St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

Spinal disorders & injuries

Facility

$72,406.28

Service Code	APR-DRG 0403
Min. Negotiated Rate	$19,725.00
Max. Negotiated Rate	$72,406.28
Rate for Payer: Affinity Essential Plan 1&2	$72,406.28
Rate for Payer: Affinity Essential Plan 3&4	$72,406.28
Rate for Payer: Affinity Medicaid/CHP/HARP	$32,180.57
Rate for Payer: Amida Care Medicaid	$32,180.57
Rate for Payer: EmblemHealth Essential Plan 1&2	$72,406.28
Rate for Payer: EmblemHealth Essential Plan 3&4	$32,180.57
Rate for Payer: Fidelis CHP/HARP/Medicaid	$32,180.57
Rate for Payer: Fidelis Qualified Health Plan	$38,616.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$32,180.57
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$32,180.57
Rate for Payer: Healthfirst Commercial	$27,732.00
Rate for Payer: Healthfirst Essential Plan	$72,406.28
Rate for Payer: Healthfirst QHP	$19,725.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$32,180.57
Rate for Payer: SOMOS Essential	$72,406.28
Rate for Payer: United Healthcare Essential Plan 1&2	$72,406.28
Rate for Payer: United Healthcare Essential Plan 3&4	$72,406.28
Rate for Payer: United Healthcare Medicaid	$32,180.57
Rate for Payer: Wellcare CHP/FHP/Medicaid	$32,180.57

Spinal disorders & injuries

Facility

$79,784.21

Service Code	APR-DRG 0404
Min. Negotiated Rate	$22,615.00
Max. Negotiated Rate	$79,784.21
Rate for Payer: Affinity Essential Plan 1&2	$79,784.21
Rate for Payer: Affinity Essential Plan 3&4	$79,784.21
Rate for Payer: Affinity Medicaid/CHP/HARP	$35,459.65
Rate for Payer: Amida Care Medicaid	$35,459.65
Rate for Payer: EmblemHealth Essential Plan 1&2	$79,784.21
Rate for Payer: EmblemHealth Essential Plan 3&4	$35,459.65
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35,459.65
Rate for Payer: Fidelis Qualified Health Plan	$42,551.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$35,459.65
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35,459.65
Rate for Payer: Healthfirst Commercial	$32,919.00
Rate for Payer: Healthfirst Essential Plan	$79,784.21
Rate for Payer: Healthfirst QHP	$22,615.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35,459.65
Rate for Payer: SOMOS Essential	$79,784.21
Rate for Payer: United Healthcare Essential Plan 1&2	$79,784.21
Rate for Payer: United Healthcare Essential Plan 3&4	$79,784.21
Rate for Payer: United Healthcare Medicaid	$35,459.65
Rate for Payer: Wellcare CHP/FHP/Medicaid	$35,459.65

SPINAL IMPLANTATION OF DRUG INFUSION DEVICE

Facility

$17,917.31

Service Code	EAPG 03030
Min. Negotiated Rate	$17,917.31
Max. Negotiated Rate	$17,917.31
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,917.31

Spinal procedures

Facility

$60,877.69

Service Code	APR-DRG 0231
Min. Negotiated Rate	$18,910.00
Max. Negotiated Rate	$60,877.69
Rate for Payer: Affinity Essential Plan 1&2	$60,877.69
Rate for Payer: Affinity Essential Plan 3&4	$60,877.69
Rate for Payer: Affinity Medicaid/CHP/HARP	$27,056.75
Rate for Payer: Amida Care Medicaid	$27,056.75
Rate for Payer: EmblemHealth Essential Plan 1&2	$60,877.69
Rate for Payer: EmblemHealth Essential Plan 3&4	$27,056.75
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27,056.75
Rate for Payer: Fidelis Qualified Health Plan	$32,468.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$27,056.75
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27,056.75
Rate for Payer: Healthfirst Commercial	$30,819.00
Rate for Payer: Healthfirst Essential Plan	$60,877.69
Rate for Payer: Healthfirst QHP	$18,910.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27,056.75
Rate for Payer: SOMOS Essential	$60,877.69
Rate for Payer: United Healthcare Essential Plan 1&2	$60,877.69
Rate for Payer: United Healthcare Essential Plan 3&4	$60,877.69
Rate for Payer: United Healthcare Medicaid	$27,056.75
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27,056.75

