Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

CAFFEINE CITRATE 60 MG/3ML IV SOLN

Facility

IP

$8.00

Service Code	NDC 2502160103
Hospital Charge Code	2502160103
Hospital Revenue Code	258
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$4.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.00

CAFFEINE CITRATE 60 MG/3ML IV SOLN

Facility

IP

$3.26

Service Code	NDC 6332340704
Hospital Charge Code	6332340704
Hospital Revenue Code	258
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$1.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.63

CAFFEINE CITRATE 60 MG/3ML IV SOLN

Facility

IP

$12.45

Service Code	NDC 6332340703
Hospital Charge Code	6332340703
Hospital Revenue Code	258
Min. Negotiated Rate	$6.23
Max. Negotiated Rate	$6.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.23

CAFFEINE CITRATE 60 MG/3ML IV SOLN

Facility

IP

$4.80

Service Code	NDC 5175405001
Hospital Charge Code	5175405001
Hospital Revenue Code	258
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.40

CAFFEINE CITRATE 60 MG/3ML IV SOLN

Facility

OP

$8.00

Service Code	NDC 2502160103
Hospital Charge Code	2502160103
Hospital Revenue Code	258
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$6.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.00
Rate for Payer: Aetna Government	$4.00
Rate for Payer: Brighton Health Commercial	$6.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.44
Rate for Payer: EmblemHealth Commercial	$4.00
Rate for Payer: Group Health Inc Commercial	$4.00
Rate for Payer: Group Health Inc Medicare	$2.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.20

CAFFEINE CITRATE 60 MG/3ML IV SOLN

Facility

IP

$4.40

Service Code	NDC 7248510410
Hospital Charge Code	7248510410
Hospital Revenue Code	258
Min. Negotiated Rate	$2.20
Max. Negotiated Rate	$2.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.20

CAFFEINE CITRATE 60 MG/3ML IV SOLN

Facility

OP

$3.26

Service Code	NDC 6332340704
Hospital Charge Code	6332340704
Hospital Revenue Code	258
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$2.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.63
Rate for Payer: Aetna Government	$1.63
Rate for Payer: Brighton Health Commercial	$2.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.21
Rate for Payer: EmblemHealth Commercial	$1.63
Rate for Payer: Group Health Inc Commercial	$1.63
Rate for Payer: Group Health Inc Medicare	$1.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.63
Rate for Payer: Hamaspik Choice Inc Medicare	$1.63
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.12

CAFFEINE CITRATE 60 MG/3ML IV SOLN

Facility

OP

$12.45

Service Code	NDC 6332340703
Hospital Charge Code	6332340703
Hospital Revenue Code	258
Min. Negotiated Rate	$4.36
Max. Negotiated Rate	$9.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.23
Rate for Payer: Aetna Government	$6.23
Rate for Payer: Brighton Health Commercial	$9.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.47
Rate for Payer: EmblemHealth Commercial	$6.23
Rate for Payer: Group Health Inc Commercial	$6.23
Rate for Payer: Group Health Inc Medicare	$4.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.23
Rate for Payer: Hamaspik Choice Inc Medicare	$6.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.09

CALAMINE 8-8 % EX LOTN

Facility

OP

$0.01

Service Code	NDC 0904253321
Hospital Charge Code	0904253321
Hospital Revenue Code	250
Max. Negotiated Rate	$0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: EmblemHealth Commercial	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

CALAMINE 8-8 % EX LOTN

Facility

IP

$0.01

Service Code	NDC 0904253321
Hospital Charge Code	0904253321
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

CALCITONIN (SALMON) 200 UNIT/ACT NA SOLN

Facility

OP

$32.04

Service Code	NDC 6050508236
Hospital Charge Code	6050508236
Hospital Revenue Code	250
Min. Negotiated Rate	$11.21
Max. Negotiated Rate	$25.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.02
Rate for Payer: Aetna Government	$16.02
Rate for Payer: Brighton Health Commercial	$24.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.79
Rate for Payer: EmblemHealth Commercial	$16.02
Rate for Payer: Group Health Inc Commercial	$16.02
Rate for Payer: Group Health Inc Medicare	$11.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.02
Rate for Payer: Hamaspik Choice Inc Medicare	$16.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.82

CALCITONIN (SALMON) 200 UNIT/ACT NA SOLN

Facility

IP

$32.04

Service Code	NDC 6050508236
Hospital Charge Code	6050508236
Hospital Revenue Code	250
Min. Negotiated Rate	$16.02
Max. Negotiated Rate	$16.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.02

CALCITONIN (SALMON) 200 UNIT/ML IJ SOLN

Facility

IP

$1.00

Service Code	HCPCS J0630
Hospital Charge Code	6745767502
Hospital Revenue Code	250
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$0.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50

CALCITONIN (SALMON) 200 UNIT/ML IJ SOLN

Facility

IP

$1.00

Service Code	HCPCS J0630
Hospital Charge Code	4202320501
Hospital Revenue Code	250
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$0.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50

