St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CARBACHOL 0.01 % IO SOLN [19704]

Facility

$35.74

Service Code	NDC 00065002315
Hospital Charge Code	00065002315
Hospital Revenue Code	250
Min. Negotiated Rate	$12.51
Max. Negotiated Rate	$28.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.87
Rate for Payer: Aetna Government	$17.87
Rate for Payer: Brighton Health Commercial	$26.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$24.31
Rate for Payer: Group Health Inc Commercial	$17.87
Rate for Payer: Group Health Inc Medicare	$12.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.87
Rate for Payer: Hamaspik Choice Inc Medicare	$17.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$23.23

CARBACHOL 1.5 % OPHTHALMIC SOLN

Facility

$94.42

Hospital Charge Code	41651508
Hospital Revenue Code	250
Min. Negotiated Rate	$33.05
Max. Negotiated Rate	$75.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$51.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$47.21
Rate for Payer: Aetna Government	$47.21
Rate for Payer: Brighton Health Commercial	$70.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$75.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$64.21
Rate for Payer: Group Health Inc Commercial	$47.21
Rate for Payer: Group Health Inc Medicare	$33.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$47.21
Rate for Payer: Hamaspik Choice Inc Medicare	$47.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$61.37

CARBACHOL 1.5 % OPHTHALMIC SOLN

Facility

$94.42

Hospital Charge Code	41641508
Hospital Revenue Code	250
Min. Negotiated Rate	$33.05
Max. Negotiated Rate	$75.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$51.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$47.21
Rate for Payer: Aetna Government	$47.21
Rate for Payer: Brighton Health Commercial	$70.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$75.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$64.21
Rate for Payer: Group Health Inc Commercial	$47.21
Rate for Payer: Group Health Inc Medicare	$33.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$47.21
Rate for Payer: Hamaspik Choice Inc Medicare	$47.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$61.37

CARBACHOL 3% OPHTHALMIC SOLN

Facility

$108.02

Hospital Charge Code	41651185
Hospital Revenue Code	250
Min. Negotiated Rate	$37.81
Max. Negotiated Rate	$86.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$59.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$54.01
Rate for Payer: Aetna Government	$54.01
Rate for Payer: Brighton Health Commercial	$81.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$86.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.45
Rate for Payer: Group Health Inc Commercial	$54.01
Rate for Payer: Group Health Inc Medicare	$37.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.01
Rate for Payer: Hamaspik Choice Inc Medicare	$54.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.21

CARBACHOL 3% OPHTHALMIC SOLN

Facility

$108.02

Hospital Charge Code	41641185
Hospital Revenue Code	250
Min. Negotiated Rate	$37.81
Max. Negotiated Rate	$86.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$59.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$54.01
Rate for Payer: Aetna Government	$54.01
Rate for Payer: Brighton Health Commercial	$81.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$86.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.45
Rate for Payer: Group Health Inc Commercial	$54.01
Rate for Payer: Group Health Inc Medicare	$37.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.01
Rate for Payer: Hamaspik Choice Inc Medicare	$54.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.21

CARBAMAZEPINE 100 MG/5ML PO SUSP [1356]

Facility

$0.20

Service Code	NDC 51672404709
Hospital Charge Code	51672404709
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.16
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	$0.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.13
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

CARBAMAZEPINE 100 MG/5ML PO SUSP [1356]

Facility

$1.33

Service Code	NDC 62135080253
Hospital Charge Code	62135080253
Hospital Revenue Code	250
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$1.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.67
Rate for Payer: Aetna Government	$0.67
Rate for Payer: Brighton Health Commercial	$1.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.91
Rate for Payer: Group Health Inc Commercial	$0.67
Rate for Payer: Group Health Inc Medicare	$0.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.67
Rate for Payer: Hamaspik Choice Inc Medicare	$0.67
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.87

CARBAMAZEPINE 100 MG/5ML PO SUSP [1356]

