St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

LACTATED RINGERS-1000CC

Facility

$10.64

Hospital Charge Code	40503500
Hospital Revenue Code	260
Min. Negotiated Rate	$3.72
Max. Negotiated Rate	$76.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.32
Rate for Payer: Aetna Government	$5.32
Rate for Payer: Brighton Health Commercial	$7.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.24
Rate for Payer: Group Health Inc Commercial	$5.32
Rate for Payer: Group Health Inc Medicare	$3.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.32
Rate for Payer: Hamaspik Choice Inc Medicare	$5.32
Rate for Payer: United Healthcare Commercial	$76.00

LACTATED RINGERS - 500CC

Facility

$8.15

Hospital Charge Code	40193501
Hospital Revenue Code	710
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$6.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$6.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.54
Rate for Payer: Group Health Inc Commercial	$4.08
Rate for Payer: Group Health Inc Medicare	$2.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.08
Rate for Payer: Hamaspik Choice Inc Medicare	$4.08

LACTATED RINGERS -500CC

Facility

$9.92

Hospital Charge Code	40503501
Hospital Revenue Code	260
Min. Negotiated Rate	$3.47
Max. Negotiated Rate	$76.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.96
Rate for Payer: Aetna Government	$4.96
Rate for Payer: Brighton Health Commercial	$7.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.75
Rate for Payer: Group Health Inc Commercial	$4.96
Rate for Payer: Group Health Inc Medicare	$3.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.96
Rate for Payer: Hamaspik Choice Inc Medicare	$4.96
Rate for Payer: United Healthcare Commercial	$76.00

LACTATED RINGERS INFUSION 1000 ML

Facility

$2.00

Service Code	HCPCS J7120
Hospital Charge Code	41642163
Hospital Revenue Code	636
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$2.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.51
Rate for Payer: Aetna Government	$2.51
Rate for Payer: Brighton Health Commercial	$1.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.15
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2.57
Rate for Payer: SOMOS Essential	$2.57
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

LACTATED RINGERS INFUSION 1000 ML

Facility

$2.00

Service Code	HCPCS J7120
Hospital Charge Code	41642163
Hospital Revenue Code	636
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00

LACTATED RINGERS INFUSION 1000 ML

Facility

$2.00

Service Code	HCPCS J7120
Hospital Charge Code	41652163
Hospital Revenue Code	636
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$2.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.51
Rate for Payer: Aetna Government	$2.51
Rate for Payer: Brighton Health Commercial	$1.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.15
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2.57
Rate for Payer: SOMOS Essential	$2.57
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

LACTATED RINGERS INFUSION 1000 ML

Facility

$2.00

Service Code	HCPCS J7120
Hospital Charge Code	41652163
Hospital Revenue Code	636
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00

LACTATED RINGERS INFUSION 500 ML

Facility

$2.00

Hospital Charge Code	41644852
Hospital Revenue Code	636
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.00
Rate for Payer: Aetna Government	$1.00
Rate for Payer: Brighton Health Commercial	$1.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.15
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

LACTATED RINGERS INFUSION 500 ML

Facility

$2.00

Hospital Charge Code	41644852
Hospital Revenue Code	636
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00

LACTATED RINGERS INFUSION 500 ML

Facility

$2.00

Hospital Charge Code	41654852
Hospital Revenue Code	636
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.00
Rate for Payer: Aetna Government	$1.00
Rate for Payer: Brighton Health Commercial	$1.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.15
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

LACTATED RINGERS INFUSION 500 ML

Facility

$2.00

Hospital Charge Code	41654852
Hospital Revenue Code	636
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00

LACTATED RINGERS IV BOLUS [400296]

Facility

$0.01

Service Code	HCPCS J7120
Hospital Charge Code	00338011704
Hospital Revenue Code	278
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.00
Rate for Payer: Hamaspik Choice Inc Medicare	$0.00

LACTATED RINGERS IV BOLUS [400296]