Spinal procedures

Facility

$70,814.61

Service Code	APR-DRG 0232
Min. Negotiated Rate	$24,542.00
Max. Negotiated Rate	$70,814.61
Rate for Payer: Affinity Essential Plan 1&2	$70,814.61
Rate for Payer: Affinity Essential Plan 3&4	$70,814.61
Rate for Payer: Affinity Medicaid/CHP/HARP	$31,473.16
Rate for Payer: Amida Care Medicaid	$31,473.16
Rate for Payer: EmblemHealth Essential Plan 1&2	$70,814.61
Rate for Payer: EmblemHealth Essential Plan 3&4	$31,473.16
Rate for Payer: Fidelis CHP/HARP/Medicaid	$31,473.16
Rate for Payer: Fidelis Qualified Health Plan	$37,767.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$31,473.16
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$31,473.16
Rate for Payer: Healthfirst Commercial	$39,239.00
Rate for Payer: Healthfirst Essential Plan	$70,814.61
Rate for Payer: Healthfirst QHP	$24,542.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$31,473.16
Rate for Payer: SOMOS Essential	$70,814.61
Rate for Payer: United Healthcare Essential Plan 1&2	$70,814.61
Rate for Payer: United Healthcare Essential Plan 3&4	$70,814.61
Rate for Payer: United Healthcare Medicaid	$31,473.16
Rate for Payer: Wellcare CHP/FHP/Medicaid	$31,473.16

Spinal procedures

Facility

$107,579.45

Service Code	APR-DRG 0233
Min. Negotiated Rate	$38,406.00
Max. Negotiated Rate	$107,579.45
Rate for Payer: Affinity Essential Plan 1&2	$107,579.45
Rate for Payer: Affinity Essential Plan 3&4	$107,579.45
Rate for Payer: Affinity Medicaid/CHP/HARP	$47,813.09
Rate for Payer: Amida Care Medicaid	$47,813.09
Rate for Payer: EmblemHealth Essential Plan 1&2	$107,579.45
Rate for Payer: EmblemHealth Essential Plan 3&4	$47,813.09
Rate for Payer: Fidelis CHP/HARP/Medicaid	$47,813.09
Rate for Payer: Fidelis Qualified Health Plan	$57,375.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$47,813.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$47,813.09
Rate for Payer: Healthfirst Commercial	$73,823.00
Rate for Payer: Healthfirst Essential Plan	$107,579.45
Rate for Payer: Healthfirst QHP	$38,406.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$47,813.09
Rate for Payer: SOMOS Essential	$107,579.45
Rate for Payer: United Healthcare Essential Plan 1&2	$107,579.45
Rate for Payer: United Healthcare Essential Plan 3&4	$107,579.45
Rate for Payer: United Healthcare Medicaid	$47,813.09
Rate for Payer: Wellcare CHP/FHP/Medicaid	$47,813.09

Spinal procedures

Facility

$174,160.30

Service Code	APR-DRG 0234
Min. Negotiated Rate	$77,404.58
Max. Negotiated Rate	$174,160.30
Rate for Payer: Affinity Essential Plan 1&2	$174,160.30
Rate for Payer: Affinity Essential Plan 3&4	$174,160.30
Rate for Payer: Affinity Medicaid/CHP/HARP	$77,404.58
Rate for Payer: Amida Care Medicaid	$77,404.58
Rate for Payer: EmblemHealth Essential Plan 1&2	$174,160.30
Rate for Payer: EmblemHealth Essential Plan 3&4	$77,404.58
Rate for Payer: Fidelis CHP/HARP/Medicaid	$77,404.58
Rate for Payer: Fidelis Qualified Health Plan	$92,885.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$77,404.58
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$77,404.58
Rate for Payer: Healthfirst Commercial	$149,434.00
Rate for Payer: Healthfirst Essential Plan	$174,160.30
Rate for Payer: Healthfirst QHP	$87,435.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$77,404.58
Rate for Payer: SOMOS Essential	$174,160.30
Rate for Payer: United Healthcare Essential Plan 1&2	$174,160.30
Rate for Payer: United Healthcare Essential Plan 3&4	$174,160.30
Rate for Payer: United Healthcare Medicaid	$77,404.58
Rate for Payer: Wellcare CHP/FHP/Medicaid	$77,404.58

SPINE INJECTIONS AND OTHER RELATED PROCEDURES

Facility

$698.92

Service Code	EAPG 00053
Min. Negotiated Rate	$698.92
Max. Negotiated Rate	$698.92
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$698.92

SPIRONOLACTONE 100 MG PO TABS

Facility

$0.88

Service Code	NDC 6068748701
Hospital Charge Code	6068748701
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.44
Rate for Payer: Aetna Government	$0.44
Rate for Payer: Brighton Health Commercial	$0.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.60
Rate for Payer: EmblemHealth Commercial	$0.44
Rate for Payer: Group Health Inc Commercial	$0.44
Rate for Payer: Group Health Inc Medicare	$0.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.44
Rate for Payer: Hamaspik Choice Inc Medicare	$0.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.57

SPIRONOLACTONE 100 MG PO TABS

Facility

$0.88

Service Code	NDC 6068748711
Hospital Charge Code	6068748711
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.44
Rate for Payer: Aetna Government	$0.44
Rate for Payer: Brighton Health Commercial	$0.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.60
Rate for Payer: EmblemHealth Commercial	$0.44
Rate for Payer: Group Health Inc Commercial	$0.44
Rate for Payer: Group Health Inc Medicare	$0.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.44
Rate for Payer: Hamaspik Choice Inc Medicare	$0.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.57