Facility

$0.52

Service Code	NDC 00078050883
Hospital Charge Code	00078050883
Hospital Revenue Code	250
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.26
Rate for Payer: Aetna Government	$0.26
Rate for Payer: Brighton Health Commercial	$0.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.35
Rate for Payer: Group Health Inc Commercial	$0.26
Rate for Payer: Group Health Inc Medicare	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.26
Rate for Payer: Hamaspik Choice Inc Medicare	$0.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.34

CARBAMAZEPINE 100 MG/5 ML SUSP

Facility

$1.00

Hospital Charge Code	41645026
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Brighton Health Commercial	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65

CARBAMAZEPINE 100 MG/5 ML SUSP

Facility

$1.00

Hospital Charge Code	41655026
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Brighton Health Commercial	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65

CARBAMAZEPINE 100 MG/5 ML SUSP UDC

Facility

$3.70

Hospital Charge Code	41654928
Hospital Revenue Code	250
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$2.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.85
Rate for Payer: Aetna Government	$1.85
Rate for Payer: Brighton Health Commercial	$2.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.52
Rate for Payer: Group Health Inc Commercial	$1.85
Rate for Payer: Group Health Inc Medicare	$1.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.85
Rate for Payer: Hamaspik Choice Inc Medicare	$1.85
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.40

CARBAMAZEPINE 100 MG/5 ML SUSP UDC

Facility

$3.70

Hospital Charge Code	41644928
Hospital Revenue Code	250
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$2.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.85
Rate for Payer: Aetna Government	$1.85
Rate for Payer: Brighton Health Commercial	$2.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.52
Rate for Payer: Group Health Inc Commercial	$1.85
Rate for Payer: Group Health Inc Medicare	$1.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.85
Rate for Payer: Hamaspik Choice Inc Medicare	$1.85
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.40

CARBAMAZEPINE 100 MG CHEWABLE TAB

Facility

$1.15

Hospital Charge Code	41645025
Hospital Revenue Code	250
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$0.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.58
Rate for Payer: Aetna Government	$0.58
Rate for Payer: Brighton Health Commercial	$0.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.78
Rate for Payer: Group Health Inc Commercial	$0.58
Rate for Payer: Group Health Inc Medicare	$0.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.58
Rate for Payer: Hamaspik Choice Inc Medicare	$0.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.75

CARBAMAZEPINE 100 MG CHEWABLE TAB

Facility

$1.15

Hospital Charge Code	41655025
Hospital Revenue Code	250
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$0.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.58
Rate for Payer: Aetna Government	$0.58
Rate for Payer: Brighton Health Commercial	$0.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.78
Rate for Payer: Group Health Inc Commercial	$0.58
Rate for Payer: Group Health Inc Medicare	$0.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.58
Rate for Payer: Hamaspik Choice Inc Medicare	$0.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.75

CARBAMAZEPINE 100 MG PO CHEW [1355]

Facility

$0.59

Service Code	NDC 60687047911
Hospital Charge Code	60687047911
Hospital Revenue Code	250
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.29
Rate for Payer: Aetna Government	$0.29
Rate for Payer: Brighton Health Commercial	$0.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.40
Rate for Payer: Group Health Inc Commercial	$0.29
Rate for Payer: Group Health Inc Medicare	$0.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.29
Rate for Payer: Hamaspik Choice Inc Medicare	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.38

CARBAMAZEPINE 100 MG PO CHEW [1355]

Facility

$0.64

Service Code	NDC 00904385461
Hospital Charge Code	00904385461
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.32
Rate for Payer: Aetna Government	$0.32
Rate for Payer: Brighton Health Commercial	$0.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.43
Rate for Payer: Group Health Inc Commercial	$0.32
Rate for Payer: Group Health Inc Medicare	$0.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.32
Rate for Payer: Hamaspik Choice Inc Medicare	$0.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.42