CALCITONIN (SALMON) 200 UNIT/ML IJ SOLN

Facility

OP

$1.00

Service Code	HCPCS J0630
Hospital Charge Code	6745767502
Hospital Revenue Code	250
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$494.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$484.97
Rate for Payer: Aetna Government	$484.97
Rate for Payer: Affinity Essential Plan 1&2	$339.48
Rate for Payer: Affinity Essential Plan 3&4	$339.48
Rate for Payer: Affinity Medicaid/CHP/HARP	$339.48
Rate for Payer: Brighton Health Commercial	$0.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$484.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: Elderplan Medicare Advantage	$484.97
Rate for Payer: EmblemHealth Commercial	$484.97
Rate for Payer: Fidelis CHP/HARP/Medicaid	$436.47
Rate for Payer: Fidelis Essential Plan Aliesa	$412.22
Rate for Payer: Fidelis Essential Plan QHP	$431.62
Rate for Payer: Fidelis Medicare Advantage	$484.97
Rate for Payer: Fidelis Qualified Health Plan	$431.62
Rate for Payer: Group Health Inc Commercial	$484.97
Rate for Payer: Group Health Inc Medicare	$484.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$484.97
Rate for Payer: Hamaspik Choice Inc Medicare	$484.97
Rate for Payer: Healthfirst Medicare Advantage	$412.22
Rate for Payer: Healthfirst QHP	$484.97
Rate for Payer: Humana Medicare	$494.67
Rate for Payer: Senior Whole Health Medicare Advantage	$484.97
Rate for Payer: United Healthcare Medicare Advantage	$484.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65
Rate for Payer: Wellcare CHP/FHP/Medicaid	$460.72
Rate for Payer: Wellcare Medicare	$460.72

CALCITONIN (SALMON) 200 UNIT/ML IJ SOLN

Facility

OP

$1.00

Service Code	HCPCS J0630
Hospital Charge Code	4202320501
Hospital Revenue Code	250
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$494.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$484.97
Rate for Payer: Aetna Government	$484.97
Rate for Payer: Affinity Essential Plan 1&2	$339.48
Rate for Payer: Affinity Essential Plan 3&4	$339.48
Rate for Payer: Affinity Medicaid/CHP/HARP	$339.48
Rate for Payer: Brighton Health Commercial	$0.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$484.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: Elderplan Medicare Advantage	$484.97
Rate for Payer: EmblemHealth Commercial	$484.97
Rate for Payer: Fidelis CHP/HARP/Medicaid	$436.47
Rate for Payer: Fidelis Essential Plan Aliesa	$412.22
Rate for Payer: Fidelis Essential Plan QHP	$431.62
Rate for Payer: Fidelis Medicare Advantage	$484.97
Rate for Payer: Fidelis Qualified Health Plan	$431.62
Rate for Payer: Group Health Inc Commercial	$484.97
Rate for Payer: Group Health Inc Medicare	$484.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$484.97
Rate for Payer: Hamaspik Choice Inc Medicare	$484.97
Rate for Payer: Healthfirst Medicare Advantage	$412.22
Rate for Payer: Healthfirst QHP	$484.97
Rate for Payer: Humana Medicare	$494.67
Rate for Payer: Senior Whole Health Medicare Advantage	$484.97
Rate for Payer: United Healthcare Medicare Advantage	$484.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65
Rate for Payer: Wellcare CHP/FHP/Medicaid	$460.72
Rate for Payer: Wellcare Medicare	$460.72

CALCITRIOL 0.25 MCG PO CAPS

Facility

IP

$0.89

Service Code	NDC 6068734501
Hospital Charge Code	6068734501
Hospital Revenue Code	250
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$0.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.44

CALCITRIOL 0.25 MCG PO CAPS

Facility

OP

$1.28

Service Code	NDC 0054000713
Hospital Charge Code	0054000713
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$1.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.64
Rate for Payer: Aetna Government	$0.64
Rate for Payer: Brighton Health Commercial	$0.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.87
Rate for Payer: EmblemHealth Commercial	$0.64
Rate for Payer: Group Health Inc Commercial	$0.64
Rate for Payer: Group Health Inc Medicare	$0.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.64
Rate for Payer: Hamaspik Choice Inc Medicare	$0.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.83

CALCITRIOL 0.25 MCG PO CAPS

Facility

OP

$0.89

Service Code	NDC 6068734501
Hospital Charge Code	6068734501
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: EmblemHealth Commercial	$0.44
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	$0.58

CALCITRIOL 0.25 MCG PO CAPS

Facility

OP

$1.28

Service Code	NDC 2315566203
Hospital Charge Code	2315566203
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$1.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.64
Rate for Payer: Aetna Government	$0.64
Rate for Payer: Brighton Health Commercial	$0.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.87
Rate for Payer: EmblemHealth Commercial	$0.64
Rate for Payer: Group Health Inc Commercial	$0.64
Rate for Payer: Group Health Inc Medicare	$0.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.64
Rate for Payer: Hamaspik Choice Inc Medicare	$0.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.83

CALCITRIOL 0.25 MCG PO CAPS

Facility

OP

$0.89

Service Code	NDC 6068734511
Hospital Charge Code	6068734511
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	$0.45
Rate for Payer: Aetna Government	$0.45
Rate for Payer: Brighton Health Commercial	$0.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.61
Rate for Payer: EmblemHealth Commercial	$0.45
Rate for Payer: Group Health Inc Commercial	$0.45
Rate for Payer: Group Health Inc Medicare	$0.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.45
Rate for Payer: Hamaspik Choice Inc Medicare	$0.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.58

CALCITRIOL 0.25 MCG PO CAPS

Facility

IP

$0.89

Service Code	NDC 6068734511
Hospital Charge Code	6068734511
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.45

CALCITRIOL 0.25 MCG PO CAPS

Facility

IP

$1.28

Service Code	NDC 2315566203
Hospital Charge Code	2315566203
Hospital Revenue Code	250
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$0.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.64

CALCITRIOL 0.25 MCG PO CAPS

Facility

IP

$1.28

Service Code	NDC 0054000713
Hospital Charge Code	0054000713
Hospital Revenue Code	250
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$0.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.64

CALCITRIOL 0.5 MCG PO CAPS

Facility

IP

$1.93

Service Code	NDC 6438072406
Hospital Charge Code	6438072406
Hospital Revenue Code	250
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$0.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.97

<<
<
65
66
67
68
69
70
71
72
73
74
>
>>