St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

NIFEDIPINE ER OSMOTIC RELEASE 60 MG PO TB24

Facility

$3.50

Service Code	NDC 0904708161
Hospital Charge Code	0904708161
Hospital Revenue Code	250
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$1.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.75

NIFEDIPINE ER OSMOTIC RELEASE 60 MG PO TB24

Facility

$2.01

Service Code	NDC 0904708106
Hospital Charge Code	0904708106
Hospital Revenue Code	250
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.01
Rate for Payer: Aetna Government	$1.01
Rate for Payer: Brighton Health Commercial	$1.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.37
Rate for Payer: EmblemHealth Commercial	$1.01
Rate for Payer: Group Health Inc Commercial	$1.01
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.01
Rate for Payer: Hamaspik Choice Inc Medicare	$1.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.31

NIFEDIPINE ER OSMOTIC RELEASE 60 MG PO TB24

Facility

$2.01

Service Code	NDC 0904708106
Hospital Charge Code	0904708106
Hospital Revenue Code	250
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$1.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.01

NIFEDIPINE ER OSMOTIC RELEASE 90 MG PO TB24

Facility

$3.75

Service Code	NDC 6808460321
Hospital Charge Code	6808460321
Hospital Revenue Code	250
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$3.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.87
Rate for Payer: Aetna Government	$1.87
Rate for Payer: Brighton Health Commercial	$2.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.55
Rate for Payer: EmblemHealth Commercial	$1.87
Rate for Payer: Group Health Inc Commercial	$1.87
Rate for Payer: Group Health Inc Medicare	$1.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.87
Rate for Payer: Hamaspik Choice Inc Medicare	$1.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.43

NIFEDIPINE ER OSMOTIC RELEASE 90 MG PO TB24

Facility

$1.04

Service Code	NDC 0904708206
Hospital Charge Code	0904708206
Hospital Revenue Code	250
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.52
Rate for Payer: Aetna Government	$0.52
Rate for Payer: Brighton Health Commercial	$0.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.83
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.71
Rate for Payer: EmblemHealth Commercial	$0.52
Rate for Payer: Group Health Inc Commercial	$0.52
Rate for Payer: Group Health Inc Medicare	$0.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.52
Rate for Payer: Hamaspik Choice Inc Medicare	$0.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.67

NIFEDIPINE ER OSMOTIC RELEASE 90 MG PO TB24

Facility

$2.31

Service Code	NDC 2497900901
Hospital Charge Code	2497900901
Hospital Revenue Code	250
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$1.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.15
Rate for Payer: Aetna Government	$1.15
Rate for Payer: Brighton Health Commercial	$1.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.57
Rate for Payer: EmblemHealth Commercial	$1.15
Rate for Payer: Group Health Inc Commercial	$1.15
Rate for Payer: Group Health Inc Medicare	$0.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.15
Rate for Payer: Hamaspik Choice Inc Medicare	$1.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.50

NIFEDIPINE ER OSMOTIC RELEASE 90 MG PO TB24

Facility

$2.49

Service Code	NDC 5026859915
Hospital Charge Code	5026859915
Hospital Revenue Code	250
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$1.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.25

NIFEDIPINE ER OSMOTIC RELEASE 90 MG PO TB24

Facility

$2.31

Service Code	NDC 2497900901
Hospital Charge Code	2497900901
Hospital Revenue Code	250
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$1.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.15

NIFEDIPINE ER OSMOTIC RELEASE 90 MG PO TB24

Facility

$3.75

Service Code	NDC 6808460321
Hospital Charge Code	6808460321
Hospital Revenue Code	250
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$1.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.87

NIFEDIPINE ER OSMOTIC RELEASE 90 MG PO TB24

Facility

$2.49

Service Code	NDC 5026859915
Hospital Charge Code	5026859915
Hospital Revenue Code	250
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$1.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.25
Rate for Payer: Aetna Government	$1.25
Rate for Payer: Brighton Health Commercial	$1.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.70
Rate for Payer: EmblemHealth Commercial	$1.25
Rate for Payer: Group Health Inc Commercial	$1.25
Rate for Payer: Group Health Inc Medicare	$0.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.62

NIFEDIPINE ER OSMOTIC RELEASE 90 MG PO TB24

Facility

$2.56

Service Code	NDC 5074226201
Hospital Charge Code	5074226201
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$2.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.28
Rate for Payer: Aetna Government	$1.28
Rate for Payer: Brighton Health Commercial	$1.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.74
Rate for Payer: EmblemHealth Commercial	$1.28
Rate for Payer: Group Health Inc Commercial	$1.28
Rate for Payer: Group Health Inc Medicare	$0.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.28
Rate for Payer: Hamaspik Choice Inc Medicare	$1.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.67

NIFEDIPINE ER OSMOTIC RELEASE 90 MG PO TB24

Facility

$1.04

Service Code	NDC 0904708206
Hospital Charge Code	0904708206
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$0.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.52

NIFEDIPINE ER OSMOTIC RELEASE 90 MG PO TB24

Facility

$2.56

Service Code	NDC 5074226201
Hospital Charge Code	5074226201
Hospital Revenue Code	250
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$1.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.28

