St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

LINE SAMPLE PEDIATRIC

Facility

$18.75

Hospital Charge Code	64903889
Hospital Revenue Code	270
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$15.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.38
Rate for Payer: Aetna Government	$9.38
Rate for Payer: Brighton Health Commercial	$14.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.75
Rate for Payer: Group Health Inc Commercial	$9.38
Rate for Payer: Group Health Inc Medicare	$6.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.38
Rate for Payer: Hamaspik Choice Inc Medicare	$9.38

LINE SAMPLING MALE/MALE LUER

Facility

$3.63

Hospital Charge Code	64902824
Hospital Revenue Code	270
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$2.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.82
Rate for Payer: Aetna Government	$1.82
Rate for Payer: Brighton Health Commercial	$2.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.47
Rate for Payer: Group Health Inc Commercial	$1.82
Rate for Payer: Group Health Inc Medicare	$1.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.82
Rate for Payer: Hamaspik Choice Inc Medicare	$1.82

LINEZOLID 100 MG/5ML PO SUSR [28225]

Facility

$5.47

Service Code	NDC 59762130801
Hospital Charge Code	59762130801
Hospital Revenue Code	250
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$4.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.73
Rate for Payer: Aetna Government	$2.73
Rate for Payer: Brighton Health Commercial	$4.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.72
Rate for Payer: Group Health Inc Commercial	$2.73
Rate for Payer: Group Health Inc Medicare	$1.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.73
Rate for Payer: Hamaspik Choice Inc Medicare	$2.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.55

LINEZOLID 100 MG/5ML PO SUSR [28225]

Facility

$5.46

Service Code	NDC 00009513601
Hospital Charge Code	00009513601
Hospital Revenue Code	250
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$4.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.73
Rate for Payer: Aetna Government	$2.73
Rate for Payer: Brighton Health Commercial	$4.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.71
Rate for Payer: Group Health Inc Commercial	$2.73
Rate for Payer: Group Health Inc Medicare	$1.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.73
Rate for Payer: Hamaspik Choice Inc Medicare	$2.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.55

LINEZOLID 200 MG/100 ML IVPB PREMIX

Facility

$111.27

Service Code	HCPCS J2020
Hospital Charge Code	41642315
Hospital Revenue Code	636
Min. Negotiated Rate	$55.64
Max. Negotiated Rate	$55.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.64
Rate for Payer: Hamaspik Choice Inc Medicare	$55.64

LINEZOLID 200 MG/100 ML IVPB PREMIX

Facility

$111.27

Service Code	HCPCS J2020
Hospital Charge Code	41652315
Hospital Revenue Code	636
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$72.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.62
Rate for Payer: Aetna Government	$6.62
Rate for Payer: Brighton Health Commercial	$66.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$63.98
Rate for Payer: Group Health Inc Commercial	$55.64
Rate for Payer: Group Health Inc Medicare	$38.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.64
Rate for Payer: Hamaspik Choice Inc Medicare	$55.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3.84
Rate for Payer: SOMOS Essential	$3.84
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$72.33

LINEZOLID 200 MG/100 ML IVPB PREMIX

Facility

$111.27

Service Code	HCPCS J2020
Hospital Charge Code	41642315
Hospital Revenue Code	636
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$72.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.62
Rate for Payer: Aetna Government	$6.62
Rate for Payer: Brighton Health Commercial	$66.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$63.98
Rate for Payer: Group Health Inc Commercial	$55.64
Rate for Payer: Group Health Inc Medicare	$38.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.64
Rate for Payer: Hamaspik Choice Inc Medicare	$55.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3.84
Rate for Payer: SOMOS Essential	$3.84
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$72.33

LINEZOLID 200 MG/100 ML IVPB PREMIX

Facility

$111.27

Service Code	HCPCS J2020
Hospital Charge Code	41652315
Hospital Revenue Code	636
Min. Negotiated Rate	$55.64
Max. Negotiated Rate	$55.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.64
Rate for Payer: Hamaspik Choice Inc Medicare	$55.64

LINEZOLID 20 MG/ML LIQUID PEDIATRICS

Facility

$5.91

Hospital Charge Code	41645452
Hospital Revenue Code	250
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$4.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.96
Rate for Payer: Aetna Government	$2.96
Rate for Payer: Brighton Health Commercial	$4.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.02
Rate for Payer: Group Health Inc Commercial	$2.96
Rate for Payer: Group Health Inc Medicare	$2.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.96
Rate for Payer: Hamaspik Choice Inc Medicare	$2.96
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.84

LINEZOLID 20 MG/ML LIQUID PEDIATRICS

Facility

$5.91

Hospital Charge Code	41655452
Hospital Revenue Code	250
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$4.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.96
Rate for Payer: Aetna Government	$2.96
Rate for Payer: Brighton Health Commercial	$4.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.02
Rate for Payer: Group Health Inc Commercial	$2.96
Rate for Payer: Group Health Inc Medicare	$2.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.96
Rate for Payer: Hamaspik Choice Inc Medicare	$2.96
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.84

LINEZOLID 600 MG/300 ML IVPB PREMIX

Facility

$103.00

Service Code	HCPCS J2020
Hospital Charge Code	41642316
Hospital Revenue Code	636
Min. Negotiated Rate	$51.50
Max. Negotiated Rate	$51.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.50
Rate for Payer: Hamaspik Choice Inc Medicare	$51.50

LINEZOLID 600 MG/300 ML IVPB PREMIX

Facility

$103.00

Service Code	HCPCS J2020
Hospital Charge Code	41652316
Hospital Revenue Code	636
Min. Negotiated Rate	$51.50
Max. Negotiated Rate	$51.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.50
Rate for Payer: Hamaspik Choice Inc Medicare	$51.50

