St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

VANCOMYCIN HCL 750 MG/150ML IV SOLN

Facility

$0.10

Service Code	HCPCS J3375
Hospital Charge Code	7059405603
Hospital Revenue Code	258
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05

VANCOMYCIN HCL 750 MG/150ML IV SOLN

Facility

$0.10

Service Code	HCPCS J3375
Hospital Charge Code	7059405603
Hospital Revenue Code	258
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.05
Rate for Payer: Aetna Government	$0.05
Rate for Payer: Brighton Health Commercial	$0.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.07
Rate for Payer: EmblemHealth Commercial	$0.05
Rate for Payer: Group Health Inc Commercial	$0.05
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.06

VANCOMYCIN HCL 750 MG/150ML IV SOLN

Facility

$0.10

Service Code	HCPCS J3375
Hospital Charge Code	7059405601
Hospital Revenue Code	258
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.05
Rate for Payer: Aetna Government	$0.05
Rate for Payer: Brighton Health Commercial	$0.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.07
Rate for Payer: EmblemHealth Commercial	$0.05
Rate for Payer: Group Health Inc Commercial	$0.05
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.06

VANCOMYCIN HCL 750 MG IV SOLR

Facility

$11.80

Service Code	HCPCS J3373
Hospital Charge Code	0409653102
Hospital Revenue Code	258
Min. Negotiated Rate	$5.90
Max. Negotiated Rate	$5.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.90

VANCOMYCIN HCL 750 MG IV SOLR

Facility

$11.40

Service Code	HCPCS J3373
Hospital Charge Code	6332320320
Hospital Revenue Code	258
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$9.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.70
Rate for Payer: Aetna Government	$5.70
Rate for Payer: Brighton Health Commercial	$8.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.75
Rate for Payer: EmblemHealth Commercial	$5.70
Rate for Payer: Group Health Inc Commercial	$5.70
Rate for Payer: Group Health Inc Medicare	$3.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.70
Rate for Payer: Hamaspik Choice Inc Medicare	$5.70
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.41

VANCOMYCIN HCL 750 MG IV SOLR

Facility

$11.80

Service Code	HCPCS J3373
Hospital Charge Code	0409653102
Hospital Revenue Code	258
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$9.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.90
Rate for Payer: Aetna Government	$5.90
Rate for Payer: Brighton Health Commercial	$8.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.03
Rate for Payer: EmblemHealth Commercial	$5.90
Rate for Payer: Group Health Inc Commercial	$5.90
Rate for Payer: Group Health Inc Medicare	$4.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.90
Rate for Payer: Hamaspik Choice Inc Medicare	$5.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.67

VANCOMYCIN HCL 750 MG IV SOLR

Facility

$9.10

Service Code	HCPCS J3373
Hospital Charge Code	6332320341
Hospital Revenue Code	258
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$4.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.55

VANCOMYCIN HCL 750 MG IV SOLR

Facility

$9.10

Service Code	HCPCS J3373
Hospital Charge Code	6332320326
Hospital Revenue Code	258
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$7.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.55
Rate for Payer: Aetna Government	$4.55
Rate for Payer: Brighton Health Commercial	$6.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.19
Rate for Payer: EmblemHealth Commercial	$4.55
Rate for Payer: Group Health Inc Commercial	$4.55
Rate for Payer: Group Health Inc Medicare	$3.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.55
Rate for Payer: Hamaspik Choice Inc Medicare	$4.55
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.91

VANCOMYCIN HCL 750 MG IV SOLR

Facility

$11.40

Service Code	HCPCS J3373
Hospital Charge Code	6332320320
Hospital Revenue Code	258
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.70

VANCOMYCIN HCL 750 MG IV SOLR

Facility

$9.10

Service Code	HCPCS J3373
Hospital Charge Code	6332320341
Hospital Revenue Code	258
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$7.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.55
Rate for Payer: Aetna Government	$4.55
Rate for Payer: Brighton Health Commercial	$6.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.19
Rate for Payer: EmblemHealth Commercial	$4.55
Rate for Payer: Group Health Inc Commercial	$4.55
Rate for Payer: Group Health Inc Medicare	$3.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.55
Rate for Payer: Hamaspik Choice Inc Medicare	$4.55
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.92

VANCOMYCIN HCL 750 MG IV SOLR

Facility

$11.63

Service Code	HCPCS J3374
Hospital Charge Code	6745770575
Hospital Revenue Code	258
Min. Negotiated Rate	$5.81
Max. Negotiated Rate	$5.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.81

VANCOMYCIN HCL 750 MG IV SOLR

Facility

$9.10

Service Code	HCPCS J3373
Hospital Charge Code	6332320326
Hospital Revenue Code	258
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$4.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.55

VANCOMYCIN HCL 750 MG IV SOLR

Facility

$11.63

Service Code	HCPCS J3374
Hospital Charge Code	6745770575
Hospital Revenue Code	258
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$9.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.81
Rate for Payer: Aetna Government	$5.81
Rate for Payer: Brighton Health Commercial	$8.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.91
Rate for Payer: EmblemHealth Commercial	$5.81
Rate for Payer: Group Health Inc Commercial	$5.81
Rate for Payer: Group Health Inc Medicare	$4.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.81
Rate for Payer: Hamaspik Choice Inc Medicare	$5.81
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.56

