Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

PHENYLEPHRINE HCL 0.5 % NA SOLN

Facility

IP

$0.26

Service Code	NDC 0225080547
Hospital Charge Code	0225080547
Hospital Revenue Code	250
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13

PHENYLEPHRINE HCL 0.5 % NA SOLN

Facility

OP

$0.26

Service Code	NDC 0225080547
Hospital Charge Code	0225080547
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.13
Rate for Payer: Aetna Government	$0.13
Rate for Payer: Brighton Health Commercial	$0.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.18
Rate for Payer: EmblemHealth Commercial	$0.13
Rate for Payer: Group Health Inc Commercial	$0.13
Rate for Payer: Group Health Inc Medicare	$0.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13
Rate for Payer: Hamaspik Choice Inc Medicare	$0.13
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.17

PHENYLEPHRINE HCL 10 % OP SOLN

Facility

IP

$10.00

Service Code	NDC 1747820605
Hospital Charge Code	1747820605
Hospital Revenue Code	250
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$5.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.00

PHENYLEPHRINE HCL 10 % OP SOLN

Facility

OP

$10.00

Service Code	NDC 1747820605
Hospital Charge Code	1747820605
Hospital Revenue Code	250
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$8.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.00
Rate for Payer: Aetna Government	$5.00
Rate for Payer: Brighton Health Commercial	$7.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.80
Rate for Payer: EmblemHealth Commercial	$5.00
Rate for Payer: Group Health Inc Commercial	$5.00
Rate for Payer: Group Health Inc Medicare	$3.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.50

PHENYLEPHRINE HCL 10 % OP SOLN

Facility

IP

$9.60

Service Code	NDC 4270210305
Hospital Charge Code	4270210305
Hospital Revenue Code	250
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.80

PHENYLEPHRINE HCL 10 % OP SOLN

Facility

OP

$9.60

Service Code	NDC 4270210305
Hospital Charge Code	4270210305
Hospital Revenue Code	250
Min. Negotiated Rate	$3.36
Max. Negotiated Rate	$7.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.80
Rate for Payer: Aetna Government	$4.80
Rate for Payer: Brighton Health Commercial	$7.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.53
Rate for Payer: EmblemHealth Commercial	$4.80
Rate for Payer: Group Health Inc Commercial	$4.80
Rate for Payer: Group Health Inc Medicare	$3.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.80
Rate for Payer: Hamaspik Choice Inc Medicare	$4.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.24

PHENYLEPHRINE HCL 10 % OP SOLN

Facility

IP

$10.00

Service Code	NDC 7075661430
Hospital Charge Code	7075661430
Hospital Revenue Code	250
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$5.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.00

PHENYLEPHRINE HCL 10 % OP SOLN

Facility

OP

$10.00

Service Code	NDC 7075661430
Hospital Charge Code	7075661430
Hospital Revenue Code	250
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$8.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.00
Rate for Payer: Aetna Government	$5.00
Rate for Payer: Brighton Health Commercial	$7.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.80
Rate for Payer: EmblemHealth Commercial	$5.00
Rate for Payer: Group Health Inc Commercial	$5.00
Rate for Payer: Group Health Inc Medicare	$3.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.50

PHENYLEPHRINE HCL 1 % NA SOLN

Facility

IP

$0.21

Service Code	NDC 0067208601
Hospital Charge Code	0067208601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11

PHENYLEPHRINE HCL 1 % NA SOLN

Facility

OP

$0.29

Service Code	NDC 0225081047
Hospital Charge Code	0225081047
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.15
Rate for Payer: Aetna Government	$0.15
Rate for Payer: Brighton Health Commercial	$0.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.20
Rate for Payer: EmblemHealth Commercial	$0.15
Rate for Payer: Group Health Inc Commercial	$0.15
Rate for Payer: Group Health Inc Medicare	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15
Rate for Payer: Hamaspik Choice Inc Medicare	$0.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.19

PHENYLEPHRINE HCL 1 % NA SOLN

Facility

IP

$0.29

Service Code	NDC 0225081047
Hospital Charge Code	0225081047
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15

PHENYLEPHRINE HCL 1 % NA SOLN

Facility

OP

$0.21

Service Code	NDC 0067208601
Hospital Charge Code	0067208601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.11
Rate for Payer: Aetna Government	$0.11
Rate for Payer: Brighton Health Commercial	$0.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.14
Rate for Payer: EmblemHealth Commercial	$0.11
Rate for Payer: Group Health Inc Commercial	$0.11
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11
Rate for Payer: Hamaspik Choice Inc Medicare	$0.11
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.14

PHENYLEPHRINE HCL 2.5 % OP SOLN

Facility

IP

$20.32

Service Code	NDC 7075662925
Hospital Charge Code	7075662925
Hospital Revenue Code	250
Min. Negotiated Rate	$10.16
Max. Negotiated Rate	$10.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.16

PHENYLEPHRINE HCL 2.5 % OP SOLN

Facility

IP

$19.50

Service Code	NDC 6931532308
Hospital Charge Code	6931532308
Hospital Revenue Code	250
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.75

