St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PULMONARY FUNCTION TESTS

Facility

$475.42

Service Code	EAPG 00060
Min. Negotiated Rate	$344.83
Max. Negotiated Rate	$475.42
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$344.83
Rate for Payer: Healthfirst Commercial	$475.42

PULMONARY INFECTION DIAGNOSES INCLUDING PNEUMONIA

Facility

$201.34

Service Code	EAPG 00581
Min. Negotiated Rate	$201.34
Max. Negotiated Rate	$201.34
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$201.34

PYRAZINAMIDE 500 MG PO TABS

Facility

$6.28

Service Code	NDC 7095448420
Hospital Charge Code	7095448420
Hospital Revenue Code	250
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$3.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.14

PYRAZINAMIDE 500 MG PO TABS

Facility

$6.16

Service Code	NDC 7095448430
Hospital Charge Code	7095448430
Hospital Revenue Code	250
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$4.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.08
Rate for Payer: Aetna Government	$3.08
Rate for Payer: Brighton Health Commercial	$4.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.19
Rate for Payer: EmblemHealth Commercial	$3.08
Rate for Payer: Group Health Inc Commercial	$3.08
Rate for Payer: Group Health Inc Medicare	$2.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.08
Rate for Payer: Hamaspik Choice Inc Medicare	$3.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.00

PYRAZINAMIDE 500 MG PO TABS

Facility

$6.28

Service Code	NDC 7095448420
Hospital Charge Code	7095448420
Hospital Revenue Code	250
Min. Negotiated Rate	$2.20
Max. Negotiated Rate	$5.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.14
Rate for Payer: Aetna Government	$3.14
Rate for Payer: Brighton Health Commercial	$4.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.27
Rate for Payer: EmblemHealth Commercial	$3.14
Rate for Payer: Group Health Inc Commercial	$3.14
Rate for Payer: Group Health Inc Medicare	$2.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.14
Rate for Payer: Hamaspik Choice Inc Medicare	$3.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.08

PYRAZINAMIDE 500 MG PO TABS

Facility

$6.16

Service Code	NDC 7095448430
Hospital Charge Code	7095448430
Hospital Revenue Code	250
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$3.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.08

PYRIDOSTIGMINE BROMIDE 10 MG/2ML IV SOLN

Facility

$19.20

Service Code	NDC 0781304095
Hospital Charge Code	0781304095
Hospital Revenue Code	258
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.60

PYRIDOSTIGMINE BROMIDE 10 MG/2ML IV SOLN

Facility

$19.20

Service Code	NDC 0781304095
Hospital Charge Code	0781304095
Hospital Revenue Code	258
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$15.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.60
Rate for Payer: Aetna Government	$9.60
Rate for Payer: Brighton Health Commercial	$14.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.06
Rate for Payer: EmblemHealth Commercial	$9.60
Rate for Payer: Group Health Inc Commercial	$9.60
Rate for Payer: Group Health Inc Medicare	$6.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.60
Rate for Payer: Hamaspik Choice Inc Medicare	$9.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.48

PYRIDOSTIGMINE BROMIDE 60 MG PO TABS

Facility

$1.61

Service Code	NDC 0904662261
Hospital Charge Code	0904662261
Hospital Revenue Code	250
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$0.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.81

PYRIDOSTIGMINE BROMIDE 60 MG PO TABS

Facility

$1.28

Service Code	NDC 6838265906
Hospital Charge Code	6838265906
Hospital Revenue Code	250
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$0.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.64

PYRIDOSTIGMINE BROMIDE 60 MG PO TABS

Facility

$1.61

Service Code	NDC 0904662261
Hospital Charge Code	0904662261
Hospital Revenue Code	250
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$1.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.81
Rate for Payer: Aetna Government	$0.81
Rate for Payer: Brighton Health Commercial	$1.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.10
Rate for Payer: EmblemHealth Commercial	$0.81
Rate for Payer: Group Health Inc Commercial	$0.81
Rate for Payer: Group Health Inc Medicare	$0.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.81
Rate for Payer: Hamaspik Choice Inc Medicare	$0.81
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.05

