St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

STERILE WATER FOR IRRIGATION IR SOLN

Facility

$0.01

Service Code	NDC 0338000403
Hospital Charge Code	0338000403
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

STERILE WATER FOR IRRIGATION IR SOLN

Facility

$0.01

Service Code	NDC 0338000347
Hospital Charge Code	0338000347
Hospital Revenue Code	250
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.00
Rate for Payer: Aetna Government	$0.00
Rate for Payer: Brighton Health Commercial	$0.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.00
Rate for Payer: EmblemHealth Commercial	$0.00
Rate for Payer: Group Health Inc Commercial	$0.00
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.00
Rate for Payer: Hamaspik Choice Inc Medicare	$0.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.00

STERILE WATER FOR IRRIGATION IR SOLN

Facility

$0.01

Service Code	NDC 0338000347
Hospital Charge Code	0338000347
Hospital Revenue Code	250
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.00

STERILE WATER FOR IRRIGATION IR SOLN

Facility

$0.00

Service Code	NDC 0338000404
Hospital Charge Code	0338000404
Hospital Revenue Code	250
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.00

STRABISMUS AND MUSCLE EYE PROCEDURES

Facility

$3,024.30

Service Code	EAPG 00239
Min. Negotiated Rate	$2,196.27
Max. Negotiated Rate	$3,024.30
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,196.27
Rate for Payer: Healthfirst Commercial	$3,024.30

STREPTOMYCIN SULFATE 1 G IM SOLR

Facility

$93.75

Service Code	HCPCS J3000
Hospital Charge Code	3982207062
Hospital Revenue Code	250
Min. Negotiated Rate	$46.88
Max. Negotiated Rate	$46.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$46.88

STREPTOMYCIN SULFATE 1 G IM SOLR

Facility

$93.75

Service Code	HCPCS J3000
Hospital Charge Code	3982207062
Hospital Revenue Code	250
Min. Negotiated Rate	$32.81
Max. Negotiated Rate	$75.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$51.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$34.55
Rate for Payer: Aetna Government	$34.55
Rate for Payer: Brighton Health Commercial	$70.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$75.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$63.75
Rate for Payer: EmblemHealth Commercial	$46.88
Rate for Payer: Group Health Inc Commercial	$46.88
Rate for Payer: Group Health Inc Medicare	$32.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$46.88
Rate for Payer: Hamaspik Choice Inc Medicare	$46.88
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$36.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$60.94

SUCCIMER 100 MG PO CAPS

Facility

$26.44

Service Code	NDC 5529220111
Hospital Charge Code	5529220111
Hospital Revenue Code	250
Min. Negotiated Rate	$13.22
Max. Negotiated Rate	$13.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.22

SUCCIMER 100 MG PO CAPS

Facility

$26.44

Service Code	NDC 5529220111
Hospital Charge Code	5529220111
Hospital Revenue Code	250
Min. Negotiated Rate	$9.25
Max. Negotiated Rate	$21.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.22
Rate for Payer: Aetna Government	$13.22
Rate for Payer: Brighton Health Commercial	$19.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.98
Rate for Payer: EmblemHealth Commercial	$13.22
Rate for Payer: Group Health Inc Commercial	$13.22
Rate for Payer: Group Health Inc Medicare	$9.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.22
Rate for Payer: Hamaspik Choice Inc Medicare	$13.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$17.19

SUCCINYLCHOLINE CHLORIDE 100 MG/5ML IV SOSY

Facility

$3.36

Service Code	NDC 6937492005
Hospital Charge Code	6937492005
Hospital Revenue Code	258
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$1.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.68

SUCCINYLCHOLINE CHLORIDE 100 MG/5ML IV SOSY

Facility

$3.36

Service Code	NDC 6937492005
Hospital Charge Code	6937492005
Hospital Revenue Code	258
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$2.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.68
Rate for Payer: Aetna Government	$1.68
Rate for Payer: Brighton Health Commercial	$2.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.28
Rate for Payer: EmblemHealth Commercial	$1.68
Rate for Payer: Group Health Inc Commercial	$1.68
Rate for Payer: Group Health Inc Medicare	$1.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.68
Rate for Payer: Hamaspik Choice Inc Medicare	$1.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.18

SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN

Facility

$2.30

Service Code	NDC 1672949345
Hospital Charge Code	1672949345
Hospital Revenue Code	250
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$1.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.15
Rate for Payer: Aetna Government	$1.15
Rate for Payer: Brighton Health Commercial	$1.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.57
Rate for Payer: EmblemHealth Commercial	$1.15
Rate for Payer: Group Health Inc Commercial	$1.15
Rate for Payer: Group Health Inc Medicare	$0.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.15
Rate for Payer: Hamaspik Choice Inc Medicare	$1.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.50

SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN

Facility

$2.30

Service Code	NDC 1672949345
Hospital Charge Code	1672949345
Hospital Revenue Code	250
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$1.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.15

SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN

Facility

$0.97

Service Code	NDC 4359866625
Hospital Charge Code	4359866625
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.48

SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN

Facility

$1.50

Service Code	NDC 6937430005
Hospital Charge Code	6937430005
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.75

SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN

Facility

$0.60

Service Code	NDC 7128871910
Hospital Charge Code	7128871910
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.30
Rate for Payer: Aetna Government	$0.30
Rate for Payer: Brighton Health Commercial	$0.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.41
Rate for Payer: EmblemHealth Commercial	$0.30
Rate for Payer: Group Health Inc Commercial	$0.30
Rate for Payer: Group Health Inc Medicare	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30
Rate for Payer: Hamaspik Choice Inc Medicare	$0.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.39

SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN

Facility

$0.60

Service Code	NDC 7128871910
Hospital Charge Code	7128871910
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30

SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN

Facility

$2.30

Service Code	NDC 3172298110
Hospital Charge Code	3172298110
Hospital Revenue Code	250
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$1.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.15
Rate for Payer: Aetna Government	$1.15
Rate for Payer: Brighton Health Commercial	$1.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.57
Rate for Payer: EmblemHealth Commercial	$1.15
Rate for Payer: Group Health Inc Commercial	$1.15
Rate for Payer: Group Health Inc Medicare	$0.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.15
Rate for Payer: Hamaspik Choice Inc Medicare	$1.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.50

SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN

Facility

$2.30

Service Code	NDC 3172298110
Hospital Charge Code	3172298110
Hospital Revenue Code	250
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$1.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.15

SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN

Facility

$2.40

Service Code	NDC 7071013771
Hospital Charge Code	7071013771
Hospital Revenue Code	250
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$1.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.20
Rate for Payer: Aetna Government	$1.20
Rate for Payer: Brighton Health Commercial	$1.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.63
Rate for Payer: EmblemHealth Commercial	$1.20
Rate for Payer: Group Health Inc Commercial	$1.20
Rate for Payer: Group Health Inc Medicare	$0.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.20
Rate for Payer: Hamaspik Choice Inc Medicare	$1.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.56

SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN

Facility

$2.40

Service Code	NDC 7071013772
Hospital Charge Code	7071013772
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.20

SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN

Facility

$2.40

Service Code	NDC 7071013772
Hospital Charge Code	7071013772
Hospital Revenue Code	250
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$1.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.20
Rate for Payer: Aetna Government	$1.20
Rate for Payer: Brighton Health Commercial	$1.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.63
Rate for Payer: EmblemHealth Commercial	$1.20
Rate for Payer: Group Health Inc Commercial	$1.20
Rate for Payer: Group Health Inc Medicare	$0.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.20
Rate for Payer: Hamaspik Choice Inc Medicare	$1.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.56

SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN

Facility

$2.33

Service Code	NDC 0409662902
Hospital Charge Code	0409662902
Hospital Revenue Code	250
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$1.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.16
Rate for Payer: Aetna Government	$1.16
Rate for Payer: Brighton Health Commercial	$1.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.58
Rate for Payer: EmblemHealth Commercial	$1.16
Rate for Payer: Group Health Inc Commercial	$1.16
Rate for Payer: Group Health Inc Medicare	$0.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.16
Rate for Payer: Hamaspik Choice Inc Medicare	$1.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.51

SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN

Facility

$0.97

Service Code	NDC 4359866625
Hospital Charge Code	4359866625
Hospital Revenue Code	250
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.77
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	$0.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.77
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

SUCCINYLCHOLINE CHLORIDE 20 MG/ML IJ SOLN

Facility

$2.30

Service Code	NDC 3172298131
Hospital Charge Code	3172298131
Hospital Revenue Code	250
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$1.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.15
Rate for Payer: Aetna Government	$1.15
Rate for Payer: Brighton Health Commercial	$1.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.57
Rate for Payer: EmblemHealth Commercial	$1.15
Rate for Payer: Group Health Inc Commercial	$1.15
Rate for Payer: Group Health Inc Medicare	$0.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.15
Rate for Payer: Hamaspik Choice Inc Medicare	$1.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.50

Know your out-of-pocket cost for care.

All Charges