Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

LORAZEPAM 2 MG/ML PO CONC

Facility

OP

$1.60

Service Code	NDC 0054353244
Hospital Charge Code	0054353244
Hospital Revenue Code	250
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$1.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.80
Rate for Payer: Aetna Government	$0.80
Rate for Payer: Brighton Health Commercial	$1.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.09
Rate for Payer: EmblemHealth Commercial	$0.80
Rate for Payer: Group Health Inc Commercial	$0.80
Rate for Payer: Group Health Inc Medicare	$0.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.80
Rate for Payer: Hamaspik Choice Inc Medicare	$0.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.04

LORAZEPAM 2 MG/ML PO CONC

Facility

IP

$1.60

Service Code	NDC 0054353244
Hospital Charge Code	0054353244
Hospital Revenue Code	250
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.80

LOSARTAN POTASSIUM 25 MG PO TABS

Facility

IP

$1.68

Service Code	NDC 6838213510
Hospital Charge Code	6838213510
Hospital Revenue Code	250
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$0.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.84

LOSARTAN POTASSIUM 25 MG PO TABS

Facility

OP

$0.60

Service Code	NDC 5026850415
Hospital Charge Code	5026850415
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.30
Rate for Payer: Aetna Government	$0.30
Rate for Payer: Brighton Health Commercial	$0.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.41
Rate for Payer: EmblemHealth Commercial	$0.30
Rate for Payer: Group Health Inc Commercial	$0.30
Rate for Payer: Group Health Inc Medicare	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30
Rate for Payer: Hamaspik Choice Inc Medicare	$0.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.39

LOSARTAN POTASSIUM 25 MG PO TABS

Facility

OP

$1.68

Service Code	NDC 6586220199
Hospital Charge Code	6586220199
Hospital Revenue Code	250
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$1.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.84
Rate for Payer: Aetna Government	$0.84
Rate for Payer: Brighton Health Commercial	$1.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.14
Rate for Payer: EmblemHealth Commercial	$0.84
Rate for Payer: Group Health Inc Commercial	$0.84
Rate for Payer: Group Health Inc Medicare	$0.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.84
Rate for Payer: Hamaspik Choice Inc Medicare	$0.84
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.09

LOSARTAN POTASSIUM 25 MG PO TABS

Facility

OP

$1.68

Service Code	NDC 6838213510
Hospital Charge Code	6838213510
Hospital Revenue Code	250
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$1.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.84
Rate for Payer: Aetna Government	$0.84
Rate for Payer: Brighton Health Commercial	$1.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.14
Rate for Payer: EmblemHealth Commercial	$0.84
Rate for Payer: Group Health Inc Commercial	$0.84
Rate for Payer: Group Health Inc Medicare	$0.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.84
Rate for Payer: Hamaspik Choice Inc Medicare	$0.84
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.09

LOSARTAN POTASSIUM 25 MG PO TABS

Facility

OP

$0.70

Service Code	NDC 0904704761
Hospital Charge Code	0904704761
Hospital Revenue Code	250
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.35
Rate for Payer: Aetna Government	$0.35
Rate for Payer: Brighton Health Commercial	$0.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.47
Rate for Payer: EmblemHealth Commercial	$0.35
Rate for Payer: Group Health Inc Commercial	$0.35
Rate for Payer: Group Health Inc Medicare	$0.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.35
Rate for Payer: Hamaspik Choice Inc Medicare	$0.35
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.45

LOSARTAN POTASSIUM 25 MG PO TABS

Facility

IP

$1.68

Service Code	NDC 6586220199
Hospital Charge Code	6586220199
Hospital Revenue Code	250
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$0.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.84

LOSARTAN POTASSIUM 25 MG PO TABS

Facility

IP

$0.60

Service Code	NDC 5026850415
Hospital Charge Code	5026850415
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30

LOSARTAN POTASSIUM 25 MG PO TABS

Facility

IP

$1.67

Service Code	NDC 6233202791
Hospital Charge Code	6233202791
Hospital Revenue Code	250
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$0.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.84

LOSARTAN POTASSIUM 25 MG PO TABS

Facility

OP

$0.60

Service Code	NDC 5026850411
Hospital Charge Code	5026850411
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.30
Rate for Payer: Aetna Government	$0.30
Rate for Payer: Brighton Health Commercial	$0.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.41
Rate for Payer: EmblemHealth Commercial	$0.30
Rate for Payer: Group Health Inc Commercial	$0.30
Rate for Payer: Group Health Inc Medicare	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30
Rate for Payer: Hamaspik Choice Inc Medicare	$0.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.39

LOSARTAN POTASSIUM 25 MG PO TABS

Facility

IP

$0.60

Service Code	NDC 5026850411
Hospital Charge Code	5026850411
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30

LOSARTAN POTASSIUM 25 MG PO TABS

Facility

IP

$0.70

Service Code	NDC 0904704761
Hospital Charge Code	0904704761
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.35

LOSARTAN POTASSIUM 25 MG PO TABS

Facility

OP

$1.67

Service Code	NDC 6233202791
Hospital Charge Code	6233202791
Hospital Revenue Code	250
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$1.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.84
Rate for Payer: Aetna Government	$0.84
Rate for Payer: Brighton Health Commercial	$1.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.14
Rate for Payer: EmblemHealth Commercial	$0.84
Rate for Payer: Group Health Inc Commercial	$0.84
Rate for Payer: Group Health Inc Medicare	$0.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.84
Rate for Payer: Hamaspik Choice Inc Medicare	$0.84
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.09

