St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

LACTULOSE 10 GM/15ML PO SOLN

Facility

$0.09

Service Code	NDC 6668903950
Hospital Charge Code	6668903950
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04

LACTULOSE 10 GM/15ML PO SOLN

Facility

$0.09

Service Code	NDC 6668903950
Hospital Charge Code	6668903950
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Brighton Health Commercial	$0.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.06
Rate for Payer: EmblemHealth Commercial	$0.04
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.06

LACTULOSE 10 GM/15ML PO SOLN

Facility

$0.12

Service Code	NDC 0121457715
Hospital Charge Code	0121457715
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$0.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.08
Rate for Payer: EmblemHealth Commercial	$0.06
Rate for Payer: Group Health Inc Commercial	$0.06
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06
Rate for Payer: Hamaspik Choice Inc Medicare	$0.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.08

LACTULOSE 10 GM/15ML PO SOLN

Facility

$0.12

Service Code	NDC 0121457740
Hospital Charge Code	0121457740
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06

LACTULOSE 10 GM/15ML PO SOLN

Facility

$0.12

Service Code	NDC 0121457740
Hospital Charge Code	0121457740
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$0.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.08
Rate for Payer: EmblemHealth Commercial	$0.06
Rate for Payer: Group Health Inc Commercial	$0.06
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06
Rate for Payer: Hamaspik Choice Inc Medicare	$0.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.08

LACTULOSE 10 GM/15ML PO SOLN

Facility

$0.10

Service Code	NDC 5038377931
Hospital Charge Code	5038377931
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05

LACTULOSE 20 GM/30ML PO SOLN

Facility

$0.06

Service Code	NDC 0121115400
Hospital Charge Code	0121115400
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.03
Rate for Payer: Aetna Government	$0.03
Rate for Payer: Brighton Health Commercial	$0.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.04
Rate for Payer: EmblemHealth Commercial	$0.03
Rate for Payer: Group Health Inc Commercial	$0.03
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.04

LACTULOSE 20 GM/30ML PO SOLN

Facility

$0.06

Service Code	NDC 0121115400
Hospital Charge Code	0121115400
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03

LACTULOSE ENCEPHALOPATHY 10 GM/15ML PO SOLN

Facility

$0.08

Service Code	NDC 4596343864
Hospital Charge Code	4596343864
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04

LACTULOSE ENCEPHALOPATHY 10 GM/15ML PO SOLN

Facility

$0.08

Service Code	NDC 4596343864
Hospital Charge Code	4596343864
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Brighton Health Commercial	$0.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: EmblemHealth Commercial	$0.04
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.05

LAMIVUDINE 10 MG/ML PO SOLN

Facility

$0.50

Service Code	NDC 5483856670
Hospital Charge Code	5483856670
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$0.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.34
Rate for Payer: EmblemHealth Commercial	$0.25
Rate for Payer: Group Health Inc Commercial	$0.25
Rate for Payer: Group Health Inc Medicare	$0.17
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	$0.32

LAMIVUDINE 10 MG/ML PO SOLN

Facility

$0.50

Service Code	NDC 5483856670
Hospital Charge Code	5483856670
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25

LAMIVUDINE 10 MG/ML PO SOLN

Facility

$1.18

Service Code	NDC 6586205524
Hospital Charge Code	6586205524
Hospital Revenue Code	250
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$0.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.59
Rate for Payer: Aetna Government	$0.59
Rate for Payer: Brighton Health Commercial	$0.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.80
Rate for Payer: EmblemHealth Commercial	$0.59
Rate for Payer: Group Health Inc Commercial	$0.59
Rate for Payer: Group Health Inc Medicare	$0.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.59
Rate for Payer: Hamaspik Choice Inc Medicare	$0.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.77

LAMIVUDINE 10 MG/ML PO SOLN

Facility

$1.18

Service Code	NDC 6586205524
Hospital Charge Code	6586205524
Hospital Revenue Code	250
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$0.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.59

