St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ISONIAZID 100 MG PO TABS

Facility

$2.42

Service Code	NDC 8166510710
Hospital Charge Code	8166510710
Hospital Revenue Code	250
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$1.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.21

ISONIAZID 300 MG PO TABS

Facility

$0.51

Service Code	NDC 0555007101
Hospital Charge Code	0555007101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25

ISONIAZID 300 MG PO TABS

Facility

$1.32

Service Code	NDC 6068755301
Hospital Charge Code	6068755301
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$1.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.66
Rate for Payer: Aetna Government	$0.66
Rate for Payer: Brighton Health Commercial	$0.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.90
Rate for Payer: EmblemHealth Commercial	$0.66
Rate for Payer: Group Health Inc Commercial	$0.66
Rate for Payer: Group Health Inc Medicare	$0.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.66
Rate for Payer: Hamaspik Choice Inc Medicare	$0.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.86

ISONIAZID 300 MG PO TABS

Facility

$0.31

Service Code	NDC 0555007102
Hospital Charge Code	0555007102
Hospital Revenue Code	250
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.16

ISONIAZID 300 MG PO TABS

Facility

$1.32

Service Code	NDC 6068755301
Hospital Charge Code	6068755301
Hospital Revenue Code	250
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$0.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.66

ISONIAZID 300 MG PO TABS

Facility

$0.51

Service Code	NDC 0555007101
Hospital Charge Code	0555007101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$0.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.35
Rate for Payer: EmblemHealth Commercial	$0.25
Rate for Payer: Group Health Inc Commercial	$0.25
Rate for Payer: Group Health Inc Medicare	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25
Rate for Payer: Hamaspik Choice Inc Medicare	$0.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.33

ISONIAZID 300 MG PO TABS

Facility

$0.31

Service Code	NDC 0555007102
Hospital Charge Code	0555007102
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.16
Rate for Payer: Aetna Government	$0.16
Rate for Payer: Brighton Health Commercial	$0.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.21
Rate for Payer: EmblemHealth Commercial	$0.16
Rate for Payer: Group Health Inc Commercial	$0.16
Rate for Payer: Group Health Inc Medicare	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.16
Rate for Payer: Hamaspik Choice Inc Medicare	$0.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.20

ISONIAZID 50 MG/5ML PO SYRP

Facility

$0.86

Service Code	NDC 4628700901
Hospital Charge Code	4628700901
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$0.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.43

ISONIAZID 50 MG/5ML PO SYRP

Facility

$0.86

Service Code	NDC 4628700901
Hospital Charge Code	4628700901
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.43
Rate for Payer: Aetna Government	$0.43
Rate for Payer: Brighton Health Commercial	$0.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.59
Rate for Payer: EmblemHealth Commercial	$0.43
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	$0.56

ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN

Facility

$144.00

Service Code	NDC 1478901505
Hospital Charge Code	1478901505
Hospital Revenue Code	250
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$115.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$79.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$72.00
Rate for Payer: Aetna Government	$72.00
Rate for Payer: Brighton Health Commercial	$108.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$115.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$97.92
Rate for Payer: EmblemHealth Commercial	$72.00
Rate for Payer: Group Health Inc Commercial	$72.00
Rate for Payer: Group Health Inc Medicare	$50.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$72.00
Rate for Payer: Hamaspik Choice Inc Medicare	$72.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$93.60

ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN

Facility

$264.00

Service Code	NDC 7012116057
Hospital Charge Code	7012116057
Hospital Revenue Code	250
Min. Negotiated Rate	$132.00
Max. Negotiated Rate	$132.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$132.00

ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN

Facility

$130.80

Service Code	NDC 5515031710
Hospital Charge Code	5515031710
Hospital Revenue Code	250
Min. Negotiated Rate	$45.78
Max. Negotiated Rate	$104.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$71.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$65.40
Rate for Payer: Aetna Government	$65.40
Rate for Payer: Brighton Health Commercial	$98.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$104.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$88.94
Rate for Payer: EmblemHealth Commercial	$65.40
Rate for Payer: Group Health Inc Commercial	$65.40
Rate for Payer: Group Health Inc Medicare	$45.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.40
Rate for Payer: Hamaspik Choice Inc Medicare	$65.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$85.02

ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN

Facility

$130.80

Service Code	NDC 5515031710
Hospital Charge Code	5515031710
Hospital Revenue Code	250
Min. Negotiated Rate	$65.40
Max. Negotiated Rate	$65.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.40

ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN

Facility

$48.00

Service Code	NDC 0548950200
Hospital Charge Code	0548950200
Hospital Revenue Code	250
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.00

ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN

Facility

$48.00

Service Code	NDC 0548950200
Hospital Charge Code	0548950200
Hospital Revenue Code	250
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$38.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24.00
Rate for Payer: Aetna Government	$24.00
Rate for Payer: Brighton Health Commercial	$36.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$38.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.64
Rate for Payer: EmblemHealth Commercial	$24.00
Rate for Payer: Group Health Inc Commercial	$24.00
Rate for Payer: Group Health Inc Medicare	$16.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.00
Rate for Payer: Hamaspik Choice Inc Medicare	$24.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$31.20

ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN

Facility

$264.00

Service Code	NDC 7012116057
Hospital Charge Code	7012116057
Hospital Revenue Code	250
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$211.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$145.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$132.00
Rate for Payer: Aetna Government	$132.00
Rate for Payer: Brighton Health Commercial	$198.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$211.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$179.52
Rate for Payer: EmblemHealth Commercial	$132.00
Rate for Payer: Group Health Inc Commercial	$132.00
Rate for Payer: Group Health Inc Medicare	$92.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$132.00
Rate for Payer: Hamaspik Choice Inc Medicare	$132.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$171.60

ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN

Facility

$57.60

Service Code	NDC 6991873501
Hospital Charge Code	6991873501
Hospital Revenue Code	250
Min. Negotiated Rate	$20.16
Max. Negotiated Rate	$46.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.80
Rate for Payer: Aetna Government	$28.80
Rate for Payer: Brighton Health Commercial	$43.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$46.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.17
Rate for Payer: EmblemHealth Commercial	$28.80
Rate for Payer: Group Health Inc Commercial	$28.80
Rate for Payer: Group Health Inc Medicare	$20.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.80
Rate for Payer: Hamaspik Choice Inc Medicare	$28.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$37.44

ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN

Facility

$540.00

Service Code	NDC 1478901101
Hospital Charge Code	1478901101
Hospital Revenue Code	250
Min. Negotiated Rate	$189.00
Max. Negotiated Rate	$432.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$297.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$270.00
Rate for Payer: Aetna Government	$270.00
Rate for Payer: Brighton Health Commercial	$405.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$432.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$367.20
Rate for Payer: EmblemHealth Commercial	$270.00
Rate for Payer: Group Health Inc Commercial	$270.00
Rate for Payer: Group Health Inc Medicare	$189.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$270.00
Rate for Payer: Hamaspik Choice Inc Medicare	$270.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$351.00

ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN

Facility

$144.00

Service Code	NDC 1478901505
Hospital Charge Code	1478901505
Hospital Revenue Code	250
Min. Negotiated Rate	$72.00
Max. Negotiated Rate	$72.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$72.00

ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN

Facility

$57.60

Service Code	NDC 6991873510
Hospital Charge Code	6991873510
Hospital Revenue Code	250
Min. Negotiated Rate	$20.16
Max. Negotiated Rate	$46.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.80
Rate for Payer: Aetna Government	$28.80
Rate for Payer: Brighton Health Commercial	$43.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$46.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.17
Rate for Payer: EmblemHealth Commercial	$28.80
Rate for Payer: Group Health Inc Commercial	$28.80
Rate for Payer: Group Health Inc Medicare	$20.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.80
Rate for Payer: Hamaspik Choice Inc Medicare	$28.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$37.44

ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN

Facility

$57.60

Service Code	NDC 6991873501
Hospital Charge Code	6991873501
Hospital Revenue Code	250
Min. Negotiated Rate	$28.80
Max. Negotiated Rate	$28.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.80

ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN

Facility

$57.60

Service Code	NDC 6991873510
Hospital Charge Code	6991873510
Hospital Revenue Code	250
Min. Negotiated Rate	$28.80
Max. Negotiated Rate	$28.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.80

ISOPROTERENOL HCL 0.2 MG/ML IJ SOLN

Facility

$540.00

Service Code	NDC 1478901101
Hospital Charge Code	1478901101
Hospital Revenue Code	250
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$270.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$270.00

ISOSORBIDE DINITRATE 10 MG PO TABS

Facility

$0.73

Service Code	NDC 0904661961
Hospital Charge Code	0904661961
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: EmblemHealth Commercial	$0.37
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

ISOSORBIDE DINITRATE 10 MG PO TABS

Facility

$1.25

Service Code	NDC 6808408211
Hospital Charge Code	6808408211
Hospital Revenue Code	250
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$1.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.63
Rate for Payer: Aetna Government	$0.63
Rate for Payer: Brighton Health Commercial	$0.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.85
Rate for Payer: EmblemHealth Commercial	$0.63
Rate for Payer: Group Health Inc Commercial	$0.63
Rate for Payer: Group Health Inc Medicare	$0.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.63
Rate for Payer: Hamaspik Choice Inc Medicare	$0.63
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.81

Know your out-of-pocket cost for care.

All Charges