St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CLINDAMYCIN 900 MG/D5W 50 ML IVPB PREMIX

Facility

$32.06

Service Code	HCPCS J3490
Hospital Charge Code	41650456
Hospital Revenue Code	636
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$16.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.03
Rate for Payer: Hamaspik Choice Inc Medicare	$16.03

CLINDAMYCIN HCL 150 MG PO CAPS [1740]

Facility

$0.73

Service Code	NDC 00904595961
Hospital Charge Code	00904595961
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.37
Rate for Payer: Aetna Government	$0.37
Rate for Payer: Brighton Health Commercial	$0.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.50
Rate for Payer: Group Health Inc Commercial	$0.37
Rate for Payer: Group Health Inc Medicare	$0.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.37
Rate for Payer: Hamaspik Choice Inc Medicare	$0.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.48

CLINDAMYCIN HCL 150 MG PO CAPS [1740]

Facility

$1.19

Service Code	NDC 63304069201
Hospital Charge Code	63304069201
Hospital Revenue Code	250
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$0.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.60
Rate for Payer: Aetna Government	$0.60
Rate for Payer: Brighton Health Commercial	$0.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.81
Rate for Payer: Group Health Inc Commercial	$0.60
Rate for Payer: Group Health Inc Medicare	$0.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.60
Rate for Payer: Hamaspik Choice Inc Medicare	$0.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.77

CLINDAMYCIN PALMITATE HCL 75 MG/5ML PO SOLR [37642]

Facility

$0.62

Service Code	NDC 59762001601
Hospital Charge Code	59762001601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.31
Rate for Payer: Aetna Government	$0.31
Rate for Payer: Brighton Health Commercial	$0.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.42
Rate for Payer: Group Health Inc Commercial	$0.31
Rate for Payer: Group Health Inc Medicare	$0.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.31
Rate for Payer: Hamaspik Choice Inc Medicare	$0.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.40

CLINDAMYCIN PHOSPHATE 1 % EX SOLN [1742]

Facility

$0.74

Service Code	NDC 00168020130
Hospital Charge Code	00168020130
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.37
Rate for Payer: Aetna Government	$0.37
Rate for Payer: Brighton Health Commercial	$0.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.50
Rate for Payer: Group Health Inc Commercial	$0.37
Rate for Payer: Group Health Inc Medicare	$0.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.37
Rate for Payer: Hamaspik Choice Inc Medicare	$0.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.48

CLINDAMYCIN PHOSPHATE 1 % EX SOLN [1742]

Facility

$1.36

Service Code	NDC 21922000221
Hospital Charge Code	21922000221
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$1.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.68
Rate for Payer: Aetna Government	$0.68
Rate for Payer: Brighton Health Commercial	$1.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.92
Rate for Payer: Group Health Inc Commercial	$0.68
Rate for Payer: Group Health Inc Medicare	$0.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.68
Rate for Payer: Hamaspik Choice Inc Medicare	$0.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.88

CLINDAMYCIN PHOSPHATE 1 % EX SOLN [1742]

Facility

$1.36

Service Code	NDC 21922000201
Hospital Charge Code	21922000201
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$1.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.68
Rate for Payer: Aetna Government	$0.68
Rate for Payer: Brighton Health Commercial	$1.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.92
Rate for Payer: Group Health Inc Commercial	$0.68
Rate for Payer: Group Health Inc Medicare	$0.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.68
Rate for Payer: Hamaspik Choice Inc Medicare	$0.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.88

CLINDAMYCIN PHOSPHATE 1 % EX SOLN [1742]

Facility

$0.97

Service Code	NDC 45802056202
Hospital Charge Code	45802056202
Hospital Revenue Code	250
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Brighton Health Commercial	$0.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.66
Rate for Payer: Group Health Inc Commercial	$0.48
Rate for Payer: Group Health Inc Medicare	$0.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.48
Rate for Payer: Hamaspik Choice Inc Medicare	$0.48
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.63

CLINDAMYCIN PHOSPHATE 300 MG/2ML IJ SOLN [82303]

