St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

KCL IN DEXTROSE-NACL 20-5-0.45 MEQ/L-%-% IV SOLN [9801]

Facility

$0.01

Service Code	NDC 00338067104
Hospital Charge Code	00338067104
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.00
Rate for Payer: Aetna Government	$0.00
Rate for Payer: Brighton Health Commercial	$0.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.00
Rate for Payer: EmblemHealth Commercial	$0.00
Rate for Payer: Fidelis Medicare Advantage	$0.01
Rate for Payer: Group Health Inc Commercial	$0.00
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.00
Rate for Payer: Hamaspik Choice Inc Medicare	$0.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.00

KCL IN DEXTROSE-NACL 20-5-0.9 MEQ/L-%-% IV SOLN [9795]

Facility

$0.01

Service Code	NDC 00338080304
Hospital Charge Code	00338080304
Hospital Revenue Code	278
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

KCL IN DEXTROSE-NACL 20-5-0.9 MEQ/L-%-% IV SOLN [9795]

Facility

$0.01

Service Code	NDC 00338080304
Hospital Charge Code	00338080304
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: EmblemHealth Commercial	$0.01
Rate for Payer: Fidelis Medicare Advantage	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

KCL IN DEXTROSE-NACL 40-5-0.45 MEQ/L-%-% IV SOLN [9807]

Facility

$0.01

Service Code	NDC 00338067504
Hospital Charge Code	00338067504
Hospital Revenue Code	278
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

KCL IN DEXTROSE-NACL 40-5-0.45 MEQ/L-%-% IV SOLN [9807]

Facility

$0.01

Service Code	NDC 00338067504
Hospital Charge Code	00338067504
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: EmblemHealth Commercial	$0.01
Rate for Payer: Fidelis Medicare Advantage	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

KCL-LACTATED RINGERS-D5W 20 MEQ/L IV SOLN [16014]

Facility

$0.01

Service Code	NDC 00338081104
Hospital Charge Code	00338081104
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: EmblemHealth Commercial	$0.01
Rate for Payer: Fidelis Medicare Advantage	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

KCL-LACTATED RINGERS-D5W 20 MEQ/L IV SOLN [16014]

Facility

$0.01

Service Code	NDC 00338081104
Hospital Charge Code	00338081104
Hospital Revenue Code	278
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

KELLY FLASH

Facility

$6.03

Hospital Charge Code	40203310
Hospital Revenue Code	270
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$4.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.02
Rate for Payer: Aetna Government	$3.02
Rate for Payer: Brighton Health Commercial	$4.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.10
Rate for Payer: Group Health Inc Commercial	$3.02
Rate for Payer: Group Health Inc Medicare	$2.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.02
Rate for Payer: Hamaspik Choice Inc Medicare	$3.02

KENDALLCATHETTALPALIDRM14.5X19CM

Facility

$835.42

Hospital Charge Code	40209975
Hospital Revenue Code	270
Min. Negotiated Rate	$292.40
Max. Negotiated Rate	$668.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$459.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$417.71
Rate for Payer: Aetna Government	$417.71
Rate for Payer: Brighton Health Commercial	$626.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$668.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$568.09
Rate for Payer: Group Health Inc Commercial	$417.71
Rate for Payer: Group Health Inc Medicare	$292.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$417.71
Rate for Payer: Hamaspik Choice Inc Medicare	$417.71

KENDALLCAT MAHURKARQ+13.5FRX19.5C

Facility

$189.84

Hospital Charge Code	40209978
Hospital Revenue Code	270
Min. Negotiated Rate	$66.44
Max. Negotiated Rate	$151.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$104.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$94.92
Rate for Payer: Aetna Government	$94.92
Rate for Payer: Brighton Health Commercial	$142.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$151.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$129.09
Rate for Payer: Group Health Inc Commercial	$94.92
Rate for Payer: Group Health Inc Medicare	$66.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$94.92
Rate for Payer: Hamaspik Choice Inc Medicare	$94.92