PHENYLEPHRINE HCL 2.5 % OP SOLN

Facility

OP

$19.50

Service Code	NDC 6931532308
Hospital Charge Code	6931532308
Hospital Revenue Code	250
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$15.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.75
Rate for Payer: Aetna Government	$9.75
Rate for Payer: Brighton Health Commercial	$14.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.26
Rate for Payer: EmblemHealth Commercial	$9.75
Rate for Payer: Group Health Inc Commercial	$9.75
Rate for Payer: Group Health Inc Medicare	$6.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.75
Rate for Payer: Hamaspik Choice Inc Medicare	$9.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.68

PHENYLEPHRINE HCL 2.5 % OP SOLN

Facility

OP

$20.32

Service Code	NDC 7075662925
Hospital Charge Code	7075662925
Hospital Revenue Code	250
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$16.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.16
Rate for Payer: Aetna Government	$10.16
Rate for Payer: Brighton Health Commercial	$15.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.81
Rate for Payer: EmblemHealth Commercial	$10.16
Rate for Payer: Group Health Inc Commercial	$10.16
Rate for Payer: Group Health Inc Medicare	$7.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.16
Rate for Payer: Hamaspik Choice Inc Medicare	$10.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.20

PHENYLEPHRINE HCL-NACL 1-0.9 MG/10ML-% IV SOSY

Facility

IP

$0.72

Service Code	NDC 6303717325
Hospital Charge Code	6303717325
Hospital Revenue Code	258
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.36

PHENYLEPHRINE HCL-NACL 1-0.9 MG/10ML-% IV SOSY

Facility

OP

$0.72

Service Code	NDC 6303717325
Hospital Charge Code	6303717325
Hospital Revenue Code	258
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.36
Rate for Payer: Aetna Government	$0.36
Rate for Payer: Brighton Health Commercial	$0.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.49
Rate for Payer: EmblemHealth Commercial	$0.36
Rate for Payer: Group Health Inc Commercial	$0.36
Rate for Payer: Group Health Inc Medicare	$0.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.36
Rate for Payer: Hamaspik Choice Inc Medicare	$0.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.47

PHENYLEPHRINE HCL-NACL 40-0.9 MG/250ML-% IV SOLN

Facility

OP

$0.28

Service Code	NDC 7000482540
Hospital Charge Code	7000482540
Hospital Revenue Code	258
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.14
Rate for Payer: Aetna Government	$0.14
Rate for Payer: Brighton Health Commercial	$0.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.19
Rate for Payer: EmblemHealth Commercial	$0.14
Rate for Payer: Group Health Inc Commercial	$0.14
Rate for Payer: Group Health Inc Medicare	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14
Rate for Payer: Hamaspik Choice Inc Medicare	$0.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.18

PHENYLEPHRINE HCL-NACL 40-0.9 MG/250ML-% IV SOLN

Facility

IP

$0.28

Service Code	NDC 7000482540
Hospital Charge Code	7000482540
Hospital Revenue Code	258
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14

PHENYLEPHRINE HCL (PRESSORS) 10 MG/ML IV SOLN

Facility

IP

$5.28

Service Code	NDC 7075662210
Hospital Charge Code	7075662210
Hospital Revenue Code	258
Min. Negotiated Rate	$2.64
Max. Negotiated Rate	$2.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.64

PHENYLEPHRINE HCL (PRESSORS) 10 MG/ML IV SOLN

Facility

OP

$2.40

Service Code	NDC 7128880877
Hospital Charge Code	7128880877
Hospital Revenue Code	258
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$1.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.20
Rate for Payer: Aetna Government	$1.20
Rate for Payer: Brighton Health Commercial	$1.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.63
Rate for Payer: EmblemHealth Commercial	$1.20
Rate for Payer: Group Health Inc Commercial	$1.20
Rate for Payer: Group Health Inc Medicare	$0.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.20
Rate for Payer: Hamaspik Choice Inc Medicare	$1.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.56

PHENYLEPHRINE HCL (PRESSORS) 10 MG/ML IV SOLN

Facility

OP

$5.28

Service Code	NDC 6199002122
Hospital Charge Code	6199002122
Hospital Revenue Code	258
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$4.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.64
Rate for Payer: Aetna Government	$2.64
Rate for Payer: Brighton Health Commercial	$3.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.59
Rate for Payer: EmblemHealth Commercial	$2.64
Rate for Payer: Group Health Inc Commercial	$2.64
Rate for Payer: Group Health Inc Medicare	$1.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.64
Rate for Payer: Hamaspik Choice Inc Medicare	$2.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.43

PHENYLEPHRINE HCL (PRESSORS) 10 MG/ML IV SOLN

Facility

IP

$2.40

Service Code	NDC 7128880701
Hospital Charge Code	7128880701
Hospital Revenue Code	258
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.20

PHENYLEPHRINE HCL (PRESSORS) 10 MG/ML IV SOLN

Facility

IP

$1.92

Service Code	NDC 8128421125
Hospital Charge Code	8128421125
Hospital Revenue Code	258
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$0.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.96

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