St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ARIPIPRAZOLE 15 MG PO TABS

Facility

$30.61

Service Code	NDC 5026809012
Hospital Charge Code	5026809012
Hospital Revenue Code	250
Min. Negotiated Rate	$10.71
Max. Negotiated Rate	$24.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.31
Rate for Payer: Aetna Government	$15.31
Rate for Payer: Brighton Health Commercial	$22.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.82
Rate for Payer: EmblemHealth Commercial	$15.31
Rate for Payer: Group Health Inc Commercial	$15.31
Rate for Payer: Group Health Inc Medicare	$10.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.31
Rate for Payer: Hamaspik Choice Inc Medicare	$15.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$19.90

ARIPIPRAZOLE 15 MG PO TABS

Facility

$30.61

Service Code	NDC 5026809011
Hospital Charge Code	5026809011
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

$32.11

Service Code	NDC 4359896830
Hospital Charge Code	4359896830
Hospital Revenue Code	250
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.05

ARIPIPRAZOLE 15 MG PO TABS

Facility

$30.61

Service Code	NDC 5026809011
Hospital Charge Code	5026809011
Hospital Revenue Code	250
Min. Negotiated Rate	$10.71
Max. Negotiated Rate	$24.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.31
Rate for Payer: Aetna Government	$15.31
Rate for Payer: Brighton Health Commercial	$22.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.82
Rate for Payer: EmblemHealth Commercial	$15.31
Rate for Payer: Group Health Inc Commercial	$15.31
Rate for Payer: Group Health Inc Medicare	$10.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.31
Rate for Payer: Hamaspik Choice Inc Medicare	$15.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$19.90

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

$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 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

$32.08

Service Code	NDC 4354730503
Hospital Charge Code	4354730503
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

$32.11

Service Code	NDC 1672928110
Hospital Charge Code	1672928110
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

$32.08

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 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

$32.08

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 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

$32.01

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

$32.01

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

$32.11

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 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

$32.11

Service Code	NDC 4359896630
Hospital Charge Code	4359896630
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 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

$0.46

Service Code	NDC 0904665640
Hospital Charge Code	0904665640
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23

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

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

$0.46

Service Code	NDC 0904665640
Hospital Charge Code	0904665640
Hospital Revenue Code	250
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.23
Rate for Payer: Aetna Government	$0.23
Rate for Payer: Brighton Health Commercial	$0.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.31
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

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

Know your out-of-pocket cost for care.

All Charges