St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PROPRANOLOL HCL 1 MG/ML IV SOLN

Facility

$9.60

Service Code	HCPCS J1800
Hospital Charge Code	0143987210
Hospital Revenue Code	258
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.80

PROPRANOLOL HCL 1 MG/ML IV SOLN

Facility

$9.60

Service Code	HCPCS J1800
Hospital Charge Code	9999123473
Hospital Revenue Code	258
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	$6.62
Rate for Payer: Aetna Government	$6.62
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

PROPRANOLOL HCL 1 MG/ML IV SOLN

Facility

$12.08

Service Code	HCPCS J1800
Hospital Charge Code	6332360401
Hospital Revenue Code	258
Min. Negotiated Rate	$4.23
Max. Negotiated Rate	$9.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.62
Rate for Payer: Aetna Government	$6.62
Rate for Payer: Brighton Health Commercial	$9.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.22
Rate for Payer: EmblemHealth Commercial	$6.04
Rate for Payer: Group Health Inc Commercial	$6.04
Rate for Payer: Group Health Inc Medicare	$4.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.04
Rate for Payer: Hamaspik Choice Inc Medicare	$6.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.85

PROPRANOLOL HCL 1 MG/ML IV SOLN

Facility

$12.08

Service Code	HCPCS J1800
Hospital Charge Code	6332360401
Hospital Revenue Code	258
Min. Negotiated Rate	$6.04
Max. Negotiated Rate	$6.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.04

PROPRANOLOL HCL 20 MG/5ML PO SOLN

Facility

$0.13

Service Code	NDC 9999123472
Hospital Charge Code	9999123472
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.07
Rate for Payer: Aetna Government	$0.07
Rate for Payer: Brighton Health Commercial	$0.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.09
Rate for Payer: EmblemHealth Commercial	$0.07
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

PROPRANOLOL HCL 20 MG/5ML PO SOLN

Facility

$0.13

Service Code	NDC 9999123472
Hospital Charge Code	9999123472
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07

PROPRANOLOL HCL 20 MG/5ML PO SOLN

Facility

$0.84

Service Code	NDC 0121090805
Hospital Charge Code	0121090805
Hospital Revenue Code	250
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$0.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42

PROPRANOLOL HCL 20 MG/5ML PO SOLN

Facility

$0.84

Service Code	NDC 0121090805
Hospital Charge Code	0121090805
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.42
Rate for Payer: Aetna Government	$0.42
Rate for Payer: Brighton Health Commercial	$0.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.57
Rate for Payer: EmblemHealth Commercial	$0.42
Rate for Payer: Group Health Inc Commercial	$0.42
Rate for Payer: Group Health Inc Medicare	$0.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42
Rate for Payer: Hamaspik Choice Inc Medicare	$0.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.55

PROPRANOLOL HCL 20 MG PO TABS

Facility

$1.34

Service Code	NDC 0904670561
Hospital Charge Code	0904670561
Hospital Revenue Code	250
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$0.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.67

PROPRANOLOL HCL 20 MG PO TABS

Facility

$1.34

Service Code	NDC 0904670561
Hospital Charge Code	0904670561
Hospital Revenue Code	250
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$1.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.67
Rate for Payer: Aetna Government	$0.67
Rate for Payer: Brighton Health Commercial	$1.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.91
Rate for Payer: EmblemHealth Commercial	$0.67
Rate for Payer: Group Health Inc Commercial	$0.67
Rate for Payer: Group Health Inc Medicare	$0.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.67
Rate for Payer: Hamaspik Choice Inc Medicare	$0.67
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.87

PROPRANOLOL HCL 20 MG PO TABS

Facility

$0.51

Service Code	NDC 0603548321
Hospital Charge Code	0603548321
Hospital Revenue Code	250
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.26
Rate for Payer: Aetna Government	$0.26
Rate for Payer: Brighton Health Commercial	$0.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.35
Rate for Payer: EmblemHealth Commercial	$0.26
Rate for Payer: Group Health Inc Commercial	$0.26
Rate for Payer: Group Health Inc Medicare	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.26
Rate for Payer: Hamaspik Choice Inc Medicare	$0.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.33

PROPRANOLOL HCL 20 MG PO TABS

Facility

$0.51

Service Code	NDC 0603548321
Hospital Charge Code	0603548321
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.26

PROPRANOLOL HCL 20 MG PO TABS

Facility

$0.55

Service Code	NDC 6068759801
Hospital Charge Code	6068759801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$0.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.28

PROPRANOLOL HCL 20 MG PO TABS

Facility

$0.55

Service Code	NDC 6068759801
Hospital Charge Code	6068759801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.28
Rate for Payer: Aetna Government	$0.28
Rate for Payer: Brighton Health Commercial	$0.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.38
Rate for Payer: EmblemHealth Commercial	$0.28
Rate for Payer: Group Health Inc Commercial	$0.28
Rate for Payer: Group Health Inc Medicare	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.28
Rate for Payer: Hamaspik Choice Inc Medicare	$0.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.36

