Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

NYSTATIN 100000 UNIT/GM EX CREA

Facility

IP

$1.17

Service Code	NDC 4580205935
Hospital Charge Code	4580205935
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.58

NYSTATIN 100000 UNIT/GM EX CREA

Facility

OP

$0.88

Service Code	NDC 4580205911
Hospital Charge Code	4580205911
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.48
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	$0.70
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	$0.57

NYSTATIN 100000 UNIT/GM EX CREA

Facility

IP

$0.88

Service Code	NDC 4580205911
Hospital Charge Code	4580205911
Hospital Revenue Code	250
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$0.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.44

NYSTATIN 100000 UNIT/GM EX OINT

Facility

IP

$1.17

Service Code	NDC 4580204835
Hospital Charge Code	4580204835
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.58

NYSTATIN 100000 UNIT/GM EX OINT

Facility

OP

$1.17

Service Code	NDC 0713068615
Hospital Charge Code	0713068615
Hospital Revenue Code	250
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$0.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.58
Rate for Payer: Aetna Government	$0.58
Rate for Payer: Brighton Health Commercial	$0.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.79
Rate for Payer: EmblemHealth Commercial	$0.58
Rate for Payer: Group Health Inc Commercial	$0.58
Rate for Payer: Group Health Inc Medicare	$0.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.58
Rate for Payer: Hamaspik Choice Inc Medicare	$0.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.76

NYSTATIN 100000 UNIT/GM EX OINT

Facility

IP

$1.12

Service Code	NDC 0168000715
Hospital Charge Code	0168000715
Hospital Revenue Code	250
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$0.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.56

NYSTATIN 100000 UNIT/GM EX OINT

Facility

IP

$0.88

Service Code	NDC 4580204811
Hospital Charge Code	4580204811
Hospital Revenue Code	250
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$0.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.44

NYSTATIN 100000 UNIT/GM EX OINT

Facility

OP

$0.88

Service Code	NDC 4580204811
Hospital Charge Code	4580204811
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.48
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	$0.70
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	$0.57

NYSTATIN 100000 UNIT/GM EX OINT

Facility

IP

$0.88

Service Code	NDC 0472016630
Hospital Charge Code	0472016630
Hospital Revenue Code	250
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$0.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.44

NYSTATIN 100000 UNIT/GM EX OINT

Facility

OP

$0.88

Service Code	NDC 0472016630
Hospital Charge Code	0472016630
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.48
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	$0.70
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	$0.57

NYSTATIN 100000 UNIT/GM EX OINT

Facility

OP

$1.12

Service Code	NDC 0168000715
Hospital Charge Code	0168000715
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$0.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.56
Rate for Payer: Aetna Government	$0.56
Rate for Payer: Brighton Health Commercial	$0.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.76
Rate for Payer: EmblemHealth Commercial	$0.56
Rate for Payer: Group Health Inc Commercial	$0.56
Rate for Payer: Group Health Inc Medicare	$0.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.56
Rate for Payer: Hamaspik Choice Inc Medicare	$0.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.73

NYSTATIN 100000 UNIT/GM EX OINT

Facility

IP

$1.17

Service Code	NDC 0713068615
Hospital Charge Code	0713068615
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.58

NYSTATIN 100000 UNIT/GM EX OINT

Facility

OP

$1.17

Service Code	NDC 4580204835
Hospital Charge Code	4580204835
Hospital Revenue Code	250
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$0.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.58
Rate for Payer: Aetna Government	$0.58
Rate for Payer: Brighton Health Commercial	$0.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.79
Rate for Payer: EmblemHealth Commercial	$0.58
Rate for Payer: Group Health Inc Commercial	$0.58
Rate for Payer: Group Health Inc Medicare	$0.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.58
Rate for Payer: Hamaspik Choice Inc Medicare	$0.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.76