Facility

$1.49

Service Code	HCPCS J0736
Hospital Charge Code	00009087026
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.90
Rate for Payer: Aetna Government	$1.90
Rate for Payer: Affinity Essential Plan 1&2	$1.33
Rate for Payer: Affinity Essential Plan 3&4	$1.33
Rate for Payer: Affinity Medicaid/CHP/HARP	$1.33
Rate for Payer: Brighton Health Commercial	$1.12
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.01
Rate for Payer: Elderplan Medicare Advantage	$1.90
Rate for Payer: EmblemHealth Commercial	$1.90
Rate for Payer: Fidelis Essential Plan Aliesa	$1.62
Rate for Payer: Fidelis Essential Plan QHP	$1.69
Rate for Payer: Fidelis Medicare Advantage	$1.90
Rate for Payer: Fidelis Qualified Health Plan	$1.69
Rate for Payer: Group Health Inc Commercial	$1.90
Rate for Payer: Group Health Inc Medicare	$1.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1.90
Rate for Payer: Healthfirst Medicare Advantage	$1.62
Rate for Payer: Healthfirst QHP	$1.90
Rate for Payer: Humana Medicare	$1.94
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2.27
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$2.40
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$2.40
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$2.40
Rate for Payer: Senior Whole Health Medicare Advantage	$1.90
Rate for Payer: United Healthcare Medicare Advantage	$1.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.97
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1.52
Rate for Payer: Wellcare Medicare	$1.81

CLINDAMYCIN PHOSPHATE 600MG/4ML

Facility

$1.30

Service Code	HCPCS J3490
Hospital Charge Code	41654156
Hospital Revenue Code	636
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.65
Rate for Payer: Aetna Government	$0.65
Rate for Payer: Brighton Health Commercial	$0.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.75
Rate for Payer: Group Health Inc Commercial	$0.65
Rate for Payer: Group Health Inc Medicare	$0.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.65
Rate for Payer: Hamaspik Choice Inc Medicare	$0.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.85

CLINDAMYCIN PHOSPHATE 600MG/4ML

Facility

$1.30

Service Code	HCPCS J3490
Hospital Charge Code	41644156
Hospital Revenue Code	636
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$0.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.65
Rate for Payer: Hamaspik Choice Inc Medicare	$0.65

CLINDAMYCIN PHOSPHATE 600MG/4ML

Facility

$1.30

Service Code	HCPCS J3490
Hospital Charge Code	41644156
Hospital Revenue Code	636
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.65
Rate for Payer: Aetna Government	$0.65
Rate for Payer: Brighton Health Commercial	$0.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.75
Rate for Payer: Group Health Inc Commercial	$0.65
Rate for Payer: Group Health Inc Medicare	$0.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.65
Rate for Payer: Hamaspik Choice Inc Medicare	$0.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.85

CLINDAMYCIN PHOSPHATE 600MG/4ML

Facility

$1.30

Service Code	HCPCS J3490
Hospital Charge Code	41654156
Hospital Revenue Code	636
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$0.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.65
Rate for Payer: Hamaspik Choice Inc Medicare	$0.65

CLINDAMYCIN PHOSPHATE 600 MG/4ML IJ SOLN [82301]

Facility

$0.88

Service Code	NDC 00009077526
Hospital Charge Code	00009077526
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.44
Rate for Payer: Aetna Government	$0.44
Rate for Payer: Brighton Health Commercial	$0.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.60
Rate for Payer: Group Health Inc Commercial	$0.44
Rate for Payer: Group Health Inc Medicare	$0.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.44
Rate for Payer: Hamaspik Choice Inc Medicare	$0.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.57

CLINDAMYCIN PHOSPHATE 900 MG/6ML IJ SOLN [82302]

Facility

$0.95

Service Code	NDC 25021011506
Hospital Charge Code	25021011506
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Brighton Health Commercial	$0.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.65
Rate for Payer: Group Health Inc Commercial	$0.48
Rate for Payer: Group Health Inc Medicare	$0.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.48
Rate for Payer: Hamaspik Choice Inc Medicare	$0.48
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.62

CLINDAMYCIN PHOSPHATE 900 MG/6ML IJ SOLN [82302]

Facility

$0.85

Service Code	NDC 00009090218
Hospital Charge Code	00009090218
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.43
Rate for Payer: Aetna Government	$0.43
Rate for Payer: Brighton Health Commercial	$0.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.58
Rate for Payer: Group Health Inc Commercial	$0.43
Rate for Payer: Group Health Inc Medicare	$0.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.43
Rate for Payer: Hamaspik Choice Inc Medicare	$0.43
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.55

CLINDAMYCIN PHOSPHATE 9 GM/60ML IJ SOLN [108134]

Facility

$0.47

Service Code	NDC 00009072805
Hospital Charge Code	00009072805
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: 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

CLINDAMYCIN PHOSPHATE IN D5W 300 MG/50ML IV SOLN [9625]

