St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CEFOXITIN IVP < 2000MG

Facility

$7.26

Service Code	HCPCS J0694
Hospital Charge Code	41647827
Hospital Revenue Code	636
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$5.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.61
Rate for Payer: Aetna Government	$4.61
Rate for Payer: Brighton Health Commercial	$4.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.17
Rate for Payer: Group Health Inc Commercial	$3.63
Rate for Payer: Group Health Inc Medicare	$2.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.63
Rate for Payer: Hamaspik Choice Inc Medicare	$3.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5.19
Rate for Payer: SOMOS Essential	$5.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.72

CEFOXITIN IVP < 2000MG

Facility

$7.26

Service Code	HCPCS J0694
Hospital Charge Code	41657827
Hospital Revenue Code	636
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$3.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.63
Rate for Payer: Hamaspik Choice Inc Medicare	$3.63

CEFOXITIN IVP < 2000MG

Facility

$7.26

Service Code	HCPCS J0694
Hospital Charge Code	41657827
Hospital Revenue Code	636
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$5.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.61
Rate for Payer: Aetna Government	$4.61
Rate for Payer: Brighton Health Commercial	$4.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.17
Rate for Payer: Group Health Inc Commercial	$3.63
Rate for Payer: Group Health Inc Medicare	$2.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.63
Rate for Payer: Hamaspik Choice Inc Medicare	$3.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5.19
Rate for Payer: SOMOS Essential	$5.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.72

CEFOXITIN IVP < 2000MG

Facility

$7.26

Service Code	HCPCS J0694
Hospital Charge Code	41647827
Hospital Revenue Code	636
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$3.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.63
Rate for Payer: Hamaspik Choice Inc Medicare	$3.63

CEFOXITIN SODIUM 1 G IV SOLR [9461]

Facility

$7.20

Service Code	HCPCS J0694
Hospital Charge Code	25021010910
Hospital Revenue Code	278
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$7.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.61
Rate for Payer: Aetna Government	$4.61
Rate for Payer: Brighton Health Commercial	$4.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.14
Rate for Payer: EmblemHealth Commercial	$3.60
Rate for Payer: Fidelis Medicare Advantage	$7.56
Rate for Payer: Group Health Inc Commercial	$3.60
Rate for Payer: Group Health Inc Medicare	$2.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.60
Rate for Payer: Hamaspik Choice Inc Medicare	$3.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.68

CEFOXITIN SODIUM 1 G IV SOLR [9461]

Facility

$11.88

Service Code	HCPCS J0694
Hospital Charge Code	00143987825
Hospital Revenue Code	278
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$12.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.61
Rate for Payer: Aetna Government	$4.61
Rate for Payer: Brighton Health Commercial	$7.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.83
Rate for Payer: EmblemHealth Commercial	$5.94
Rate for Payer: Fidelis Medicare Advantage	$12.47
Rate for Payer: Group Health Inc Commercial	$5.94
Rate for Payer: Group Health Inc Medicare	$4.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.94
Rate for Payer: Hamaspik Choice Inc Medicare	$5.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.72

CEFOXITIN SODIUM 1 G IV SOLR [9461]

Facility

$11.88

Service Code	HCPCS J0694
Hospital Charge Code	00143987825
Hospital Revenue Code	278
Min. Negotiated Rate	$5.94
Max. Negotiated Rate	$5.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.94
Rate for Payer: Hamaspik Choice Inc Medicare	$5.94

CEFOXITIN SODIUM 1 G IV SOLR [9461]

Facility

$11.94

Service Code	HCPCS J0694
Hospital Charge Code	44567024525
Hospital Revenue Code	278
Min. Negotiated Rate	$5.97
Max. Negotiated Rate	$5.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.97
Rate for Payer: Hamaspik Choice Inc Medicare	$5.97

CEFOXITIN SODIUM 1 G IV SOLR [9461]

Facility

$11.94

Service Code	HCPCS J0694
Hospital Charge Code	44567024525
Hospital Revenue Code	278
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$12.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.61
Rate for Payer: Aetna Government	$4.61
Rate for Payer: Brighton Health Commercial	$7.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.87
Rate for Payer: EmblemHealth Commercial	$5.97
Rate for Payer: Fidelis Medicare Advantage	$12.54
Rate for Payer: Group Health Inc Commercial	$5.97
Rate for Payer: Group Health Inc Medicare	$4.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.97
Rate for Payer: Hamaspik Choice Inc Medicare	$5.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.76