NYSTATIN 100000 UNIT/GM EX POWD

Facility

OP

$1.83

Service Code	NDC 0574200815
Hospital Charge Code	0574200815
Hospital Revenue Code	250
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$1.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.92
Rate for Payer: Aetna Government	$0.92
Rate for Payer: Brighton Health Commercial	$1.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.25
Rate for Payer: EmblemHealth Commercial	$0.92
Rate for Payer: Group Health Inc Commercial	$0.92
Rate for Payer: Group Health Inc Medicare	$0.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.92
Rate for Payer: Hamaspik Choice Inc Medicare	$0.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.19

NYSTATIN 100000 UNIT/GM EX POWD

Facility

IP

$1.83

Service Code	NDC 0574200815
Hospital Charge Code	0574200815
Hospital Revenue Code	250
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$0.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.92

NYSTATIN 100000 UNIT/GM EX POWD

Facility

IP

$2.50

Service Code	NDC 0832046515
Hospital Charge Code	0832046515
Hospital Revenue Code	250
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$1.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.25

NYSTATIN 100000 UNIT/GM EX POWD

Facility

OP

$2.50

Service Code	NDC 0832046515
Hospital Charge Code	0832046515
Hospital Revenue Code	250
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$2.00
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	$2.00
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

NYSTATIN 100000 UNIT/ML MT SUSP

Facility

OP

$0.25

Service Code	NDC 0121086816
Hospital Charge Code	0121086816
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.12
Rate for Payer: Aetna Government	$0.12
Rate for Payer: Brighton Health Commercial	$0.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.17
Rate for Payer: EmblemHealth Commercial	$0.12
Rate for Payer: Group Health Inc Commercial	$0.12
Rate for Payer: Group Health Inc Medicare	$0.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.12
Rate for Payer: Hamaspik Choice Inc Medicare	$0.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.16

NYSTATIN 100000 UNIT/ML MT SUSP

Facility

OP

$0.24

Service Code	NDC 0121086802
Hospital Charge Code	0121086802
Hospital Revenue Code	250
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.12
Rate for Payer: Aetna Government	$0.12
Rate for Payer: Brighton Health Commercial	$0.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.16
Rate for Payer: EmblemHealth Commercial	$0.12
Rate for Payer: Group Health Inc Commercial	$0.12
Rate for Payer: Group Health Inc Medicare	$0.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.12
Rate for Payer: Hamaspik Choice Inc Medicare	$0.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.16

NYSTATIN 100000 UNIT/ML MT SUSP

Facility

IP

$0.24

Service Code	NDC 0121086802
Hospital Charge Code	0121086802
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.12

NYSTATIN 100000 UNIT/ML MT SUSP

Facility

IP

$0.20

Service Code	NDC 0904727670
Hospital Charge Code	0904727670
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10

NYSTATIN 100000 UNIT/ML MT SUSP

Facility

OP

$0.20

Service Code	NDC 0904727670
Hospital Charge Code	0904727670
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.10
Rate for Payer: Aetna Government	$0.10
Rate for Payer: Brighton Health Commercial	$0.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.14
Rate for Payer: EmblemHealth Commercial	$0.10
Rate for Payer: Group Health Inc Commercial	$0.10
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10
Rate for Payer: Hamaspik Choice Inc Medicare	$0.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.13

NYSTATIN 100000 UNIT/ML MT SUSP

Facility

IP

$0.25

Service Code	NDC 0121086816
Hospital Charge Code	0121086816
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.12

NYSTATIN 100000 UNIT/ML MT SUSP

Facility

OP

$0.20

Service Code	NDC 6668903799
Hospital Charge Code	6668903799
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.10
Rate for Payer: Aetna Government	$0.10
Rate for Payer: Brighton Health Commercial	$0.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.14
Rate for Payer: EmblemHealth Commercial	$0.10
Rate for Payer: Group Health Inc Commercial	$0.10
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10
Rate for Payer: Hamaspik Choice Inc Medicare	$0.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.13

NYSTATIN 100000 UNIT/ML MT SUSP

Facility

IP

$0.20

Service Code	NDC 6668903799
Hospital Charge Code	6668903799
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10

<<
<
858
859
860
861
862
863
864
865
866
867
>
>>