St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ARIPIPRAZOLE 15 MG PO TABS

Facility

$32.11

Service Code	NDC 4359896830
Hospital Charge Code	4359896830
Hospital Revenue Code	250
Min. Negotiated Rate	$11.24
Max. Negotiated Rate	$25.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.05
Rate for Payer: Aetna Government	$16.05
Rate for Payer: Brighton Health Commercial	$24.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.83
Rate for Payer: EmblemHealth Commercial	$16.05
Rate for Payer: Group Health Inc Commercial	$16.05
Rate for Payer: Group Health Inc Medicare	$11.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.05
Rate for Payer: Hamaspik Choice Inc Medicare	$16.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.87

ARIPIPRAZOLE 15 MG PO TABS

Facility

$32.11

Service Code	NDC 1672928110
Hospital Charge Code	1672928110
Hospital Revenue Code	250
Min. Negotiated Rate	$16.06
Max. Negotiated Rate	$16.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.06

ARIPIPRAZOLE 15 MG PO TABS

Facility

$30.61

Service Code	NDC 5026809012
Hospital Charge Code	5026809012
Hospital Revenue Code	250
Min. Negotiated Rate	$15.31
Max. Negotiated Rate	$15.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.31

ARIPIPRAZOLE 15 MG PO TABS

Facility

$32.08

Service Code	NDC 6516289903
Hospital Charge Code	6516289903
Hospital Revenue Code	250
Min. Negotiated Rate	$11.23
Max. Negotiated Rate	$25.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.04
Rate for Payer: Aetna Government	$16.04
Rate for Payer: Brighton Health Commercial	$24.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.81
Rate for Payer: EmblemHealth Commercial	$16.04
Rate for Payer: Group Health Inc Commercial	$16.04
Rate for Payer: Group Health Inc Medicare	$11.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.04
Rate for Payer: Hamaspik Choice Inc Medicare	$16.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.85

ARIPIPRAZOLE 15 MG PO TABS

Facility

$23.35

Service Code	NDC 5914800913
Hospital Charge Code	5914800913
Hospital Revenue Code	250
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$18.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.68
Rate for Payer: Aetna Government	$11.68
Rate for Payer: Brighton Health Commercial	$17.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.88
Rate for Payer: EmblemHealth Commercial	$11.68
Rate for Payer: Group Health Inc Commercial	$11.68
Rate for Payer: Group Health Inc Medicare	$8.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.68
Rate for Payer: Hamaspik Choice Inc Medicare	$11.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15.18

ARIPIPRAZOLE 15 MG PO TABS

Facility

$32.01

Service Code	NDC 6787743303
Hospital Charge Code	6787743303
Hospital Revenue Code	250
Min. Negotiated Rate	$16.00
Max. Negotiated Rate	$16.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.00

ARIPIPRAZOLE 15 MG PO TABS

Facility

$23.35

Service Code	NDC 5914800913
Hospital Charge Code	5914800913
Hospital Revenue Code	250
Min. Negotiated Rate	$11.68
Max. Negotiated Rate	$11.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.68

ARIPIPRAZOLE 15 MG PO TABS

Facility

$32.08

Service Code	NDC 6516289903
Hospital Charge Code	6516289903
Hospital Revenue Code	250
Min. Negotiated Rate	$16.04
Max. Negotiated Rate	$16.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.04

ARIPIPRAZOLE 15 MG PO TABS

Facility

$32.01

Service Code	NDC 6787743303
Hospital Charge Code	6787743303
Hospital Revenue Code	250
Min. Negotiated Rate	$11.20
Max. Negotiated Rate	$25.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.00
Rate for Payer: Aetna Government	$16.00
Rate for Payer: Brighton Health Commercial	$24.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.76
Rate for Payer: EmblemHealth Commercial	$16.00
Rate for Payer: Group Health Inc Commercial	$16.00
Rate for Payer: Group Health Inc Medicare	$11.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.00
Rate for Payer: Hamaspik Choice Inc Medicare	$16.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.80

ARIPIPRAZOLE 2 MG PO TABS

Facility

$32.08

Service Code	NDC 4354730203
Hospital Charge Code	4354730203
Hospital Revenue Code	250
Min. Negotiated Rate	$16.04
Max. Negotiated Rate	$16.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.04

ARIPIPRAZOLE 2 MG PO TABS

Facility

$32.01

Service Code	NDC 6787743003
Hospital Charge Code	6787743003
Hospital Revenue Code	250
Min. Negotiated Rate	$16.00
Max. Negotiated Rate	$16.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.00

ARIPIPRAZOLE 2 MG PO TABS

Facility

$32.11

Service Code	NDC 1672927810
Hospital Charge Code	1672927810
Hospital Revenue Code	250
Min. Negotiated Rate	$16.06
Max. Negotiated Rate	$16.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.06

ARIPIPRAZOLE 2 MG PO TABS

Facility

$32.11

Service Code	NDC 1672927810
Hospital Charge Code	1672927810
Hospital Revenue Code	250
Min. Negotiated Rate	$11.24
Max. Negotiated Rate	$25.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.06
Rate for Payer: Aetna Government	$16.06
Rate for Payer: Brighton Health Commercial	$24.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.84
Rate for Payer: EmblemHealth Commercial	$16.06
Rate for Payer: Group Health Inc Commercial	$16.06
Rate for Payer: Group Health Inc Medicare	$11.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.06
Rate for Payer: Hamaspik Choice Inc Medicare	$16.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.87