CEFOXITIN SODIUM 1 G IV SOLR [9461]

Facility

$7.20

Service Code	HCPCS J0694
Hospital Charge Code	25021010910
Hospital Revenue Code	278
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.60
Rate for Payer: Hamaspik Choice Inc Medicare	$3.60

CEFOXITIN SODIUM 2 G IV SOLR [9463]

Facility

$12.00

Service Code	HCPCS J0694
Hospital Charge Code	25021011020
Hospital Revenue Code	278
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$12.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.61
Rate for Payer: Aetna Government	$4.61
Rate for Payer: Brighton Health Commercial	$7.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.90
Rate for Payer: EmblemHealth Commercial	$6.00
Rate for Payer: Fidelis Medicare Advantage	$12.60
Rate for Payer: Group Health Inc Commercial	$6.00
Rate for Payer: Group Health Inc Medicare	$4.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.80

CEFOXITIN SODIUM 2 G IV SOLR [9463]

Facility

$12.00

Service Code	HCPCS J0694
Hospital Charge Code	25021011020
Hospital Revenue Code	278
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6.00

CEFOXITIN SODIUM 2 G IV SOLR [9463]

Facility

$23.76

Service Code	HCPCS J0694
Hospital Charge Code	00143987725
Hospital Revenue Code	278
Min. Negotiated Rate	$4.61
Max. Negotiated Rate	$24.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.61
Rate for Payer: Aetna Government	$4.61
Rate for Payer: Brighton Health Commercial	$14.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.66
Rate for Payer: EmblemHealth Commercial	$11.88
Rate for Payer: Fidelis Medicare Advantage	$24.95
Rate for Payer: Group Health Inc Commercial	$11.88
Rate for Payer: Group Health Inc Medicare	$8.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.88
Rate for Payer: Hamaspik Choice Inc Medicare	$11.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15.44

CEFOXITIN SODIUM 2 G IV SOLR [9463]

Facility

$23.94

Service Code	HCPCS J0694
Hospital Charge Code	44567024625
Hospital Revenue Code	278
Min. Negotiated Rate	$11.97
Max. Negotiated Rate	$11.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.97
Rate for Payer: Hamaspik Choice Inc Medicare	$11.97

CEFOXITIN SODIUM 2 G IV SOLR [9463]

Facility

$23.76

Service Code	HCPCS J0694
Hospital Charge Code	00143987725
Hospital Revenue Code	278
Min. Negotiated Rate	$11.88
Max. Negotiated Rate	$11.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.88
Rate for Payer: Hamaspik Choice Inc Medicare	$11.88

CEFOXITIN SODIUM 2 G IV SOLR [9463]

Facility

$23.94

Service Code	HCPCS J0694
Hospital Charge Code	44567024625
Hospital Revenue Code	278
Min. Negotiated Rate	$4.61
Max. Negotiated Rate	$25.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.61
Rate for Payer: Aetna Government	$4.61
Rate for Payer: Brighton Health Commercial	$14.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.77
Rate for Payer: EmblemHealth Commercial	$11.97
Rate for Payer: Fidelis Medicare Advantage	$25.14
Rate for Payer: Group Health Inc Commercial	$11.97
Rate for Payer: Group Health Inc Medicare	$8.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.97
Rate for Payer: Hamaspik Choice Inc Medicare	$11.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15.56

CEFPODOXIME PROXETIL 200 MG PO TABS [9469]

Facility

$8.46

Service Code	NDC 65862009620
Hospital Charge Code	65862009620
Hospital Revenue Code	250
Min. Negotiated Rate	$2.96
Max. Negotiated Rate	$6.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.23
Rate for Payer: Aetna Government	$4.23
Rate for Payer: Brighton Health Commercial	$6.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.75
Rate for Payer: Group Health Inc Commercial	$4.23
Rate for Payer: Group Health Inc Medicare	$2.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.23
Rate for Payer: Hamaspik Choice Inc Medicare	$4.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.50

