Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

GUAIFENESIN 100 MG/5ML PO LIQD

Facility

IP

$0.19

Service Code	NDC 0121148810
Hospital Charge Code	0121148810
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10

GUAIFENESIN 100 MG/5ML PO LIQD

Facility

OP

$0.01

Service Code	NDC 0904676320
Hospital Charge Code	0904676320
Hospital Revenue Code	250
Max. Negotiated Rate	$0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: EmblemHealth Commercial	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

GUAIFENESIN 100 MG/5ML PO LIQD

Facility

OP

$0.02

Service Code	NDC 0536118297
Hospital Charge Code	0536118297
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: EmblemHealth Commercial	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

GUAIFENESIN 100 MG/5ML PO LIQD

Facility

IP

$0.01

Service Code	NDC 0904676320
Hospital Charge Code	0904676320
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

GUAIFENESIN 100 MG/5ML PO LIQD

Facility

OP

$0.19

Service Code	NDC 0121148810
Hospital Charge Code	0121148810
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.10
Rate for Payer: Aetna Government	$0.10
Rate for Payer: Brighton Health Commercial	$0.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.13
Rate for Payer: EmblemHealth Commercial	$0.10
Rate for Payer: Group Health Inc Commercial	$0.10
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10
Rate for Payer: Hamaspik Choice Inc Medicare	$0.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.13

GUAIFENESIN 100 MG/5ML PO LIQD

Facility

IP

$0.02

Service Code	NDC 0536118297
Hospital Charge Code	0536118297
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

GUAIFENESIN 100 MG/5ML PO LIQD

Facility

IP

$0.19

Service Code	NDC 0121148800
Hospital Charge Code	0121148800
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10

GUAIFENESIN 100 MG/5ML PO LIQD

Facility

OP

$0.22

Service Code	NDC 8103310210
Hospital Charge Code	8103310210
Hospital Revenue Code	250
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.11
Rate for Payer: Aetna Government	$0.11
Rate for Payer: Brighton Health Commercial	$0.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.15
Rate for Payer: EmblemHealth Commercial	$0.11
Rate for Payer: Group Health Inc Commercial	$0.11
Rate for Payer: Group Health Inc Medicare	$0.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11
Rate for Payer: Hamaspik Choice Inc Medicare	$0.11
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.14

GUAIFENESIN 100 MG/5ML PO LIQD

Facility

IP

$0.22

Service Code	NDC 8103310210
Hospital Charge Code	8103310210
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11

GUAIFENESIN 100 MG/5ML PO LIQD

Facility

OP

$0.19

Service Code	NDC 0121148800
Hospital Charge Code	0121148800
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.10
Rate for Payer: Aetna Government	$0.10
Rate for Payer: Brighton Health Commercial	$0.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.13
Rate for Payer: EmblemHealth Commercial	$0.10
Rate for Payer: Group Health Inc Commercial	$0.10
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10
Rate for Payer: Hamaspik Choice Inc Medicare	$0.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.13

GUAIFENESIN-DM 100-10 MG/5ML PO SYRP

Facility

IP

$0.28

Service Code	NDC 0121127600
Hospital Charge Code	0121127600
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14

GUAIFENESIN-DM 100-10 MG/5ML PO SYRP

Facility

OP

$0.28

Service Code	NDC 0121127600
Hospital Charge Code	0121127600
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.14
Rate for Payer: Aetna Government	$0.14
Rate for Payer: Brighton Health Commercial	$0.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.19
Rate for Payer: EmblemHealth Commercial	$0.14
Rate for Payer: Group Health Inc Commercial	$0.14
Rate for Payer: Group Health Inc Medicare	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14
Rate for Payer: Hamaspik Choice Inc Medicare	$0.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.18

GUAIFENESIN ER 600 MG PO TB12

Facility

IP

$0.61

Service Code	NDC 6382400834
Hospital Charge Code	6382400834
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30

GUAIFENESIN ER 600 MG PO TB12

Facility

OP

$0.61

Service Code	NDC 6382400834
Hospital Charge Code	6382400834
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.49
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	$0.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.49
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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.40