ARIPIPRAZOLE 2 MG PO TABS

Facility

$32.01

Service Code	NDC 6787743003
Hospital Charge Code	6787743003
Hospital Revenue Code	250
Min. Negotiated Rate	$11.20
Max. Negotiated Rate	$25.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.00
Rate for Payer: Aetna Government	$16.00
Rate for Payer: Brighton Health Commercial	$24.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.76
Rate for Payer: EmblemHealth Commercial	$16.00
Rate for Payer: Group Health Inc Commercial	$16.00
Rate for Payer: Group Health Inc Medicare	$11.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.00
Rate for Payer: Hamaspik Choice Inc Medicare	$16.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.80

ARIPIPRAZOLE 2 MG PO TABS

Facility

$32.08

Service Code	NDC 4354730203
Hospital Charge Code	4354730203
Hospital Revenue Code	250
Min. Negotiated Rate	$11.23
Max. Negotiated Rate	$25.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.04
Rate for Payer: Aetna Government	$16.04
Rate for Payer: Brighton Health Commercial	$24.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.81
Rate for Payer: EmblemHealth Commercial	$16.04
Rate for Payer: Group Health Inc Commercial	$16.04
Rate for Payer: Group Health Inc Medicare	$11.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.04
Rate for Payer: Hamaspik Choice Inc Medicare	$16.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.85

ARIPIPRAZOLE 2 MG PO TABS

Facility

$32.08

Service Code	NDC 6516289603
Hospital Charge Code	6516289603
Hospital Revenue Code	250
Min. Negotiated Rate	$11.23
Max. Negotiated Rate	$25.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.04
Rate for Payer: Aetna Government	$16.04
Rate for Payer: Brighton Health Commercial	$24.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.81
Rate for Payer: EmblemHealth Commercial	$16.04
Rate for Payer: Group Health Inc Commercial	$16.04
Rate for Payer: Group Health Inc Medicare	$11.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.04
Rate for Payer: Hamaspik Choice Inc Medicare	$16.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.85

ARIPIPRAZOLE 2 MG PO TABS

Facility

$32.08

Service Code	NDC 6516289603
Hospital Charge Code	6516289603
Hospital Revenue Code	250
Min. Negotiated Rate	$16.04
Max. Negotiated Rate	$16.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.04

ARIPIPRAZOLE 5 MG PO TABS

Facility

$32.11

Service Code	NDC 4359896630
Hospital Charge Code	4359896630
Hospital Revenue Code	250
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.05

ARIPIPRAZOLE 5 MG PO TABS

Facility

$32.08

Service Code	NDC 6516289703
Hospital Charge Code	6516289703
Hospital Revenue Code	250
Min. Negotiated Rate	$16.04
Max. Negotiated Rate	$16.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.04

ARIPIPRAZOLE 5 MG PO TABS

Facility

$32.08

Service Code	NDC 6516289703
Hospital Charge Code	6516289703
Hospital Revenue Code	250
Min. Negotiated Rate	$11.23
Max. Negotiated Rate	$25.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.04
Rate for Payer: Aetna Government	$16.04
Rate for Payer: Brighton Health Commercial	$24.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.81
Rate for Payer: EmblemHealth Commercial	$16.04
Rate for Payer: Group Health Inc Commercial	$16.04
Rate for Payer: Group Health Inc Medicare	$11.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.04
Rate for Payer: Hamaspik Choice Inc Medicare	$16.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.85

ARIPIPRAZOLE 5 MG PO TABS

Facility

$32.01

Service Code	NDC 6787743103
Hospital Charge Code	6787743103
Hospital Revenue Code	250
Min. Negotiated Rate	$11.20
Max. Negotiated Rate	$25.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.00
Rate for Payer: Aetna Government	$16.00
Rate for Payer: Brighton Health Commercial	$24.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.76
Rate for Payer: EmblemHealth Commercial	$16.00
Rate for Payer: Group Health Inc Commercial	$16.00
Rate for Payer: Group Health Inc Medicare	$11.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.00
Rate for Payer: Hamaspik Choice Inc Medicare	$16.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.80

ARIPIPRAZOLE 5 MG PO TABS

Facility

$32.07

Service Code	NDC 1672927901
Hospital Charge Code	1672927901
Hospital Revenue Code	250
Min. Negotiated Rate	$11.23
Max. Negotiated Rate	$25.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.04
Rate for Payer: Aetna Government	$16.04
Rate for Payer: Brighton Health Commercial	$24.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.81
Rate for Payer: EmblemHealth Commercial	$16.04
Rate for Payer: Group Health Inc Commercial	$16.04
Rate for Payer: Group Health Inc Medicare	$11.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.04
Rate for Payer: Hamaspik Choice Inc Medicare	$16.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.85

ARIPIPRAZOLE 5 MG PO TABS

Facility

$32.01

Service Code	NDC 6787743103
Hospital Charge Code	6787743103
Hospital Revenue Code	250
Min. Negotiated Rate	$16.00
Max. Negotiated Rate	$16.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.00

ARIPIPRAZOLE 5 MG PO TABS

Facility

$32.07

Service Code	NDC 1672927901
Hospital Charge Code	1672927901
Hospital Revenue Code	250
Min. Negotiated Rate	$16.04
Max. Negotiated Rate	$16.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.04

ARIPIPRAZOLE 5 MG PO TABS

Facility

$10.04

Service Code	NDC 0904736706
Hospital Charge Code	0904736706
Hospital Revenue Code	250
Min. Negotiated Rate	$5.02
Max. Negotiated Rate	$5.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.02

Know your out-of-pocket cost for care.

All Charges