LAMIVUDINE 10 MG/ML PO SOLN

Facility

$0.50

Service Code	NDC 5723727424
Hospital Charge Code	5723727424
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$0.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.34
Rate for Payer: EmblemHealth Commercial	$0.25
Rate for Payer: Group Health Inc Commercial	$0.25
Rate for Payer: Group Health Inc Medicare	$0.17
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	$0.32

LAMIVUDINE 10 MG/ML PO SOLN

Facility

$0.50

Service Code	NDC 5723727424
Hospital Charge Code	5723727424
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25

LAMIVUDINE 150 MG PO TABS

Facility

$7.15

Service Code	NDC 3334200109
Hospital Charge Code	3334200109
Hospital Revenue Code	250
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$5.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.58
Rate for Payer: Aetna Government	$3.58
Rate for Payer: Brighton Health Commercial	$5.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.86
Rate for Payer: EmblemHealth Commercial	$3.58
Rate for Payer: Group Health Inc Commercial	$3.58
Rate for Payer: Group Health Inc Medicare	$2.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.58
Rate for Payer: Hamaspik Choice Inc Medicare	$3.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.65

LAMIVUDINE 150 MG PO TABS

Facility

$7.16

Service Code	NDC 6050532516
Hospital Charge Code	6050532516
Hospital Revenue Code	250
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$3.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.58

LAMIVUDINE 150 MG PO TABS

Facility

$7.16

Service Code	NDC 6050532516
Hospital Charge Code	6050532516
Hospital Revenue Code	250
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$5.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.58
Rate for Payer: Aetna Government	$3.58
Rate for Payer: Brighton Health Commercial	$5.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.87
Rate for Payer: EmblemHealth Commercial	$3.58
Rate for Payer: Group Health Inc Commercial	$3.58
Rate for Payer: Group Health Inc Medicare	$2.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.58
Rate for Payer: Hamaspik Choice Inc Medicare	$3.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.65

LAMIVUDINE 150 MG PO TABS

Facility

$9.24

Service Code	NDC 0904658304
Hospital Charge Code	0904658304
Hospital Revenue Code	250
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$7.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.62
Rate for Payer: Aetna Government	$4.62
Rate for Payer: Brighton Health Commercial	$6.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.28
Rate for Payer: EmblemHealth Commercial	$4.62
Rate for Payer: Group Health Inc Commercial	$4.62
Rate for Payer: Group Health Inc Medicare	$3.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.62
Rate for Payer: Hamaspik Choice Inc Medicare	$4.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.00

LAMIVUDINE 150 MG PO TABS

Facility

$9.24

Service Code	NDC 0904658304
Hospital Charge Code	0904658304
Hospital Revenue Code	250
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$4.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.62

LAMIVUDINE 150 MG PO TABS

Facility

$7.16

Service Code	NDC 6818060207
Hospital Charge Code	6818060207
Hospital Revenue Code	250
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$3.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.58

LAMIVUDINE 150 MG PO TABS

Facility

$7.15

Service Code	NDC 3334200109
Hospital Charge Code	3334200109
Hospital Revenue Code	250
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$3.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.58

LAMIVUDINE 150 MG PO TABS

Facility

$7.16

Service Code	NDC 6818060207
Hospital Charge Code	6818060207
Hospital Revenue Code	250
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$5.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.58
Rate for Payer: Aetna Government	$3.58
Rate for Payer: Brighton Health Commercial	$5.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.87
Rate for Payer: EmblemHealth Commercial	$3.58
Rate for Payer: Group Health Inc Commercial	$3.58
Rate for Payer: Group Health Inc Medicare	$2.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.58
Rate for Payer: Hamaspik Choice Inc Medicare	$3.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.65

LAMIVUDINE-ZIDOVUDINE 150-300 MG PO TABS

Facility

$15.53

Service Code	NDC 3172250660
Hospital Charge Code	3172250660
Hospital Revenue Code	250
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$7.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.76

Know your out-of-pocket cost for care.

All Charges