GYNECOLOGIC PREVENTIVE MEDICINE

Facility

OP

$222.15

Service Code	EAPG 00878
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$222.15
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$162.00
Rate for Payer: Healthfirst Commercial	$222.15

HAEMOPHILUS B POLYSAC CONJ VAC 7.5 MCG/0.5 ML IM SUSP

Facility

OP

$71.00

Service Code	NDC 0006489700
Hospital Charge Code	0006489700
Hospital Revenue Code	250
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$56.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$39.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$35.50
Rate for Payer: Aetna Government	$35.50
Rate for Payer: Brighton Health Commercial	$53.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$56.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.28
Rate for Payer: EmblemHealth Commercial	$35.50
Rate for Payer: Group Health Inc Commercial	$35.50
Rate for Payer: Group Health Inc Medicare	$24.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.50
Rate for Payer: Hamaspik Choice Inc Medicare	$35.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$46.15

HAEMOPHILUS B POLYSAC CONJ VAC 7.5 MCG/0.5 ML IM SUSP

Facility

IP

$71.00

Service Code	NDC 0006489700
Hospital Charge Code	0006489700
Hospital Revenue Code	250
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$35.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.50

HAEMOPHILUS B POLYSAC CONJ VAC IM SOLR

Facility

OP

$15.35

Service Code	NDC 4928154503
Hospital Charge Code	4928154503
Hospital Revenue Code	250
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$12.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.68
Rate for Payer: Aetna Government	$7.68
Rate for Payer: Brighton Health Commercial	$11.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.44
Rate for Payer: EmblemHealth Commercial	$7.68
Rate for Payer: Group Health Inc Commercial	$7.68
Rate for Payer: Group Health Inc Medicare	$5.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.68
Rate for Payer: Hamaspik Choice Inc Medicare	$7.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.98

HAEMOPHILUS B POLYSAC CONJ VAC IM SOLR

Facility

IP

$15.35

Service Code	NDC 4928154503
Hospital Charge Code	4928154503
Hospital Revenue Code	250
Min. Negotiated Rate	$7.68
Max. Negotiated Rate	$7.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.68

HALOPERIDOL 0.5 MG PO TABS

Facility

IP

$0.35

Service Code	NDC 5107973320
Hospital Charge Code	5107973320
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.17

HALOPERIDOL 0.5 MG PO TABS

Facility

OP

$0.33

Service Code	NDC 0378035101
Hospital Charge Code	0378035101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.16
Rate for Payer: Aetna Government	$0.16
Rate for Payer: Brighton Health Commercial	$0.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.22
Rate for Payer: EmblemHealth Commercial	$0.16
Rate for Payer: Group Health Inc Commercial	$0.16
Rate for Payer: Group Health Inc Medicare	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.16
Rate for Payer: Hamaspik Choice Inc Medicare	$0.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.21

HALOPERIDOL 0.5 MG PO TABS

Facility

IP

$0.35

Service Code	NDC 5107973301
Hospital Charge Code	5107973301
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.17

HALOPERIDOL 0.5 MG PO TABS

Facility

OP

$0.47

Service Code	NDC 0904724061
Hospital Charge Code	0904724061
Hospital Revenue Code	250
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.23
Rate for Payer: Aetna Government	$0.23
Rate for Payer: Brighton Health Commercial	$0.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.32
Rate for Payer: EmblemHealth Commercial	$0.23
Rate for Payer: Group Health Inc Commercial	$0.23
Rate for Payer: Group Health Inc Medicare	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23
Rate for Payer: Hamaspik Choice Inc Medicare	$0.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.30

HALOPERIDOL 0.5 MG PO TABS

Facility

IP

$0.47

Service Code	NDC 0904724061
Hospital Charge Code	0904724061
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23

HALOPERIDOL 0.5 MG PO TABS

Facility

IP

$0.33

Service Code	NDC 0378035101
Hospital Charge Code	0378035101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.16

<<
<
286
287
288
289
290
291
292
293
294
295
>
>>