St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SODIUM CHLORIDE (PF) 0.9 % IJ SOLN

Facility

$0.11

Service Code	NDC 0409488810
Hospital Charge Code	0409488810
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$0.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.08
Rate for Payer: EmblemHealth Commercial	$0.06
Rate for Payer: Group Health Inc Commercial	$0.06
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06
Rate for Payer: Hamaspik Choice Inc Medicare	$0.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.07

SODIUM CHLORIDE (PF) 0.9 % IJ SOLN

Facility

$0.11

Service Code	NDC 0409488802
Hospital Charge Code	0409488802
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06

SODIUM CHLORIDE (PF) 0.9 % IJ SOLN

Facility

$0.12

Service Code	NDC 6332318601
Hospital Charge Code	6332318601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$0.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.08
Rate for Payer: EmblemHealth Commercial	$0.06
Rate for Payer: Group Health Inc Commercial	$0.06
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06
Rate for Payer: Hamaspik Choice Inc Medicare	$0.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.08

SODIUM CHLORIDE (PF) 0.9 % IJ SOLN

Facility

$0.25

Service Code	NDC 0409488801
Hospital Charge Code	0409488801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.13
Rate for Payer: Aetna Government	$0.13
Rate for Payer: Brighton Health Commercial	$0.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.17
Rate for Payer: EmblemHealth Commercial	$0.13
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	$0.16

SODIUM CHLORIDE (PF) 0.9 % IJ SOLN

Facility

$0.11

Service Code	NDC 6332318603
Hospital Charge Code	6332318603
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$0.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.07
Rate for Payer: EmblemHealth Commercial	$0.06
Rate for Payer: Group Health Inc Commercial	$0.06
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06
Rate for Payer: Hamaspik Choice Inc Medicare	$0.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.07

SODIUM CHLORIDE (PF) 0.9 % IJ SOLN

Facility

$0.12

Service Code	NDC 6332318601
Hospital Charge Code	6332318601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06

SODIUM CHLORIDE (PF) 0.9 % IJ SOLN

Facility

$0.12

Service Code	NDC 6332318610
Hospital Charge Code	6332318610
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06

SODIUM CHLORIDE (PF) 0.9 % IJ SOLN

Facility

$0.11

Service Code	NDC 6332318603
Hospital Charge Code	6332318603
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06

SODIUM CHLORIDE (PF) 0.9 % IJ SOLN

Facility

$0.25

Service Code	NDC 0409488801
Hospital Charge Code	0409488801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13

SODIUM CHLORIDE (PF) 0.9 % IJ SOLN

Facility

$0.11

Service Code	NDC 0409488802
Hospital Charge Code	0409488802
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$0.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.08
Rate for Payer: EmblemHealth Commercial	$0.06
Rate for Payer: Group Health Inc Commercial	$0.06
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06
Rate for Payer: Hamaspik Choice Inc Medicare	$0.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.07

SODIUM CHLORIDE (PF) 0.9 % IJ SOLN

Facility

$0.11

Service Code	NDC 0409488810
Hospital Charge Code	0409488810
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06

SODIUM HYALURONATE 13.8 MG/0.6ML IO SOSY

Facility

$237.92

Service Code	NDC 5047463699
Hospital Charge Code	5047463699
Hospital Revenue Code	250
Min. Negotiated Rate	$83.27
Max. Negotiated Rate	$190.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.96
Rate for Payer: Aetna Government	$118.96
Rate for Payer: Brighton Health Commercial	$178.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$190.33
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.78
Rate for Payer: EmblemHealth Commercial	$118.96
Rate for Payer: Group Health Inc Commercial	$118.96
Rate for Payer: Group Health Inc Medicare	$83.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.96
Rate for Payer: Hamaspik Choice Inc Medicare	$118.96
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$154.65

SODIUM HYALURONATE 13.8 MG/0.6ML IO SOSY

Facility

$237.92

Service Code	NDC 8544636991
Hospital Charge Code	8544636991
Hospital Revenue Code	250
Min. Negotiated Rate	$83.27
Max. Negotiated Rate	$190.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.96
Rate for Payer: Aetna Government	$118.96
Rate for Payer: Brighton Health Commercial	$178.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$190.33
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.78
Rate for Payer: EmblemHealth Commercial	$118.96
Rate for Payer: Group Health Inc Commercial	$118.96
Rate for Payer: Group Health Inc Medicare	$83.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.96
Rate for Payer: Hamaspik Choice Inc Medicare	$118.96
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$154.65