Facility

$0.01

Service Code	HCPCS J7120
Hospital Charge Code	00338011703
Hospital Revenue Code	278
Max. Negotiated Rate	$2.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.51
Rate for Payer: Aetna Government	$2.51
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

LACTATED RINGERS IV BOLUS [400296]

Facility

$0.01

Service Code	HCPCS J7120
Hospital Charge Code	00338011703
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

LACTATED RINGERS IV BOLUS [400296]

Facility

$0.01

Service Code	HCPCS J7120
Hospital Charge Code	00338011704
Hospital Revenue Code	278
Max. Negotiated Rate	$2.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.51
Rate for Payer: Aetna Government	$2.51
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

LACTATED RINGERS IV SOLN [4318]

Facility

$0.01

Service Code	HCPCS J7120
Hospital Charge Code	00338011704
Hospital Revenue Code	278
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.00
Rate for Payer: Hamaspik Choice Inc Medicare	$0.00

LACTATED RINGERS IV SOLN [4318]

Facility

$0.01

Service Code	HCPCS J7120
Hospital Charge Code	00338011703
Hospital Revenue Code	278
Max. Negotiated Rate	$2.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.51
Rate for Payer: Aetna Government	$2.51
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

LACTATED RINGERS IV SOLN [4318]

Facility

$0.01

Service Code	HCPCS J7120
Hospital Charge Code	00338011703
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

LACTATED RINGERS IV SOLN [4318]

Facility

$0.01

Service Code	HCPCS J7120
Hospital Charge Code	00338011704
Hospital Revenue Code	278
Max. Negotiated Rate	$2.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.51
Rate for Payer: Aetna Government	$2.51
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

LACTIC ACID

Facility

$28.93

Service Code	HCPCS 83605
Hospital Charge Code	40602170
Hospital Revenue Code	301
Rate for Payer: Cash Price	$11.57

LACTIC ACID

Facility

$28.93

Service Code	HCPCS 83605
Hospital Charge Code	40602170
Hospital Revenue Code	301
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$21.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.57
Rate for Payer: Aetna Government	$11.57
Rate for Payer: Affinity Essential Plan 1&2	$8.10
Rate for Payer: Affinity Essential Plan 3&4	$8.10
Rate for Payer: Affinity Medicaid/CHP/HARP	$8.10
Rate for Payer: Brighton Health Commercial	$21.70
Rate for Payer: Cash Price	$11.57
Rate for Payer: Cash Price	$11.57
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$11.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.37
Rate for Payer: Elderplan Medicare Advantage	$11.57
Rate for Payer: EmblemHealth Commercial	$11.57
Rate for Payer: Fidelis Essential Plan Aliesa	$9.83
Rate for Payer: Fidelis Essential Plan QHP	$10.30
Rate for Payer: Fidelis Medicare Advantage	$11.57
Rate for Payer: Fidelis Qualified Health Plan	$10.30
Rate for Payer: Group Health Inc Commercial	$11.57
Rate for Payer: Group Health Inc Medicare	$11.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.46
Rate for Payer: Hamaspik Choice Inc Medicare	$11.57
Rate for Payer: Healthfirst Medicare Advantage	$11.57
Rate for Payer: Healthfirst QHP	$11.57
Rate for Payer: Humana Medicare	$11.80
Rate for Payer: Senior Whole Health Medicare Advantage	$11.57
Rate for Payer: United Healthcare Commercial	$13.53
Rate for Payer: United Healthcare Medicare Advantage	$11.57
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.57
Rate for Payer: Wellcare CHP/FHP/Medicaid	$9.26
Rate for Payer: Wellcare Medicare	$10.41

LACTIC DEHYDIGENASE,ISOGENZYME

Facility

$31.98

Service Code	HCPCS 83625
Hospital Charge Code	40602515
Hospital Revenue Code	301
Rate for Payer: Cash Price	$12.79