PROPRANOLOL HCL 20 MG PO TABS

Facility

$0.55

Service Code	NDC 6068759811
Hospital Charge Code	6068759811
Hospital Revenue Code	250
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$0.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.28

PROPRANOLOL HCL 20 MG PO TABS

Facility

$0.55

Service Code	NDC 6068759811
Hospital Charge Code	6068759811
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.28
Rate for Payer: Aetna Government	$0.28
Rate for Payer: Brighton Health Commercial	$0.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.38
Rate for Payer: EmblemHealth Commercial	$0.28
Rate for Payer: Group Health Inc Commercial	$0.28
Rate for Payer: Group Health Inc Medicare	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.28
Rate for Payer: Hamaspik Choice Inc Medicare	$0.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.36

PROPRANOLOL HCL 40 MG PO TABS

Facility

$0.67

Service Code	NDC 6068760911
Hospital Charge Code	6068760911
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.34
Rate for Payer: Aetna Government	$0.34
Rate for Payer: Brighton Health Commercial	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.46
Rate for Payer: EmblemHealth Commercial	$0.34
Rate for Payer: Group Health Inc Commercial	$0.34
Rate for Payer: Group Health Inc Medicare	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34
Rate for Payer: Hamaspik Choice Inc Medicare	$0.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.44

PROPRANOLOL HCL 40 MG PO TABS

Facility

$0.67

Service Code	NDC 6068760901
Hospital Charge Code	6068760901
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.34
Rate for Payer: Aetna Government	$0.34
Rate for Payer: Brighton Health Commercial	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.46
Rate for Payer: EmblemHealth Commercial	$0.34
Rate for Payer: Group Health Inc Commercial	$0.34
Rate for Payer: Group Health Inc Medicare	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34
Rate for Payer: Hamaspik Choice Inc Medicare	$0.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.44

PROPRANOLOL HCL 40 MG PO TABS

Facility

$0.67

Service Code	NDC 6068760911
Hospital Charge Code	6068760911
Hospital Revenue Code	250
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34

PROPRANOLOL HCL 40 MG PO TABS

Facility

$0.72

Service Code	NDC 0603548421
Hospital Charge Code	0603548421
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.39
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	$0.57
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

PROPRANOLOL HCL 40 MG PO TABS

Facility

$0.72

Service Code	NDC 0603548421
Hospital Charge Code	0603548421
Hospital Revenue Code	250
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.36

PROPRANOLOL HCL 40 MG PO TABS

Facility

$0.67

Service Code	NDC 6068760901
Hospital Charge Code	6068760901
Hospital Revenue Code	250
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34

PROPRANOLOL HCL 80 MG PO TABS

Facility

$0.97

Service Code	NDC 0603548621
Hospital Charge Code	0603548621
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.48

PROPRANOLOL HCL 80 MG PO TABS

Facility

$0.97

Service Code	NDC 0603548621
Hospital Charge Code	0603548621
Hospital Revenue Code	250
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Brighton Health Commercial	$0.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.66
Rate for Payer: EmblemHealth Commercial	$0.48
Rate for Payer: Group Health Inc Commercial	$0.48
Rate for Payer: Group Health Inc Medicare	$0.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.48
Rate for Payer: Hamaspik Choice Inc Medicare	$0.48
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.63

PR OPRATIVE ABLTJ VENTR ARRHYTHMOGENIC FOC W/BYPASS

Professional

Both

$7,094.05

Service Code	HCPCS 33261
Min. Negotiated Rate	$1,310.59
Max. Negotiated Rate	$4,212.61
Rate for Payer: Cash Price	$1,885.85
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,872.27
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,685.04
Rate for Payer: Fidelis Essential Plan Aliesa	$1,685.04
Rate for Payer: Fidelis Essential Plan QHP	$1,778.66
Rate for Payer: Fidelis Medicare Advantage	$1,872.27
Rate for Payer: Fidelis Qualified Health Plan	$1,778.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,872.27
Rate for Payer: Hamaspik Choice Inc Medicare	$1,872.27
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,404.20
Rate for Payer: Healthfirst Commercial	$1,872.27
Rate for Payer: Healthfirst Essential Plan	$4,212.61
Rate for Payer: Healthfirst Medicare Advantage	$1,778.66
Rate for Payer: Healthfirst QHP	$1,872.27
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$1,310.59
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$1,872.27
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$1,591.43
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$1,310.59
Rate for Payer: Senior Whole Health Medicare Advantage	$1,872.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,404.20
Rate for Payer: SOMOS Essential	$1,404.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,872.27

Know your out-of-pocket cost for care.

All Charges