SODIUM HYALURONATE 13.8 MG/0.6ML IO SOSY

Facility

$237.92

Service Code	NDC 8544636991
Hospital Charge Code	8544636991
Hospital Revenue Code	250
Min. Negotiated Rate	$118.96
Max. Negotiated Rate	$118.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.96

SODIUM HYALURONATE 13.8 MG/0.6ML IO SOSY

Facility

$237.92

Service Code	NDC 5047463699
Hospital Charge Code	5047463699
Hospital Revenue Code	250
Min. Negotiated Rate	$118.96
Max. Negotiated Rate	$118.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.96

SODIUM HYALURONATE 8.5 MG/0.85ML IO SOSY

Facility

$201.54

Service Code	NDC 5047463698
Hospital Charge Code	5047463698
Hospital Revenue Code	250
Min. Negotiated Rate	$70.54
Max. Negotiated Rate	$161.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$100.77
Rate for Payer: Aetna Government	$100.77
Rate for Payer: Brighton Health Commercial	$151.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$161.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$137.05
Rate for Payer: EmblemHealth Commercial	$100.77
Rate for Payer: Group Health Inc Commercial	$100.77
Rate for Payer: Group Health Inc Medicare	$70.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.77
Rate for Payer: Hamaspik Choice Inc Medicare	$100.77
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$131.00

SODIUM HYALURONATE 8.5 MG/0.85ML IO SOSY

Facility

$201.54

Service Code	NDC 5047463698
Hospital Charge Code	5047463698
Hospital Revenue Code	250
Min. Negotiated Rate	$100.77
Max. Negotiated Rate	$100.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.77

SODIUM HYALURONATE 8.5 MG/0.85ML IO SOSY

Facility

$201.54

Service Code	NDC 8544636981
Hospital Charge Code	8544636981
Hospital Revenue Code	250
Min. Negotiated Rate	$100.77
Max. Negotiated Rate	$100.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.77

SODIUM HYALURONATE 8.5 MG/0.85ML IO SOSY

Facility

$333.06

Service Code	NDC 8065183085
Hospital Charge Code	8065183085
Hospital Revenue Code	250
Min. Negotiated Rate	$116.57
Max. Negotiated Rate	$266.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$183.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$166.53
Rate for Payer: Aetna Government	$166.53
Rate for Payer: Brighton Health Commercial	$249.79
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$266.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$226.48
Rate for Payer: EmblemHealth Commercial	$166.53
Rate for Payer: Group Health Inc Commercial	$166.53
Rate for Payer: Group Health Inc Medicare	$116.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.53
Rate for Payer: Hamaspik Choice Inc Medicare	$166.53
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$216.49

SODIUM HYALURONATE 8.5 MG/0.85ML IO SOSY

Facility

$333.06

Service Code	NDC 8065183085
Hospital Charge Code	8065183085
Hospital Revenue Code	250
Min. Negotiated Rate	$166.53
Max. Negotiated Rate	$166.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.53

SODIUM HYALURONATE 8.5 MG/0.85ML IO SOSY

Facility

$201.54

Service Code	NDC 8544636981
Hospital Charge Code	8544636981
Hospital Revenue Code	250
Min. Negotiated Rate	$70.54
Max. Negotiated Rate	$161.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$100.77
Rate for Payer: Aetna Government	$100.77
Rate for Payer: Brighton Health Commercial	$151.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$161.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$137.05
Rate for Payer: EmblemHealth Commercial	$100.77
Rate for Payer: Group Health Inc Commercial	$100.77
Rate for Payer: Group Health Inc Medicare	$70.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.77
Rate for Payer: Hamaspik Choice Inc Medicare	$100.77
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$131.00

SODIUM HYPOCHLORITE 0.0125 % EX SOLN

Facility

$0.02

Service Code	NDC 0436066916
Hospital Charge Code	0436066916
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

SODIUM HYPOCHLORITE 0.0125 % EX SOLN

Facility

$0.02

Service Code	NDC 0436066916
Hospital Charge Code	0436066916
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.02
Rate for Payer: EmblemHealth Commercial	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.01
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	$0.02

SODIUM HYPOCHLORITE 0.125 % EX SOLN

Facility

$0.03

Service Code	NDC 0436067216
Hospital Charge Code	0436067216
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

SODIUM HYPOCHLORITE 0.125 % EX SOLN

Facility

$0.04

Service Code	NDC 3932806412
Hospital Charge Code	3932806412
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

Know your out-of-pocket cost for care.

All Charges