KENDALL CAT TALPALIDRM14.5X23CM

Facility

$835.42

Hospital Charge Code	40209976
Hospital Revenue Code	270
Min. Negotiated Rate	$292.40
Max. Negotiated Rate	$668.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$459.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$417.71
Rate for Payer: Aetna Government	$417.71
Rate for Payer: Brighton Health Commercial	$626.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$668.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$568.09
Rate for Payer: Group Health Inc Commercial	$417.71
Rate for Payer: Group Health Inc Medicare	$292.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$417.71
Rate for Payer: Hamaspik Choice Inc Medicare	$417.71

KENDALLCAT TALPALIDRM DUAL14.5X23

Facility

$835.42

Hospital Charge Code	40209977
Hospital Revenue Code	270
Min. Negotiated Rate	$292.40
Max. Negotiated Rate	$668.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$459.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$417.71
Rate for Payer: Aetna Government	$417.71
Rate for Payer: Brighton Health Commercial	$626.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$668.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$568.09
Rate for Payer: Group Health Inc Commercial	$417.71
Rate for Payer: Group Health Inc Medicare	$292.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$417.71
Rate for Payer: Hamaspik Choice Inc Medicare	$417.71

KERATOPLASTY

Facility

$11,564.78

Service Code	HCPCS 65710
Hospital Charge Code	40072515
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$8,673.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,065.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,044.08
Rate for Payer: Aetna Government	$6,044.08
Rate for Payer: Affinity Essential Plan 1&2	$4,230.86
Rate for Payer: Affinity Essential Plan 3&4	$4,230.86
Rate for Payer: Affinity Medicaid/CHP/HARP	$4,230.86
Rate for Payer: Brighton Health Commercial	$8,673.58
Rate for Payer: Cash Price	$6,044.08
Rate for Payer: Cash Price	$6,044.08
Rate for Payer: Cash Price	$6,044.08
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6,044.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$6,044.08
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$5,137.47
Rate for Payer: Fidelis Essential Plan QHP	$5,379.23
Rate for Payer: Fidelis Medicare Advantage	$6,044.08
Rate for Payer: Fidelis Qualified Health Plan	$5,379.23
Rate for Payer: Group Health Inc Commercial	$6,044.08
Rate for Payer: Group Health Inc Medicare	$6,044.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,782.39
Rate for Payer: Hamaspik Choice Inc Medicare	$6,044.08
Rate for Payer: Healthfirst Medicare Advantage	$5,137.47
Rate for Payer: Healthfirst QHP	$6,044.08
Rate for Payer: Humana Medicare	$6,164.96
Rate for Payer: Senior Whole Health Medicare Advantage	$6,044.08
Rate for Payer: United Healthcare Commercial	$2,683.00
Rate for Payer: United Healthcare Medicare Advantage	$6,044.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,044.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4,835.26
Rate for Payer: Wellcare Medicare	$5,741.88

KERATOPLASTY

Facility

$11,564.78

Service Code	HCPCS 65710
Hospital Charge Code	40072515
Hospital Revenue Code	360
Rate for Payer: Cash Price	$6,044.08

KETAMINE 10MG/ML 1ML SYRINGE

Facility

$0.53

Service Code	HCPCS J3490
Hospital Charge Code	41647820
Hospital Revenue Code	636
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$0.27

KETAMINE 10MG/ML 1ML SYRINGE

Facility

$0.53

Service Code	HCPCS J3490
Hospital Charge Code	41647820
Hospital Revenue Code	636
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.27
Rate for Payer: Aetna Government	$0.27
Rate for Payer: Brighton Health Commercial	$0.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.30
Rate for Payer: Group Health Inc Commercial	$0.27
Rate for Payer: Group Health Inc Medicare	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$0.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.34