CEFTAROLINE 200MG/D5W 50ML IVPB

Facility

$7.76

Service Code	HCPCS J0712
Hospital Charge Code	41655719
Hospital Revenue Code	636
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.88
Rate for Payer: Hamaspik Choice Inc Medicare	$3.88

CEFTAROLINE 200MG/D5W 50ML IVPB

Facility

$7.76

Service Code	HCPCS J0712
Hospital Charge Code	41655719
Hospital Revenue Code	636
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$5.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.84
Rate for Payer: Aetna Government	$3.84
Rate for Payer: Affinity Essential Plan 1&2	$2.68
Rate for Payer: Affinity Essential Plan 3&4	$2.68
Rate for Payer: Affinity Medicaid/CHP/HARP	$2.68
Rate for Payer: Brighton Health Commercial	$4.66
Rate for Payer: Cash Price	$3.84
Rate for Payer: Cash Price	$3.84
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.46
Rate for Payer: Elderplan Medicare Advantage	$3.84
Rate for Payer: EmblemHealth Commercial	$3.84
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3.84
Rate for Payer: Fidelis Essential Plan Aliesa	$3.84
Rate for Payer: Fidelis Essential Plan QHP	$4.03
Rate for Payer: Fidelis Medicare Advantage	$3.84
Rate for Payer: Fidelis Qualified Health Plan	$4.03
Rate for Payer: Group Health Inc Commercial	$3.84
Rate for Payer: Group Health Inc Medicare	$3.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.88
Rate for Payer: Hamaspik Choice Inc Medicare	$3.88
Rate for Payer: Healthfirst Medicare Advantage	$3.26
Rate for Payer: Healthfirst QHP	$3.84
Rate for Payer: Humana Medicare	$3.91
Rate for Payer: Senior Whole Health Medicare Advantage	$3.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4.09
Rate for Payer: SOMOS Essential	$4.09
Rate for Payer: United Healthcare Commercial	$3.78
Rate for Payer: United Healthcare Medicare Advantage	$3.84
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.04
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.07
Rate for Payer: Wellcare Medicare	$3.64

CEFTAROLINE 200MG/D5W 50ML IVPB

Facility

$7.76

Service Code	HCPCS J0712
Hospital Charge Code	41645719
Hospital Revenue Code	636
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$5.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.84
Rate for Payer: Aetna Government	$3.84
Rate for Payer: Affinity Essential Plan 1&2	$2.68
Rate for Payer: Affinity Essential Plan 3&4	$2.68
Rate for Payer: Affinity Medicaid/CHP/HARP	$2.68
Rate for Payer: Brighton Health Commercial	$4.66
Rate for Payer: Cash Price	$3.84
Rate for Payer: Cash Price	$3.84
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.46
Rate for Payer: Elderplan Medicare Advantage	$3.84
Rate for Payer: EmblemHealth Commercial	$3.84
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3.84
Rate for Payer: Fidelis Essential Plan Aliesa	$3.84
Rate for Payer: Fidelis Essential Plan QHP	$4.03
Rate for Payer: Fidelis Medicare Advantage	$3.84
Rate for Payer: Fidelis Qualified Health Plan	$4.03
Rate for Payer: Group Health Inc Commercial	$3.84
Rate for Payer: Group Health Inc Medicare	$3.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.88
Rate for Payer: Hamaspik Choice Inc Medicare	$3.88
Rate for Payer: Healthfirst Medicare Advantage	$3.26
Rate for Payer: Healthfirst QHP	$3.84
Rate for Payer: Humana Medicare	$3.91
Rate for Payer: Senior Whole Health Medicare Advantage	$3.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4.09
Rate for Payer: SOMOS Essential	$4.09
Rate for Payer: United Healthcare Commercial	$3.78
Rate for Payer: United Healthcare Medicare Advantage	$3.84
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.04
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.07
Rate for Payer: Wellcare Medicare	$3.64

CEFTAROLINE 200MG/D5W 50ML IVPB

Facility

$7.76

Service Code	HCPCS J0712
Hospital Charge Code	41645719
Hospital Revenue Code	636
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.88
Rate for Payer: Hamaspik Choice Inc Medicare	$3.88

