Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL FILM

Facility

IP

$4.91

Service Code	NDC 4778135503
Hospital Charge Code	4778135503
Hospital Revenue Code	250
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.45

BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL FILM

Facility

IP

$4.91

Service Code	NDC 4778135511
Hospital Charge Code	4778135511
Hospital Revenue Code	250
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.45

BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL FILM

Facility

IP

$4.91

Service Code	NDC 4359857901
Hospital Charge Code	4359857901
Hospital Revenue Code	250
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$2.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.46

BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL FILM

Facility

OP

$4.91

Service Code	NDC 4778135503
Hospital Charge Code	4778135503
Hospital Revenue Code	250
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$3.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.45
Rate for Payer: Aetna Government	$2.45
Rate for Payer: Brighton Health Commercial	$3.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.34
Rate for Payer: EmblemHealth Commercial	$2.45
Rate for Payer: Group Health Inc Commercial	$2.45
Rate for Payer: Group Health Inc Medicare	$1.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.45
Rate for Payer: Hamaspik Choice Inc Medicare	$2.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.19

BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL FILM

Facility

OP

$6.01

Service Code	NDC 1249612023
Hospital Charge Code	1249612023
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.01
Rate for Payer: Aetna Government	$3.01
Rate for Payer: Brighton Health Commercial	$4.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.09
Rate for Payer: EmblemHealth Commercial	$3.01
Rate for Payer: Group Health Inc Commercial	$3.01
Rate for Payer: Group Health Inc Medicare	$2.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.01
Rate for Payer: Hamaspik Choice Inc Medicare	$3.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.91

BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL FILM (4W DETOX)

Facility

OP

$4.91

Service Code	NDC 4359857901
Hospital Charge Code	4359857901
Hospital Revenue Code	250
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$3.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.46
Rate for Payer: Aetna Government	$2.46
Rate for Payer: Brighton Health Commercial	$3.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.34
Rate for Payer: EmblemHealth Commercial	$2.46
Rate for Payer: Group Health Inc Commercial	$2.46
Rate for Payer: Group Health Inc Medicare	$1.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.46
Rate for Payer: Hamaspik Choice Inc Medicare	$2.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.19

BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL FILM (4W DETOX)

Facility

IP

$4.91

Service Code	NDC 4359857930
Hospital Charge Code	4359857930
Hospital Revenue Code	250
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$2.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.46

BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL FILM (4W DETOX)

Facility

OP

$4.91

Service Code	NDC 4359857930
Hospital Charge Code	4359857930
Hospital Revenue Code	250
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$3.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.46
Rate for Payer: Aetna Government	$2.46
Rate for Payer: Brighton Health Commercial	$3.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.34
Rate for Payer: EmblemHealth Commercial	$2.46
Rate for Payer: Group Health Inc Commercial	$2.46
Rate for Payer: Group Health Inc Medicare	$1.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.46
Rate for Payer: Hamaspik Choice Inc Medicare	$2.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.19

BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL FILM (4W DETOX)

Facility

OP

$4.91

Service Code	NDC 4778135511
Hospital Charge Code	4778135511
Hospital Revenue Code	250
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$3.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.45
Rate for Payer: Aetna Government	$2.45
Rate for Payer: Brighton Health Commercial	$3.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.34
Rate for Payer: EmblemHealth Commercial	$2.45
Rate for Payer: Group Health Inc Commercial	$2.45
Rate for Payer: Group Health Inc Medicare	$1.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.45
Rate for Payer: Hamaspik Choice Inc Medicare	$2.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.19

BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL FILM (4W DETOX)

Facility

OP

$6.01

Service Code	NDC 1249612023
Hospital Charge Code	1249612023
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.01
Rate for Payer: Aetna Government	$3.01
Rate for Payer: Brighton Health Commercial	$4.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.09
Rate for Payer: EmblemHealth Commercial	$3.01
Rate for Payer: Group Health Inc Commercial	$3.01
Rate for Payer: Group Health Inc Medicare	$2.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.01
Rate for Payer: Hamaspik Choice Inc Medicare	$3.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.91

BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL FILM (4W DETOX)

Facility

IP

$4.91

Service Code	NDC 4359857901
Hospital Charge Code	4359857901
Hospital Revenue Code	250
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$2.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.46

BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL FILM (4W DETOX)

Facility

IP

$6.01

Service Code	NDC 1249612023
Hospital Charge Code	1249612023
Hospital Revenue Code	250
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$3.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.01

BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL FILM (4W DETOX)

Facility

IP

$4.91

Service Code	NDC 4778135503
Hospital Charge Code	4778135503
Hospital Revenue Code	250
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.45

BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL FILM (4W DETOX)

Facility

IP

$4.91

Service Code	NDC 4778135511
Hospital Charge Code	4778135511
Hospital Revenue Code	250
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.45

BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL FILM (4W DETOX)

Facility

OP

$4.91

Service Code	NDC 4778135503
Hospital Charge Code	4778135503
Hospital Revenue Code	250
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$3.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.45
Rate for Payer: Aetna Government	$2.45
Rate for Payer: Brighton Health Commercial	$3.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.34
Rate for Payer: EmblemHealth Commercial	$2.45
Rate for Payer: Group Health Inc Commercial	$2.45
Rate for Payer: Group Health Inc Medicare	$1.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.45
Rate for Payer: Hamaspik Choice Inc Medicare	$2.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.19

BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL SUBL

Facility

OP

$5.83

Service Code	NDC 0054018813
Hospital Charge Code	0054018813
Hospital Revenue Code	250
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$4.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.91
Rate for Payer: Aetna Government	$2.91
Rate for Payer: Brighton Health Commercial	$4.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.96
Rate for Payer: EmblemHealth Commercial	$2.91
Rate for Payer: Group Health Inc Commercial	$2.91
Rate for Payer: Group Health Inc Medicare	$2.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.91
Rate for Payer: Hamaspik Choice Inc Medicare	$2.91
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.79

BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL SUBL

Facility

IP

$5.83

Service Code	NDC 0054018813
Hospital Charge Code	0054018813
Hospital Revenue Code	250
Min. Negotiated Rate	$2.91
Max. Negotiated Rate	$2.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.91

BUPRENORPHINE HCL-NALOXONE HCL 4-1 MG SL FILM

Facility

IP

$8.80

Service Code	NDC 4359858001
Hospital Charge Code	4359858001
Hospital Revenue Code	250
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$4.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.40

BUPRENORPHINE HCL-NALOXONE HCL 4-1 MG SL FILM

Facility

IP

$10.78

Service Code	NDC 1249612043
Hospital Charge Code	1249612043
Hospital Revenue Code	250
Min. Negotiated Rate	$5.39
Max. Negotiated Rate	$5.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.39

BUPRENORPHINE HCL-NALOXONE HCL 4-1 MG SL FILM

Facility

OP

$10.78

Service Code	NDC 1249612043
Hospital Charge Code	1249612043
Hospital Revenue Code	250
Min. Negotiated Rate	$3.77
Max. Negotiated Rate	$8.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.39
Rate for Payer: Aetna Government	$5.39
Rate for Payer: Brighton Health Commercial	$8.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.33
Rate for Payer: EmblemHealth Commercial	$5.39
Rate for Payer: Group Health Inc Commercial	$5.39
Rate for Payer: Group Health Inc Medicare	$3.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.39
Rate for Payer: Hamaspik Choice Inc Medicare	$5.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.00

BUPRENORPHINE HCL-NALOXONE HCL 4-1 MG SL FILM

Facility

IP

$8.79

Service Code	NDC 4778135603
Hospital Charge Code	4778135603
Hospital Revenue Code	250
Min. Negotiated Rate	$4.39
Max. Negotiated Rate	$4.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.39

BUPRENORPHINE HCL-NALOXONE HCL 4-1 MG SL FILM

Facility

IP

$8.79

Service Code	NDC 4778135611
Hospital Charge Code	4778135611
Hospital Revenue Code	250
Min. Negotiated Rate	$4.39
Max. Negotiated Rate	$4.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.39

BUPRENORPHINE HCL-NALOXONE HCL 4-1 MG SL FILM

Facility

OP

$8.79

Service Code	NDC 4778135611
Hospital Charge Code	4778135611
Hospital Revenue Code	250
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$7.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.39
Rate for Payer: Aetna Government	$4.39
Rate for Payer: Brighton Health Commercial	$6.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.98
Rate for Payer: EmblemHealth Commercial	$4.39
Rate for Payer: Group Health Inc Commercial	$4.39
Rate for Payer: Group Health Inc Medicare	$3.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.39
Rate for Payer: Hamaspik Choice Inc Medicare	$4.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.71

BUPRENORPHINE HCL-NALOXONE HCL 4-1 MG SL FILM

Facility

IP

$8.80

Service Code	NDC 4359858030
Hospital Charge Code	4359858030
Hospital Revenue Code	250
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$4.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.40

BUPRENORPHINE HCL-NALOXONE HCL 4-1 MG SL FILM

Facility

OP

$8.79

Service Code	NDC 4778135603
Hospital Charge Code	4778135603
Hospital Revenue Code	250
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$7.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.39
Rate for Payer: Aetna Government	$4.39
Rate for Payer: Brighton Health Commercial	$6.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.98
Rate for Payer: EmblemHealth Commercial	$4.39
Rate for Payer: Group Health Inc Commercial	$4.39
Rate for Payer: Group Health Inc Medicare	$3.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.39
Rate for Payer: Hamaspik Choice Inc Medicare	$4.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.71

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