PYRIDOSTIGMINE BROMIDE 60 MG PO TABS

Facility

$1.28

Service Code	NDC 6838265906
Hospital Charge Code	6838265906
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$1.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.64
Rate for Payer: Aetna Government	$0.64
Rate for Payer: Brighton Health Commercial	$0.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.87
Rate for Payer: EmblemHealth Commercial	$0.64
Rate for Payer: Group Health Inc Commercial	$0.64
Rate for Payer: Group Health Inc Medicare	$0.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.64
Rate for Payer: Hamaspik Choice Inc Medicare	$0.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.83

PYRIDOXINE HCL 100 MG/ML IJ SOLN

Facility

$22.87

Service Code	HCPCS J3415
Hospital Charge Code	6332318000
Hospital Revenue Code	250
Min. Negotiated Rate	$11.44
Max. Negotiated Rate	$11.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.44

PYRIDOXINE HCL 100 MG/ML IJ SOLN

Facility

$22.87

Service Code	HCPCS J3415
Hospital Charge Code	6332318001
Hospital Revenue Code	250
Min. Negotiated Rate	$6.05
Max. Negotiated Rate	$18.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.23
Rate for Payer: Aetna Government	$11.23
Rate for Payer: Brighton Health Commercial	$17.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.55
Rate for Payer: EmblemHealth Commercial	$11.44
Rate for Payer: Group Health Inc Commercial	$11.44
Rate for Payer: Group Health Inc Medicare	$8.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.44
Rate for Payer: Hamaspik Choice Inc Medicare	$11.44
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$6.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14.87

PYRIDOXINE HCL 100 MG/ML IJ SOLN

Facility

$22.87

Service Code	HCPCS J3415
Hospital Charge Code	6332318001
Hospital Revenue Code	250
Min. Negotiated Rate	$11.44
Max. Negotiated Rate	$11.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.44

PYRIDOXINE HCL 100 MG/ML IJ SOLN

Facility

$22.87

Service Code	HCPCS J3415
Hospital Charge Code	6332318000
Hospital Revenue Code	250
Min. Negotiated Rate	$6.05
Max. Negotiated Rate	$18.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.23
Rate for Payer: Aetna Government	$11.23
Rate for Payer: Brighton Health Commercial	$17.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.55
Rate for Payer: EmblemHealth Commercial	$11.44
Rate for Payer: Group Health Inc Commercial	$11.44
Rate for Payer: Group Health Inc Medicare	$8.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.44
Rate for Payer: Hamaspik Choice Inc Medicare	$11.44
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$6.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14.87

PYRIMETHAMINE 25 MG PO TABS

Facility

$796.88

Service Code	NDC 4778192530
Hospital Charge Code	4778192530
Hospital Revenue Code	250
Min. Negotiated Rate	$398.44
Max. Negotiated Rate	$398.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$398.44

PYRIMETHAMINE 25 MG PO TABS

Facility

$796.88

Service Code	NDC 4778192530
Hospital Charge Code	4778192530
Hospital Revenue Code	250
Min. Negotiated Rate	$278.91
Max. Negotiated Rate	$637.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$438.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.44
Rate for Payer: Aetna Government	$398.44
Rate for Payer: Brighton Health Commercial	$597.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$637.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$541.88
Rate for Payer: EmblemHealth Commercial	$398.44
Rate for Payer: Group Health Inc Commercial	$398.44
Rate for Payer: Group Health Inc Medicare	$278.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$398.44
Rate for Payer: Hamaspik Choice Inc Medicare	$398.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$517.97

PYRIMETHAMINE 25 MG PO TABS

Facility

$796.88

Service Code	NDC 4359867230
Hospital Charge Code	4359867230
Hospital Revenue Code	250
Min. Negotiated Rate	$398.44
Max. Negotiated Rate	$398.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$398.44