NIFEDIPINE ER OSMOTIC RELEASE 90 MG PO TB24

Facility

$2.49

Service Code	NDC 5026859911
Hospital Charge Code	5026859911
Hospital Revenue Code	250
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$1.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.25
Rate for Payer: Aetna Government	$1.25
Rate for Payer: Brighton Health Commercial	$1.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.70
Rate for Payer: EmblemHealth Commercial	$1.25
Rate for Payer: Group Health Inc Commercial	$1.25
Rate for Payer: Group Health Inc Medicare	$0.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.62

NIFEDIPINE ER OSMOTIC RELEASE 90 MG PO TB24

Facility

$2.49

Service Code	NDC 5026859911
Hospital Charge Code	5026859911
Hospital Revenue Code	250
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$1.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.25

NIMODIPINE 30 MG PO CAPS

Facility

$18.41

Service Code	NDC 2315551200
Hospital Charge Code	2315551200
Hospital Revenue Code	250
Min. Negotiated Rate	$9.21
Max. Negotiated Rate	$9.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.21

NIMODIPINE 30 MG PO CAPS

Facility

$18.41

Service Code	NDC 2315551200
Hospital Charge Code	2315551200
Hospital Revenue Code	250
Min. Negotiated Rate	$6.44
Max. Negotiated Rate	$14.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.21
Rate for Payer: Aetna Government	$9.21
Rate for Payer: Brighton Health Commercial	$13.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.52
Rate for Payer: EmblemHealth Commercial	$9.21
Rate for Payer: Group Health Inc Commercial	$9.21
Rate for Payer: Group Health Inc Medicare	$6.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.21
Rate for Payer: Hamaspik Choice Inc Medicare	$9.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.97

NIMODIPINE 30 MG PO CAPS

Facility

$18.41

Service Code	NDC 6945220920
Hospital Charge Code	6945220920
Hospital Revenue Code	250
Min. Negotiated Rate	$9.21
Max. Negotiated Rate	$9.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.21

NIMODIPINE 30 MG PO CAPS

Facility

$18.41

Service Code	NDC 6945220920
Hospital Charge Code	6945220920
Hospital Revenue Code	250
Min. Negotiated Rate	$6.44
Max. Negotiated Rate	$14.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.21
Rate for Payer: Aetna Government	$9.21
Rate for Payer: Brighton Health Commercial	$13.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.52
Rate for Payer: EmblemHealth Commercial	$9.21
Rate for Payer: Group Health Inc Commercial	$9.21
Rate for Payer: Group Health Inc Medicare	$6.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.21
Rate for Payer: Hamaspik Choice Inc Medicare	$9.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.97

NIMODIPINE 30 MG PO CAPS

Facility

$19.23

Service Code	NDC 6945220913
Hospital Charge Code	6945220913
Hospital Revenue Code	250
Min. Negotiated Rate	$9.62
Max. Negotiated Rate	$9.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.62

NIMODIPINE 30 MG PO CAPS

Facility

$19.23

Service Code	NDC 6945220913
Hospital Charge Code	6945220913
Hospital Revenue Code	250
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$15.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.62
Rate for Payer: Aetna Government	$9.62
Rate for Payer: Brighton Health Commercial	$14.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.08
Rate for Payer: EmblemHealth Commercial	$9.62
Rate for Payer: Group Health Inc Commercial	$9.62
Rate for Payer: Group Health Inc Medicare	$6.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.62
Rate for Payer: Hamaspik Choice Inc Medicare	$9.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.50

NIMODIPINE 60 MG/20ML PO SOLN

Facility

$3.35

Service Code	NDC 9999123441
Hospital Charge Code	9999123441
Hospital Revenue Code	250
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$2.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.68
Rate for Payer: Aetna Government	$1.68
Rate for Payer: Brighton Health Commercial	$2.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.28
Rate for Payer: EmblemHealth Commercial	$1.68
Rate for Payer: Group Health Inc Commercial	$1.68
Rate for Payer: Group Health Inc Medicare	$1.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.68
Rate for Payer: Hamaspik Choice Inc Medicare	$1.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.18

NIMODIPINE 60 MG/20ML PO SOLN

Facility

$3.35

Service Code	NDC 9999123441
Hospital Charge Code	9999123441
Hospital Revenue Code	250
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$1.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.68

NIRSEVIMAB-ALIP 100 MG/ML IM SOSY

Facility

$623.70

Service Code	NDC 4928157415
Hospital Charge Code	4928157415
Hospital Revenue Code	250
Min. Negotiated Rate	$218.29
Max. Negotiated Rate	$498.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$343.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$311.85
Rate for Payer: Aetna Government	$311.85
Rate for Payer: Brighton Health Commercial	$467.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$498.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$424.12
Rate for Payer: EmblemHealth Commercial	$311.85
Rate for Payer: Group Health Inc Commercial	$311.85
Rate for Payer: Group Health Inc Medicare	$218.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$311.85
Rate for Payer: Hamaspik Choice Inc Medicare	$311.85
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$405.40

NIRSEVIMAB-ALIP 100 MG/ML IM SOSY

Facility

$623.70

Service Code	NDC 4928157415
Hospital Charge Code	4928157415
Hospital Revenue Code	250
Min. Negotiated Rate	$311.85
Max. Negotiated Rate	$311.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$311.85

Know your out-of-pocket cost for care.

All Charges