Facility

$0.17

Service Code	HCPCS J0736
Hospital Charge Code	00338341024
Hospital Revenue Code	278
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.90
Rate for Payer: Aetna Government	$1.90
Rate for Payer: Brighton Health Commercial	$0.10
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: Elderplan Medicare Advantage	$1.90
Rate for Payer: EmblemHealth Commercial	$0.09
Rate for Payer: Fidelis Medicare Advantage	$1.90
Rate for Payer: Group Health Inc Commercial	$1.90
Rate for Payer: Group Health Inc Medicare	$1.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.09
Rate for Payer: Hamaspik Choice Inc Medicare	$0.09
Rate for Payer: Healthfirst Medicare Advantage	$1.62
Rate for Payer: Healthfirst QHP	$1.90
Rate for Payer: Humana Medicare	$1.94
Rate for Payer: Senior Whole Health Medicare Advantage	$1.90
Rate for Payer: United Healthcare Medicare Advantage	$1.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.11
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1.52

CLINDAMYCIN PHOSPHATE IN D5W 300 MG/50ML IV SOLN [9625]

Facility

$0.17

Service Code	HCPCS J0736
Hospital Charge Code	00338341050
Hospital Revenue Code	278
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.90
Rate for Payer: Aetna Government	$1.90
Rate for Payer: Brighton Health Commercial	$0.10
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: Elderplan Medicare Advantage	$1.90
Rate for Payer: EmblemHealth Commercial	$0.09
Rate for Payer: Fidelis Medicare Advantage	$1.90
Rate for Payer: Group Health Inc Commercial	$1.90
Rate for Payer: Group Health Inc Medicare	$1.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.09
Rate for Payer: Hamaspik Choice Inc Medicare	$0.09
Rate for Payer: Healthfirst Medicare Advantage	$1.62
Rate for Payer: Healthfirst QHP	$1.90
Rate for Payer: Humana Medicare	$1.94
Rate for Payer: Senior Whole Health Medicare Advantage	$1.90
Rate for Payer: United Healthcare Medicare Advantage	$1.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.11
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1.52

CLINDAMYCIN PHOSPHATE IN D5W 300 MG/50ML IV SOLN [9625]

Facility

$0.17

Service Code	HCPCS J0736
Hospital Charge Code	00338341050
Hospital Revenue Code	278
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.09
Rate for Payer: Hamaspik Choice Inc Medicare	$0.09

CLINDAMYCIN PHOSPHATE IN D5W 300 MG/50ML IV SOLN [9625]

Facility

$0.17

Service Code	HCPCS J0736
Hospital Charge Code	00338341024
Hospital Revenue Code	278
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.09
Rate for Payer: Hamaspik Choice Inc Medicare	$0.09

CLINDAMYCIN PHOSPHATE IN D5W 600 MG/50ML IV SOLN [9626]

Facility

$0.26

Service Code	HCPCS J0736
Hospital Charge Code	00338361650
Hospital Revenue Code	278
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13
Rate for Payer: Hamaspik Choice Inc Medicare	$0.13

CLINDAMYCIN PHOSPHATE IN D5W 600 MG/50ML IV SOLN [9626]

Facility

$0.26

Service Code	HCPCS J0736
Hospital Charge Code	00338361650
Hospital Revenue Code	278
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$1.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.90
Rate for Payer: Aetna Government	$1.90
Rate for Payer: Brighton Health Commercial	$0.15
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.15
Rate for Payer: Elderplan Medicare Advantage	$1.90
Rate for Payer: EmblemHealth Commercial	$0.13
Rate for Payer: Fidelis Medicare Advantage	$1.90
Rate for Payer: Group Health Inc Commercial	$1.90
Rate for Payer: Group Health Inc Medicare	$1.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13
Rate for Payer: Hamaspik Choice Inc Medicare	$0.13
Rate for Payer: Healthfirst Medicare Advantage	$1.62
Rate for Payer: Healthfirst QHP	$1.90
Rate for Payer: Humana Medicare	$1.94
Rate for Payer: Senior Whole Health Medicare Advantage	$1.90
Rate for Payer: United Healthcare Medicare Advantage	$1.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.17
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1.52

CLINDAMYCIN PHOSPHATE IN D5W 600 MG/50ML IV SOLN [9626]

Facility

$0.26

Service Code	HCPCS J0736
Hospital Charge Code	00338361250
Hospital Revenue Code	278
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13
Rate for Payer: Hamaspik Choice Inc Medicare	$0.13

CLINDAMYCIN PHOSPHATE IN D5W 600 MG/50ML IV SOLN [9626]

Facility

$0.30

Service Code	HCPCS J0736
Hospital Charge Code	00781328991
Hospital Revenue Code	278
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15
Rate for Payer: Hamaspik Choice Inc Medicare	$0.15

Know your out-of-pocket cost for care.

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