KETAMINE 10ML/ML 1ML SYRINGE

Facility

$0.53

Service Code	HCPCS J3490
Hospital Charge Code	41657820
Hospital Revenue Code	636
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.27
Rate for Payer: Aetna Government	$0.27
Rate for Payer: Brighton Health Commercial	$0.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.30
Rate for Payer: Group Health Inc Commercial	$0.27
Rate for Payer: Group Health Inc Medicare	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$0.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.34

KETAMINE 10ML/ML 1ML SYRINGE

Facility

$0.53

Service Code	HCPCS J3490
Hospital Charge Code	41657820
Hospital Revenue Code	636
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$0.27

KETAMINE 200MG/100ML

Facility

$47.72

Hospital Charge Code	41650224
Hospital Revenue Code	636
Min. Negotiated Rate	$16.70
Max. Negotiated Rate	$31.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.86
Rate for Payer: Aetna Government	$23.86
Rate for Payer: Brighton Health Commercial	$28.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$23.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$27.44
Rate for Payer: Group Health Inc Commercial	$23.86
Rate for Payer: Group Health Inc Medicare	$16.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.86
Rate for Payer: Hamaspik Choice Inc Medicare	$23.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$31.02

KETAMINE 200MG/100ML

Facility

$47.72

Hospital Charge Code	41640224
Hospital Revenue Code	636
Min. Negotiated Rate	$16.70
Max. Negotiated Rate	$31.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.86
Rate for Payer: Aetna Government	$23.86
Rate for Payer: Brighton Health Commercial	$28.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$23.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$27.44
Rate for Payer: Group Health Inc Commercial	$23.86
Rate for Payer: Group Health Inc Medicare	$16.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.86
Rate for Payer: Hamaspik Choice Inc Medicare	$23.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$31.02

KETAMINE 200MG/100ML

Facility

$47.72

Hospital Charge Code	41640224
Hospital Revenue Code	636
Min. Negotiated Rate	$23.86
Max. Negotiated Rate	$23.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.86
Rate for Payer: Hamaspik Choice Inc Medicare	$23.86

KETAMINE 200MG/100ML

Facility

$47.72

Hospital Charge Code	41650224
Hospital Revenue Code	636
Min. Negotiated Rate	$23.86
Max. Negotiated Rate	$23.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.86
Rate for Payer: Hamaspik Choice Inc Medicare	$23.86

KETAMINE 200MG/20ML INJ

Facility

$26.44

Hospital Charge Code	41646552
Hospital Revenue Code	250
Min. Negotiated Rate	$9.25
Max. Negotiated Rate	$21.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.22
Rate for Payer: Aetna Government	$13.22
Rate for Payer: Brighton Health Commercial	$19.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.98
Rate for Payer: Group Health Inc Commercial	$13.22
Rate for Payer: Group Health Inc Medicare	$9.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.22
Rate for Payer: Hamaspik Choice Inc Medicare	$13.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$17.19

KETAMINE 200MG/20ML INJ

Facility

$26.44

Hospital Charge Code	41656552
Hospital Revenue Code	250
Min. Negotiated Rate	$9.25
Max. Negotiated Rate	$21.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.22
Rate for Payer: Aetna Government	$13.22
Rate for Payer: Brighton Health Commercial	$19.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.98
Rate for Payer: Group Health Inc Commercial	$13.22
Rate for Payer: Group Health Inc Medicare	$9.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.22
Rate for Payer: Hamaspik Choice Inc Medicare	$13.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$17.19

KETAMINE 25MG/0.5ML SYRINGE

Facility

$0.32

Hospital Charge Code	41657828
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.16
Rate for Payer: Aetna Government	$0.16
Rate for Payer: Brighton Health Commercial	$0.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.22
Rate for Payer: Group Health Inc Commercial	$0.16
Rate for Payer: Group Health Inc Medicare	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.16
Rate for Payer: Hamaspik Choice Inc Medicare	$0.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.21

Know your out-of-pocket cost for care.

All Charges