LOSARTAN POTASSIUM 50 MG PO TABS

Facility

OP

$2.25

Service Code	NDC 6233202891
Hospital Charge Code	6233202891
Hospital Revenue Code	250
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$1.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.12
Rate for Payer: Aetna Government	$1.12
Rate for Payer: Brighton Health Commercial	$1.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.53
Rate for Payer: EmblemHealth Commercial	$1.12
Rate for Payer: Group Health Inc Commercial	$1.12
Rate for Payer: Group Health Inc Medicare	$0.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.46

LOSARTAN POTASSIUM 50 MG PO TABS

Facility

IP

$2.26

Service Code	NDC 6586220299
Hospital Charge Code	6586220299
Hospital Revenue Code	250
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$1.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.13

LOSARTAN POTASSIUM 50 MG PO TABS

Facility

OP

$2.26

Service Code	NDC 6586220299
Hospital Charge Code	6586220299
Hospital Revenue Code	250
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$1.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.13
Rate for Payer: Aetna Government	$1.13
Rate for Payer: Brighton Health Commercial	$1.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.54
Rate for Payer: EmblemHealth Commercial	$1.13
Rate for Payer: Group Health Inc Commercial	$1.13
Rate for Payer: Group Health Inc Medicare	$0.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.13
Rate for Payer: Hamaspik Choice Inc Medicare	$1.13
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.47

LOSARTAN POTASSIUM 50 MG PO TABS

Facility

IP

$2.25

Service Code	NDC 6233202891
Hospital Charge Code	6233202891
Hospital Revenue Code	250
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$1.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.12

LOSARTAN POTASSIUM 50 MG PO TABS

Facility

OP

$0.81

Service Code	NDC 0904704861
Hospital Charge Code	0904704861
Hospital Revenue Code	250
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$0.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.41
Rate for Payer: Aetna Government	$0.41
Rate for Payer: Brighton Health Commercial	$0.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.55
Rate for Payer: EmblemHealth Commercial	$0.41
Rate for Payer: Group Health Inc Commercial	$0.41
Rate for Payer: Group Health Inc Medicare	$0.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.41
Rate for Payer: Hamaspik Choice Inc Medicare	$0.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.53

LOSARTAN POTASSIUM 50 MG PO TABS

Facility

IP

$0.81

Service Code	NDC 0904704861
Hospital Charge Code	0904704861
Hospital Revenue Code	250
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$0.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.41

LOSARTAN POTASSIUM 50 MG PO TABS

Facility

OP

$2.26

Service Code	NDC 6586220290
Hospital Charge Code	6586220290
Hospital Revenue Code	250
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$1.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.13
Rate for Payer: Aetna Government	$1.13
Rate for Payer: Brighton Health Commercial	$1.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.54
Rate for Payer: EmblemHealth Commercial	$1.13
Rate for Payer: Group Health Inc Commercial	$1.13
Rate for Payer: Group Health Inc Medicare	$0.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.13
Rate for Payer: Hamaspik Choice Inc Medicare	$1.13
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.47

LOSARTAN POTASSIUM 50 MG PO TABS

Facility

IP

$2.26

Service Code	NDC 6586220290
Hospital Charge Code	6586220290
Hospital Revenue Code	250
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$1.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.13

LOSARTAN POTASSIUM 50 MG PO TABS

Facility

OP

$0.63

Service Code	NDC 5026850515
Hospital Charge Code	5026850515
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.32
Rate for Payer: Aetna Government	$0.32
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	$0.43
Rate for Payer: EmblemHealth Commercial	$0.32
Rate for Payer: Group Health Inc Commercial	$0.32
Rate for Payer: Group Health Inc Medicare	$0.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.32
Rate for Payer: Hamaspik Choice Inc Medicare	$0.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.41

LOSARTAN POTASSIUM 50 MG PO TABS

Facility

IP

$0.63

Service Code	NDC 5026850515
Hospital Charge Code	5026850515
Hospital Revenue Code	250
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$0.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.32

Lower extremity arterial procedures #

Facility

IP

$57,254.67

Service Code	APR-DRG 1811
Min. Negotiated Rate	$25,446.52
Max. Negotiated Rate	$57,254.67
Rate for Payer: Affinity Essential Plan 1&2	$57,254.67
Rate for Payer: Affinity Essential Plan 3&4	$57,254.67
Rate for Payer: Affinity Medicaid/CHP/HARP	$25,446.52
Rate for Payer: Amida Care Medicaid	$25,446.52
Rate for Payer: EmblemHealth Essential Plan 1&2	$57,254.67
Rate for Payer: EmblemHealth Essential Plan 3&4	$25,446.52
Rate for Payer: Fidelis CHP/HARP/Medicaid	$25,446.52
Rate for Payer: Fidelis Qualified Health Plan	$30,535.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$25,446.52
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25,446.52
Rate for Payer: Healthfirst Essential Plan	$57,254.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25,446.52
Rate for Payer: SOMOS Essential	$57,254.67
Rate for Payer: United Healthcare Essential Plan 1&2	$57,254.67
Rate for Payer: United Healthcare Essential Plan 3&4	$57,254.67
Rate for Payer: United Healthcare Medicaid	$25,446.52
Rate for Payer: Wellcare CHP/FHP/Medicaid	$25,446.52

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