St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

MEPERIDINE 100 MG/ML INJ

Facility

$3.00

Service Code	HCPCS J2175
Hospital Charge Code	41644244
Hospital Revenue Code	636
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$7.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.48
Rate for Payer: Aetna Government	$6.48
Rate for Payer: Brighton Health Commercial	$1.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.72
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7.31
Rate for Payer: SOMOS Essential	$7.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

MEPERIDINE 100MGML INJ

Facility

$1.75

Service Code	HCPCS J2175
Hospital Charge Code	41658139
Hospital Revenue Code	636
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$0.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.88
Rate for Payer: Hamaspik Choice Inc Medicare	$0.88

MEPERIDINE 100MGML INJ

Facility

$1.75

Service Code	HCPCS J2175
Hospital Charge Code	41658139
Hospital Revenue Code	636
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$7.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.48
Rate for Payer: Aetna Government	$6.48
Rate for Payer: Brighton Health Commercial	$1.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.01
Rate for Payer: Group Health Inc Commercial	$0.88
Rate for Payer: Group Health Inc Medicare	$0.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.88
Rate for Payer: Hamaspik Choice Inc Medicare	$0.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7.31
Rate for Payer: SOMOS Essential	$7.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.14

MEPERIDINE 100MGML INJ

Facility

$1.75

Service Code	HCPCS J2175
Hospital Charge Code	41648139
Hospital Revenue Code	636
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$7.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.48
Rate for Payer: Aetna Government	$6.48
Rate for Payer: Brighton Health Commercial	$1.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.01
Rate for Payer: Group Health Inc Commercial	$0.88
Rate for Payer: Group Health Inc Medicare	$0.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.88
Rate for Payer: Hamaspik Choice Inc Medicare	$0.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7.31
Rate for Payer: SOMOS Essential	$7.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.14

MEPERIDINE 100MGML INJ

Facility

$1.75

Service Code	HCPCS J2175
Hospital Charge Code	41648139
Hospital Revenue Code	636
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$0.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.88
Rate for Payer: Hamaspik Choice Inc Medicare	$0.88

MEPERIDINE 25 MG/ML INJ

Facility

$3.00

Service Code	HCPCS J2175
Hospital Charge Code	41644242
Hospital Revenue Code	636
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$7.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.48
Rate for Payer: Aetna Government	$6.48
Rate for Payer: Brighton Health Commercial	$1.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.72
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7.31
Rate for Payer: SOMOS Essential	$7.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

MEPERIDINE 25 MG/ML INJ

Facility

$3.00

Service Code	HCPCS J2175
Hospital Charge Code	41654242
Hospital Revenue Code	636
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$7.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.48
Rate for Payer: Aetna Government	$6.48
Rate for Payer: Brighton Health Commercial	$1.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.72
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7.31
Rate for Payer: SOMOS Essential	$7.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

MEPERIDINE 25 MG/ML INJ

Facility

$3.00

Service Code	HCPCS J2175
Hospital Charge Code	41654242
Hospital Revenue Code	636
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

MEPERIDINE 25 MG/ML INJ

Facility

$3.00

Service Code	HCPCS J2175
Hospital Charge Code	41644242
Hospital Revenue Code	636
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

MEPERIDINE 25MGML INJ

Facility

$0.29

Service Code	HCPCS J2175
Hospital Charge Code	41648133
Hospital Revenue Code	636
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$7.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.48
Rate for Payer: Aetna Government	$6.48
Rate for Payer: Brighton Health Commercial	$0.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.17
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: SOMOS CHP/HARP/Medicaid	$7.31
Rate for Payer: SOMOS Essential	$7.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.19

MEPERIDINE 25MGML INJ

Facility

$0.29

Service Code	HCPCS J2175
Hospital Charge Code	41658133
Hospital Revenue Code	636
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15
Rate for Payer: Hamaspik Choice Inc Medicare	$0.15

MEPERIDINE 25MGML INJ

Facility

$0.29

Service Code	HCPCS J2175
Hospital Charge Code	41648133
Hospital Revenue Code	636
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15
Rate for Payer: Hamaspik Choice Inc Medicare	$0.15

MEPERIDINE 25MGML INJ

Facility

$0.29

Service Code	HCPCS J2175
Hospital Charge Code	41658133
Hospital Revenue Code	636
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$7.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.48
Rate for Payer: Aetna Government	$6.48
Rate for Payer: Brighton Health Commercial	$0.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.17
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: SOMOS CHP/HARP/Medicaid	$7.31
Rate for Payer: SOMOS Essential	$7.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.19