CEFTAROLINE 200MG/NL 50ML IVPB

Facility

$7.76

Service Code	HCPCS J0712
Hospital Charge Code	41655721
Hospital Revenue Code	636
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.88
Rate for Payer: Hamaspik Choice Inc Medicare	$3.88

CEFTAROLINE 200MG/NL 50ML IVPB

Facility

$7.76

Service Code	HCPCS J0712
Hospital Charge Code	41655721
Hospital Revenue Code	636
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$5.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.84
Rate for Payer: Aetna Government	$3.84
Rate for Payer: Affinity Essential Plan 1&2	$2.68
Rate for Payer: Affinity Essential Plan 3&4	$2.68
Rate for Payer: Affinity Medicaid/CHP/HARP	$2.68
Rate for Payer: Brighton Health Commercial	$4.66
Rate for Payer: Cash Price	$3.84
Rate for Payer: Cash Price	$3.84
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.46
Rate for Payer: Elderplan Medicare Advantage	$3.84
Rate for Payer: EmblemHealth Commercial	$3.84
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3.84
Rate for Payer: Fidelis Essential Plan Aliesa	$3.84
Rate for Payer: Fidelis Essential Plan QHP	$4.03
Rate for Payer: Fidelis Medicare Advantage	$3.84
Rate for Payer: Fidelis Qualified Health Plan	$4.03
Rate for Payer: Group Health Inc Commercial	$3.84
Rate for Payer: Group Health Inc Medicare	$3.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.88
Rate for Payer: Hamaspik Choice Inc Medicare	$3.88
Rate for Payer: Healthfirst Medicare Advantage	$3.26
Rate for Payer: Healthfirst QHP	$3.84
Rate for Payer: Humana Medicare	$3.91
Rate for Payer: Senior Whole Health Medicare Advantage	$3.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4.09
Rate for Payer: SOMOS Essential	$4.09
Rate for Payer: United Healthcare Commercial	$3.78
Rate for Payer: United Healthcare Medicare Advantage	$3.84
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.04
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.07
Rate for Payer: Wellcare Medicare	$3.64

CEFTAROLINE 300MG/D5W 50ML IVPB

Facility

$7.00

Service Code	HCPCS J0712
Hospital Charge Code	41655723
Hospital Revenue Code	636
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$4.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.84
Rate for Payer: Aetna Government	$3.84
Rate for Payer: Affinity Essential Plan 1&2	$2.68
Rate for Payer: Affinity Essential Plan 3&4	$2.68
Rate for Payer: Affinity Medicaid/CHP/HARP	$2.68
Rate for Payer: Brighton Health Commercial	$4.20
Rate for Payer: Cash Price	$3.84
Rate for Payer: Cash Price	$3.84
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.02
Rate for Payer: Elderplan Medicare Advantage	$3.84
Rate for Payer: EmblemHealth Commercial	$3.84
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3.84
Rate for Payer: Fidelis Essential Plan Aliesa	$3.84
Rate for Payer: Fidelis Essential Plan QHP	$4.03
Rate for Payer: Fidelis Medicare Advantage	$3.84
Rate for Payer: Fidelis Qualified Health Plan	$4.03
Rate for Payer: Group Health Inc Commercial	$3.84
Rate for Payer: Group Health Inc Medicare	$3.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50
Rate for Payer: Healthfirst Medicare Advantage	$3.26
Rate for Payer: Healthfirst QHP	$3.84
Rate for Payer: Humana Medicare	$3.91
Rate for Payer: Senior Whole Health Medicare Advantage	$3.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4.09
Rate for Payer: SOMOS Essential	$4.09
Rate for Payer: United Healthcare Commercial	$3.78
Rate for Payer: United Healthcare Medicare Advantage	$3.84
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.55
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.07
Rate for Payer: Wellcare Medicare	$3.64

CEFTAROLINE 300MG/D5W 50ML IVPB

Facility

$7.00

Service Code	HCPCS J0712
Hospital Charge Code	41655723
Hospital Revenue Code	636
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$3.50
Rate for Payer: Cash Price	$3.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50

Know your out-of-pocket cost for care.

All Charges