SPIRONOLACTONE 100 MG PO TABS

Facility

$0.88

Service Code	NDC 6068748701
Hospital Charge Code	6068748701
Hospital Revenue Code	250
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$0.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.44

SPIRONOLACTONE 100 MG PO TABS

Facility

$1.42

Service Code	NDC 5348932901
Hospital Charge Code	5348932901
Hospital Revenue Code	250
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$1.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.71
Rate for Payer: Aetna Government	$0.71
Rate for Payer: Brighton Health Commercial	$1.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.96
Rate for Payer: EmblemHealth Commercial	$0.71
Rate for Payer: Group Health Inc Commercial	$0.71
Rate for Payer: Group Health Inc Medicare	$0.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.71
Rate for Payer: Hamaspik Choice Inc Medicare	$0.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.92

SPIRONOLACTONE 100 MG PO TABS

Facility

$1.42

Service Code	NDC 5348932901
Hospital Charge Code	5348932901
Hospital Revenue Code	250
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$0.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.71

SPIRONOLACTONE 100 MG PO TABS

Facility

$0.88

Service Code	NDC 6068748711
Hospital Charge Code	6068748711
Hospital Revenue Code	250
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$0.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.44

SPIRONOLACTONE 25 MG PO TABS

Facility

$0.45

Service Code	NDC 1672922516
Hospital Charge Code	1672922516
Hospital Revenue Code	250
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.22
Rate for Payer: Aetna Government	$0.22
Rate for Payer: Brighton Health Commercial	$0.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.30
Rate for Payer: EmblemHealth Commercial	$0.22
Rate for Payer: Group Health Inc Commercial	$0.22
Rate for Payer: Group Health Inc Medicare	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.22
Rate for Payer: Hamaspik Choice Inc Medicare	$0.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.29

SPIRONOLACTONE 25 MG PO TABS

Facility

$0.19

Service Code	NDC 0904692761
Hospital Charge Code	0904692761
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.09

SPIRONOLACTONE 25 MG PO TABS

Facility

$0.19

Service Code	NDC 0904692761
Hospital Charge Code	0904692761
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.09
Rate for Payer: Aetna Government	$0.09
Rate for Payer: Brighton Health Commercial	$0.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.13
Rate for Payer: EmblemHealth Commercial	$0.09
Rate for Payer: Group Health Inc Commercial	$0.09
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.09
Rate for Payer: Hamaspik Choice Inc Medicare	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.12

SPIRONOLACTONE 25 MG PO TABS

Facility

$0.46

Service Code	NDC 5348914301
Hospital Charge Code	5348914301
Hospital Revenue Code	250
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.23
Rate for Payer: Aetna Government	$0.23
Rate for Payer: Brighton Health Commercial	$0.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.31
Rate for Payer: EmblemHealth Commercial	$0.23
Rate for Payer: Group Health Inc Commercial	$0.23
Rate for Payer: Group Health Inc Medicare	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23
Rate for Payer: Hamaspik Choice Inc Medicare	$0.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.30

SPIRONOLACTONE 25 MG PO TABS

Facility

$0.45

Service Code	NDC 1672922516
Hospital Charge Code	1672922516
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.22

SPIRONOLACTONE 25 MG PO TABS

Facility

$0.46

Service Code	NDC 5348914301
Hospital Charge Code	5348914301
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23

SPIRONOLACTONE 25 MG PO TABS

Facility

$0.23

Service Code	NDC 6068746511
Hospital Charge Code	6068746511
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11

SPIRONOLACTONE 25 MG PO TABS

Facility

$0.43

Service Code	NDC 6373954410
Hospital Charge Code	6373954410
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21

SPIRONOLACTONE 25 MG PO TABS

Facility

$0.23

Service Code	NDC 6068746511
Hospital Charge Code	6068746511
Hospital Revenue Code	250
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.11
Rate for Payer: Aetna Government	$0.11
Rate for Payer: Brighton Health Commercial	$0.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.16
Rate for Payer: EmblemHealth Commercial	$0.11
Rate for Payer: Group Health Inc Commercial	$0.11
Rate for Payer: Group Health Inc Medicare	$0.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11
Rate for Payer: Hamaspik Choice Inc Medicare	$0.11
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.15

SPIRONOLACTONE 25 MG PO TABS

Facility

$0.43

Service Code	NDC 6373954410
Hospital Charge Code	6373954410
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.21
Rate for Payer: Aetna Government	$0.21
Rate for Payer: Brighton Health Commercial	$0.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.29
Rate for Payer: EmblemHealth Commercial	$0.21
Rate for Payer: Group Health Inc Commercial	$0.21
Rate for Payer: Group Health Inc Medicare	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.28

SPIRONOLACTONE 5 MG/ML PO SUSP - COMPOUNDED

Facility

$1.00

Service Code	NDC 9999701384
Hospital Charge Code	9999701384
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Brighton Health Commercial	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: EmblemHealth Commercial	$0.50
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65

Know your out-of-pocket cost for care.

All Charges