MEPERIDINE 25MG/ML VIAL - 100MG

Facility

$8.00

Service Code	HCPCS J2175
Hospital Charge Code	41659575
Hospital Revenue Code	636
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$4.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4.00

MEPERIDINE 25MG/ML VIAL - 100MG

Facility

$8.00

Service Code	HCPCS J2175
Hospital Charge Code	41659575
Hospital Revenue Code	636
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$7.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.48
Rate for Payer: Aetna Government	$6.48
Rate for Payer: Brighton Health Commercial	$4.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.60
Rate for Payer: Group Health Inc Commercial	$4.00
Rate for Payer: Group Health Inc Medicare	$2.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7.31
Rate for Payer: SOMOS Essential	$7.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.20

MEPERIDINE 25MG/ML VIAL-100MG

Facility

$8.00

Service Code	HCPCS J2175
Hospital Charge Code	41649575
Hospital Revenue Code	636
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$7.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.48
Rate for Payer: Aetna Government	$6.48
Rate for Payer: Brighton Health Commercial	$4.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.60
Rate for Payer: Group Health Inc Commercial	$4.00
Rate for Payer: Group Health Inc Medicare	$2.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7.31
Rate for Payer: SOMOS Essential	$7.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.20

MEPERIDINE 25MG/ML VIAL-100MG

Facility

$8.00

Service Code	HCPCS J2175
Hospital Charge Code	41649575
Hospital Revenue Code	636
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$4.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4.00

MEPERIDINE 50MGML INJ

Facility

$0.34

Service Code	HCPCS J2175
Hospital Charge Code	41658135
Hospital Revenue Code	636
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.17
Rate for Payer: Hamaspik Choice Inc Medicare	$0.17

MEPERIDINE 50MGML INJ

Facility

$0.34

Service Code	HCPCS J2175
Hospital Charge Code	41648135
Hospital Revenue Code	636
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.17
Rate for Payer: Hamaspik Choice Inc Medicare	$0.17

MEPERIDINE 50MGML INJ

Facility

$0.34

Service Code	HCPCS J2175
Hospital Charge Code	41648135
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$7.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.48
Rate for Payer: Aetna Government	$6.48
Rate for Payer: Brighton Health Commercial	$0.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.20
Rate for Payer: Group Health Inc Commercial	$0.17
Rate for Payer: Group Health Inc Medicare	$0.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.17
Rate for Payer: Hamaspik Choice Inc Medicare	$0.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7.31
Rate for Payer: SOMOS Essential	$7.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.22

MEPERIDINE 50MGML INJ

Facility

$0.34

Service Code	HCPCS J2175
Hospital Charge Code	41658135
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$7.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.48
Rate for Payer: Aetna Government	$6.48
Rate for Payer: Brighton Health Commercial	$0.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.20
Rate for Payer: Group Health Inc Commercial	$0.17
Rate for Payer: Group Health Inc Medicare	$0.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.17
Rate for Payer: Hamaspik Choice Inc Medicare	$0.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7.31
Rate for Payer: SOMOS Essential	$7.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.22

MEPERIDINE 50 MG/ML INJ SYRINGE

Facility

$3.00

Service Code	HCPCS J2175
Hospital Charge Code	41654243
Hospital Revenue Code	636
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

MEPERIDINE 50 MG/ML INJ SYRINGE

Facility

$3.00

Service Code	HCPCS J2175
Hospital Charge Code	41644243
Hospital Revenue Code	636
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$7.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.48
Rate for Payer: Aetna Government	$6.48
Rate for Payer: Brighton Health Commercial	$1.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.72
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7.31
Rate for Payer: SOMOS Essential	$7.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

MEPERIDINE 50 MG/ML INJ SYRINGE

Facility

$3.00

Service Code	HCPCS J2175
Hospital Charge Code	41644243
Hospital Revenue Code	636
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

MEPERIDINE 50 MG/ML INJ SYRINGE

Facility

$3.00

Service Code	HCPCS J2175
Hospital Charge Code	41654243
Hospital Revenue Code	636
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$7.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.48
Rate for Payer: Aetna Government	$6.48
Rate for Payer: Brighton Health Commercial	$1.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.72
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7.31
Rate for Payer: SOMOS Essential	$7.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

Know your out-of-pocket cost for care.

All Charges