VANCOMYCIN HCL 750 MG IV SOLR

Facility

$11.40

Service Code	HCPCS J3373
Hospital Charge Code	6332320301
Hospital Revenue Code	258
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$9.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.70
Rate for Payer: Aetna Government	$5.70
Rate for Payer: Brighton Health Commercial	$8.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.75
Rate for Payer: EmblemHealth Commercial	$5.70
Rate for Payer: Group Health Inc Commercial	$5.70
Rate for Payer: Group Health Inc Medicare	$3.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.70
Rate for Payer: Hamaspik Choice Inc Medicare	$5.70
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.41

VANCOMYCIN HCL 750 MG IV SOLR

Facility

$11.40

Service Code	HCPCS J3373
Hospital Charge Code	6332320301
Hospital Revenue Code	258
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.70

VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR

Facility

$209.04

Service Code	NDC 0006482701
Hospital Charge Code	0006482701
Hospital Revenue Code	250
Min. Negotiated Rate	$104.52
Max. Negotiated Rate	$104.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$104.52

VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR

Facility

$209.04

Service Code	NDC 0006482700
Hospital Charge Code	0006482700
Hospital Revenue Code	250
Min. Negotiated Rate	$73.16
Max. Negotiated Rate	$167.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$114.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$104.52
Rate for Payer: Aetna Government	$104.52
Rate for Payer: Brighton Health Commercial	$156.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$167.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$142.15
Rate for Payer: EmblemHealth Commercial	$104.52
Rate for Payer: Group Health Inc Commercial	$104.52
Rate for Payer: Group Health Inc Medicare	$73.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$104.52
Rate for Payer: Hamaspik Choice Inc Medicare	$104.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$135.87

VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR

Facility

$209.04

Service Code	NDC 0006482701
Hospital Charge Code	0006482701
Hospital Revenue Code	250
Min. Negotiated Rate	$73.16
Max. Negotiated Rate	$167.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$114.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$104.52
Rate for Payer: Aetna Government	$104.52
Rate for Payer: Brighton Health Commercial	$156.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$167.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$142.15
Rate for Payer: EmblemHealth Commercial	$104.52
Rate for Payer: Group Health Inc Commercial	$104.52
Rate for Payer: Group Health Inc Medicare	$73.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$104.52
Rate for Payer: Hamaspik Choice Inc Medicare	$104.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$135.87

VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR

Facility

$209.04

Service Code	NDC 0006482700
Hospital Charge Code	0006482700
Hospital Revenue Code	250
Min. Negotiated Rate	$104.52
Max. Negotiated Rate	$104.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$104.52

VASCULAR ACCESS BY NEEDLE OR CATHETER

Facility

$331.04

Service Code	EAPG 00423
Min. Negotiated Rate	$240.69
Max. Negotiated Rate	$331.04
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$240.69
Rate for Payer: Healthfirst Commercial	$331.04

VASOPRESSIN 20 UNIT/ML IV SOLN

Facility

$60.00

Service Code	HCPCS J2598
Hospital Charge Code	0517102025
Hospital Revenue Code	258
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.00

VASOPRESSIN 20 UNIT/ML IV SOLN

Facility

$97.20

Service Code	HCPCS J2598
Hospital Charge Code	4202316425
Hospital Revenue Code	258
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$48.60

VASOPRESSIN 20 UNIT/ML IV SOLN

Facility

$126.13

Service Code	HCPCS J2598
Hospital Charge Code	7012116425
Hospital Revenue Code	258
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$100.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$69.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$63.06
Rate for Payer: Aetna Government	$63.06
Rate for Payer: Brighton Health Commercial	$94.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.77
Rate for Payer: EmblemHealth Commercial	$63.06
Rate for Payer: Group Health Inc Commercial	$63.06
Rate for Payer: Group Health Inc Medicare	$44.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.06
Rate for Payer: Hamaspik Choice Inc Medicare	$63.06
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.93
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$81.98

VASOPRESSIN 20 UNIT/ML IV SOLN

Facility

$60.00

Service Code	HCPCS J2598
Hospital Charge Code	0517102025
Hospital Revenue Code	258
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$48.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.00
Rate for Payer: Aetna Government	$30.00
Rate for Payer: Brighton Health Commercial	$45.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.80
Rate for Payer: EmblemHealth Commercial	$30.00
Rate for Payer: Group Health Inc Commercial	$30.00
Rate for Payer: Group Health Inc Medicare	$21.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.00
Rate for Payer: Hamaspik Choice Inc Medicare	$30.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.93
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$39.00

VASOPRESSIN 20 UNIT/ML IV SOLN

Facility

$180.18

Service Code	HCPCS J2598
Hospital Charge Code	5515037125
Hospital Revenue Code	258
Min. Negotiated Rate	$90.09
Max. Negotiated Rate	$90.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$90.09

Know your out-of-pocket cost for care.

All Charges