$0.14

Service Code	NDC 6931511601
Hospital Charge Code	6931511601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.07
Rate for Payer: Aetna Government	$0.07
Rate for Payer: Brighton Health Commercial	$0.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: EmblemHealth Commercial	$0.07
Rate for Payer: Group Health Inc Commercial	$0.07
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.09

FUROSEMIDE 20 MG PO TABS

Facility

$0.09

Service Code	NDC 0904717761
Hospital Charge Code	0904717761
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04

FUROSEMIDE 20 MG PO TABS

Facility

$0.15

Service Code	NDC 5107907220
Hospital Charge Code	5107907220
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07

FUROSEMIDE 20 MG PO TABS

Facility

$0.14

Service Code	NDC 6931511610
Hospital Charge Code	6931511610
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07

FUROSEMIDE 20 MG PO TABS

Facility

$0.14

Service Code	NDC 4354740111
Hospital Charge Code	4354740111
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.07
Rate for Payer: Aetna Government	$0.07
Rate for Payer: Brighton Health Commercial	$0.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: EmblemHealth Commercial	$0.07
Rate for Payer: Group Health Inc Commercial	$0.07
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.09

FUROSEMIDE 20 MG PO TABS

Facility

$0.15

Service Code	NDC 5107907220
Hospital Charge Code	5107907220
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.07
Rate for Payer: Aetna Government	$0.07
Rate for Payer: Brighton Health Commercial	$0.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: EmblemHealth Commercial	$0.07
Rate for Payer: Group Health Inc Commercial	$0.07
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.10

FUROSEMIDE 20 MG PO TABS

Facility

$0.14

Service Code	NDC 6931511610
Hospital Charge Code	6931511610
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.07
Rate for Payer: Aetna Government	$0.07
Rate for Payer: Brighton Health Commercial	$0.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: EmblemHealth Commercial	$0.07
Rate for Payer: Group Health Inc Commercial	$0.07
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.09

FUROSEMIDE 20 MG PO TABS

Facility

$0.09

Service Code	NDC 0904717761
Hospital Charge Code	0904717761
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Brighton Health Commercial	$0.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.06
Rate for Payer: EmblemHealth Commercial	$0.04
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.06

Know your out-of-pocket cost for care.

All Charges