PYRIMETHAMINE 25 MG PO TABS

Facility

$796.88

Service Code	NDC 4359867230
Hospital Charge Code	4359867230
Hospital Revenue Code	250
Min. Negotiated Rate	$278.91
Max. Negotiated Rate	$637.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$438.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.44
Rate for Payer: Aetna Government	$398.44
Rate for Payer: Brighton Health Commercial	$597.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$637.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$541.88
Rate for Payer: EmblemHealth Commercial	$398.44
Rate for Payer: Group Health Inc Commercial	$398.44
Rate for Payer: Group Health Inc Medicare	$278.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$398.44
Rate for Payer: Hamaspik Choice Inc Medicare	$398.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$517.97

PYRIMETHAMINE 25 MG PO TABS

Facility

$855.00

Service Code	NDC 0480372001
Hospital Charge Code	0480372001
Hospital Revenue Code	250
Min. Negotiated Rate	$427.50
Max. Negotiated Rate	$427.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$427.50

PYRIMETHAMINE 25 MG PO TABS

Facility

$855.00

Service Code	NDC 0480372001
Hospital Charge Code	0480372001
Hospital Revenue Code	250
Min. Negotiated Rate	$299.25
Max. Negotiated Rate	$684.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$470.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$427.50
Rate for Payer: Aetna Government	$427.50
Rate for Payer: Brighton Health Commercial	$641.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$684.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$581.40
Rate for Payer: EmblemHealth Commercial	$427.50
Rate for Payer: Group Health Inc Commercial	$427.50
Rate for Payer: Group Health Inc Medicare	$299.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$427.50
Rate for Payer: Hamaspik Choice Inc Medicare	$427.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$555.75

PYRIMETHAMINE POWD

Facility

$17.43

Service Code	NDC 3877908843
Hospital Charge Code	3877908843
Hospital Revenue Code	250
Min. Negotiated Rate	$6.10
Max. Negotiated Rate	$13.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.72
Rate for Payer: Aetna Government	$8.72
Rate for Payer: Brighton Health Commercial	$13.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.86
Rate for Payer: EmblemHealth Commercial	$8.72
Rate for Payer: Group Health Inc Commercial	$8.72
Rate for Payer: Group Health Inc Medicare	$6.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.72
Rate for Payer: Hamaspik Choice Inc Medicare	$8.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.33

PYRIMETHAMINE POWD

Facility

$17.43

Service Code	NDC 3877908843
Hospital Charge Code	3877908843
Hospital Revenue Code	250
Min. Negotiated Rate	$8.72
Max. Negotiated Rate	$8.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.72

QUANTITATION OF THERAPEUTIC DRUG, NOT ELSEWHERE SPECIFIED

Facility

$46.00

Service Code	CPT 80299
Hospital Charge Code	3018029919
Hospital Revenue Code	301
Min. Negotiated Rate	$13.05
Max. Negotiated Rate	$34.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.64
Rate for Payer: Aetna Government	$18.64
Rate for Payer: Affinity Essential Plan 1&2	$13.05
Rate for Payer: Affinity Essential Plan 3&4	$13.05
Rate for Payer: Affinity Medicaid/CHP/HARP	$13.05
Rate for Payer: Brighton Health Commercial	$34.50
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$18.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$23.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.60
Rate for Payer: Elderplan Medicare Advantage	$18.64
Rate for Payer: EmblemHealth Commercial	$18.64
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16.78
Rate for Payer: Fidelis Essential Plan Aliesa	$15.84
Rate for Payer: Fidelis Essential Plan QHP	$16.59
Rate for Payer: Fidelis Medicare Advantage	$18.64
Rate for Payer: Fidelis Qualified Health Plan	$16.59
Rate for Payer: Group Health Inc Commercial	$18.64
Rate for Payer: Group Health Inc Medicare	$18.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.64
Rate for Payer: Hamaspik Choice Inc Medicare	$18.64
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18.64
Rate for Payer: Healthfirst Medicare Advantage	$18.64
Rate for Payer: Healthfirst QHP	$18.64
Rate for Payer: Humana Medicare	$19.01
Rate for Payer: Senior Whole Health Medicare Advantage	$18.64
Rate for Payer: United Healthcare Commercial	$17.34
Rate for Payer: United Healthcare Medicare Advantage	$18.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$18.64
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17.71
Rate for Payer: Wellcare Medicare	$16.78

Know your out-of-pocket cost for care.

All Charges