CARBAMAZEPINE 100 MG PO CHEW [1355]

Facility

$0.59

Service Code	NDC 60687047901
Hospital Charge Code	60687047901
Hospital Revenue Code	250
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.29
Rate for Payer: Aetna Government	$0.29
Rate for Payer: Brighton Health Commercial	$0.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.40
Rate for Payer: Group Health Inc Commercial	$0.29
Rate for Payer: Group Health Inc Medicare	$0.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.29
Rate for Payer: Hamaspik Choice Inc Medicare	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.38

CARBAMAZEPINE 200 MG/10 ML SUSP UDC

Facility

$4.00

Hospital Charge Code	41653436
Hospital Revenue Code	250
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$3.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.00
Rate for Payer: Aetna Government	$2.00
Rate for Payer: Brighton Health Commercial	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.72
Rate for Payer: Group Health Inc Commercial	$2.00
Rate for Payer: Group Health Inc Medicare	$1.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.60

CARBAMAZEPINE 200 MG/10 ML SUSP UDC

Facility

$4.00

Hospital Charge Code	41643436
Hospital Revenue Code	250
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$3.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.00
Rate for Payer: Aetna Government	$2.00
Rate for Payer: Brighton Health Commercial	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.72
Rate for Payer: Group Health Inc Commercial	$2.00
Rate for Payer: Group Health Inc Medicare	$1.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.60

CARBAMAZEPINE 200 MG PO TABS [1357]

Facility

$3.61

Service Code	NDC 00078050905
Hospital Charge Code	00078050905
Hospital Revenue Code	250
Min. Negotiated Rate	$1.26
Max. Negotiated Rate	$2.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.81
Rate for Payer: Aetna Government	$1.81
Rate for Payer: Brighton Health Commercial	$2.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.46
Rate for Payer: Group Health Inc Commercial	$1.81
Rate for Payer: Group Health Inc Medicare	$1.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.81
Rate for Payer: Hamaspik Choice Inc Medicare	$1.81
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.35

CARBAMAZEPINE 200 MG PO TABS [1357]

Facility

$1.60

Service Code	NDC 51672400501
Hospital Charge Code	51672400501
Hospital Revenue Code	250
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$1.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.80
Rate for Payer: Aetna Government	$0.80
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	$1.09
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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.04

CARBAMAZEPINE 200 MG PO TABS [1357]

Facility

$1.60

Service Code	NDC 75834022101
Hospital Charge Code	75834022101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$1.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.80
Rate for Payer: Aetna Government	$0.80
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	$1.09
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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.04

CARBAMAZEPINE 200 MG PO TABS [1357]

Facility

$1.68

Service Code	NDC 13668026801
Hospital Charge Code	13668026801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$1.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.84
Rate for Payer: Aetna Government	$0.84
Rate for Payer: Brighton Health Commercial	$1.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.14
Rate for Payer: Group Health Inc Commercial	$0.84
Rate for Payer: Group Health Inc Medicare	$0.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.84
Rate for Payer: Hamaspik Choice Inc Medicare	$0.84
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.09

CARBAMAZEPINE 200 MG PO TABS [1357]

Facility

$1.12

Service Code	NDC 00904617261
Hospital Charge Code	00904617261
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$0.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.56
Rate for Payer: Aetna Government	$0.56
Rate for Payer: Brighton Health Commercial	$0.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.76
Rate for Payer: Group Health Inc Commercial	$0.56
Rate for Payer: Group Health Inc Medicare	$0.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.56
Rate for Payer: Hamaspik Choice Inc Medicare	$0.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.73

CARBAMAZEPINE 200 MG TAB

Facility

$2.00

Hospital Charge Code	41654970
Hospital Revenue Code	250
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.00
Rate for Payer: Aetna Government	$1.00
Rate for Payer: Brighton Health Commercial	$1.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.36
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

Know your out-of-pocket cost for care.

All Charges