LACTIC DEHYDIGENASE,ISOGENZYME

Facility

$31.98

Service Code	HCPCS 83625
Hospital Charge Code	40602515
Hospital Revenue Code	301
Min. Negotiated Rate	$8.95
Max. Negotiated Rate	$23.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.79
Rate for Payer: Aetna Government	$12.79
Rate for Payer: Affinity Essential Plan 1&2	$8.95
Rate for Payer: Affinity Essential Plan 3&4	$8.95
Rate for Payer: Affinity Medicaid/CHP/HARP	$8.95
Rate for Payer: Brighton Health Commercial	$23.98
Rate for Payer: Cash Price	$12.79
Rate for Payer: Cash Price	$12.79
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$12.79
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.22
Rate for Payer: Elderplan Medicare Advantage	$12.79
Rate for Payer: EmblemHealth Commercial	$12.79
Rate for Payer: Fidelis Essential Plan Aliesa	$10.87
Rate for Payer: Fidelis Essential Plan QHP	$11.38
Rate for Payer: Fidelis Medicare Advantage	$12.79
Rate for Payer: Fidelis Qualified Health Plan	$11.38
Rate for Payer: Group Health Inc Commercial	$12.79
Rate for Payer: Group Health Inc Medicare	$12.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.99
Rate for Payer: Hamaspik Choice Inc Medicare	$12.79
Rate for Payer: Healthfirst Medicare Advantage	$12.79
Rate for Payer: Healthfirst QHP	$12.79
Rate for Payer: Humana Medicare	$13.05
Rate for Payer: Senior Whole Health Medicare Advantage	$12.79
Rate for Payer: United Healthcare Commercial	$16.21
Rate for Payer: United Healthcare Medicare Advantage	$12.79
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.79
Rate for Payer: Wellcare CHP/FHP/Medicaid	$10.23
Rate for Payer: Wellcare Medicare	$11.51

LACTIC DEHYDROGENASE (LDH)

Facility

$15.10

Service Code	HCPCS 83615
Hospital Charge Code	40602130
Hospital Revenue Code	301
Rate for Payer: Cash Price	$6.04

LACTIC DEHYDROGENASE (LDH)

Facility

$15.10

Service Code	HCPCS 83615
Hospital Charge Code	40602130
Hospital Revenue Code	301
Min. Negotiated Rate	$4.23
Max. Negotiated Rate	$11.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.04
Rate for Payer: Aetna Government	$6.04
Rate for Payer: Affinity Essential Plan 1&2	$4.23
Rate for Payer: Affinity Essential Plan 3&4	$4.23
Rate for Payer: Affinity Medicaid/CHP/HARP	$4.23
Rate for Payer: Brighton Health Commercial	$11.32
Rate for Payer: Cash Price	$6.04
Rate for Payer: Cash Price	$6.04
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.14
Rate for Payer: Elderplan Medicare Advantage	$6.04
Rate for Payer: EmblemHealth Commercial	$6.04
Rate for Payer: Fidelis Essential Plan Aliesa	$5.13
Rate for Payer: Fidelis Essential Plan QHP	$5.38
Rate for Payer: Fidelis Medicare Advantage	$6.04
Rate for Payer: Fidelis Qualified Health Plan	$5.38
Rate for Payer: Group Health Inc Commercial	$6.04
Rate for Payer: Group Health Inc Medicare	$6.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.55
Rate for Payer: Hamaspik Choice Inc Medicare	$6.04
Rate for Payer: Healthfirst Medicare Advantage	$6.04
Rate for Payer: Healthfirst QHP	$6.04
Rate for Payer: Humana Medicare	$6.16
Rate for Payer: Senior Whole Health Medicare Advantage	$6.04
Rate for Payer: United Healthcare Commercial	$7.65
Rate for Payer: United Healthcare Medicare Advantage	$6.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.04
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.83
Rate for Payer: Wellcare Medicare	$5.44

Know your out-of-pocket cost for care.

All Charges