LINEZOLID 600 MG/300 ML IVPB PREMIX

Facility

$103.00

Service Code	HCPCS J2020
Hospital Charge Code	41642316
Hospital Revenue Code	636
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$66.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.62
Rate for Payer: Aetna Government	$6.62
Rate for Payer: Brighton Health Commercial	$61.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.22
Rate for Payer: Group Health Inc Commercial	$51.50
Rate for Payer: Group Health Inc Medicare	$36.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.50
Rate for Payer: Hamaspik Choice Inc Medicare	$51.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3.84
Rate for Payer: SOMOS Essential	$3.84
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.95

LINEZOLID 600 MG/300 ML IVPB PREMIX

Facility

$103.00

Service Code	HCPCS J2020
Hospital Charge Code	41652316
Hospital Revenue Code	636
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$66.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.62
Rate for Payer: Aetna Government	$6.62
Rate for Payer: Brighton Health Commercial	$61.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.22
Rate for Payer: Group Health Inc Commercial	$51.50
Rate for Payer: Group Health Inc Medicare	$36.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.50
Rate for Payer: Hamaspik Choice Inc Medicare	$51.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3.84
Rate for Payer: SOMOS Essential	$3.84
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.95

LINEZOLID 600 MG/300ML IV SOLN [131499]

Facility

$0.13

Service Code	HCPCS J2020
Hospital Charge Code	00009514001
Hospital Revenue Code	278
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07

LINEZOLID 600 MG/300ML IV SOLN [131499]

Facility

$0.37

Service Code	HCPCS J2020
Hospital Charge Code	55150024251
Hospital Revenue Code	278
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$6.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.62
Rate for Payer: Aetna Government	$6.62
Rate for Payer: Brighton Health Commercial	$0.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.21
Rate for Payer: EmblemHealth Commercial	$0.18
Rate for Payer: Fidelis Medicare Advantage	$0.39
Rate for Payer: Group Health Inc Commercial	$0.18
Rate for Payer: Group Health Inc Medicare	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.18
Rate for Payer: Hamaspik Choice Inc Medicare	$0.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.24

LINEZOLID 600 MG/300ML IV SOLN [131499]

Facility

$0.26

Service Code	HCPCS J2020
Hospital Charge Code	00781343395
Hospital Revenue Code	278
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13
Rate for Payer: Hamaspik Choice Inc Medicare	$0.13

LINEZOLID 600 MG/300ML IV SOLN [131499]

Facility

$0.26

Service Code	HCPCS J2020
Hospital Charge Code	00781343346
Hospital Revenue Code	278
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13
Rate for Payer: Hamaspik Choice Inc Medicare	$0.13

LINEZOLID 600 MG/300ML IV SOLN [131499]

Facility

$0.26

Service Code	HCPCS J2020
Hospital Charge Code	57664068357
Hospital Revenue Code	278
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$6.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.62
Rate for Payer: Aetna Government	$6.62
Rate for Payer: Brighton Health Commercial	$0.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.15
Rate for Payer: EmblemHealth Commercial	$0.13
Rate for Payer: Fidelis Medicare Advantage	$0.27
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

LINEZOLID 600 MG/300ML IV SOLN [131499]

Facility

$0.37

Service Code	HCPCS J2020
Hospital Charge Code	55150024251
Hospital Revenue Code	278
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.18
Rate for Payer: Hamaspik Choice Inc Medicare	$0.18

LINEZOLID 600 MG/300ML IV SOLN [131499]

Facility

$0.13

Service Code	HCPCS J2020
Hospital Charge Code	00009514001
Hospital Revenue Code	278
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$6.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.62
Rate for Payer: Aetna Government	$6.62
Rate for Payer: Brighton Health Commercial	$0.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.08
Rate for Payer: EmblemHealth Commercial	$0.07
Rate for Payer: Fidelis Medicare Advantage	$0.14
Rate for Payer: Group Health Inc Commercial	$0.07
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.09

LINEZOLID 600 MG/300ML IV SOLN [131499]

Facility

$0.26

Service Code	HCPCS J2020
Hospital Charge Code	00781343395
Hospital Revenue Code	278
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$6.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.62
Rate for Payer: Aetna Government	$6.62
Rate for Payer: Brighton Health Commercial	$0.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.15
Rate for Payer: EmblemHealth Commercial	$0.13
Rate for Payer: Fidelis Medicare Advantage	$0.27
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

LINEZOLID 600 MG/300ML IV SOLN [131499]

Facility

$0.13

Service Code	HCPCS J2020
Hospital Charge Code	00009514004
Hospital Revenue Code	278
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$6.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.62
Rate for Payer: Aetna Government	$6.62
Rate for Payer: Brighton Health Commercial	$0.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.08
Rate for Payer: EmblemHealth Commercial	$0.07
Rate for Payer: Fidelis Medicare Advantage	$0.14
Rate for Payer: Group Health Inc Commercial	$0.07
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.09

LINEZOLID 600 MG/300ML IV SOLN [131499]

Facility

$0.26

Service Code	HCPCS J2020
Hospital Charge Code	57664068357
Hospital Revenue Code	278
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13
Rate for Payer: Hamaspik Choice Inc Medicare	$0.13

LINEZOLID 600 MG/300ML IV SOLN [131499]

Facility

$0.13

Service Code	HCPCS J2020
Hospital Charge Code	00009514004
Hospital Revenue Code	278
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07

Know your out-of-pocket cost for care.

All Charges