St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

Viral illness

Facility

$79,286.49

Service Code	APR-DRG 7234
Min. Negotiated Rate	$27,851.00
Max. Negotiated Rate	$79,286.49
Rate for Payer: Affinity Essential Plan 1&2	$79,286.49
Rate for Payer: Affinity Essential Plan 3&4	$79,286.49
Rate for Payer: Affinity Medicaid/CHP/HARP	$35,238.44
Rate for Payer: Amida Care Medicaid	$35,238.44
Rate for Payer: EmblemHealth Essential Plan 1&2	$79,286.49
Rate for Payer: EmblemHealth Essential Plan 3&4	$35,238.44
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35,238.44
Rate for Payer: Fidelis Qualified Health Plan	$42,286.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$35,238.44
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35,238.44
Rate for Payer: Healthfirst Commercial	$54,542.00
Rate for Payer: Healthfirst Essential Plan	$79,286.49
Rate for Payer: Healthfirst QHP	$27,851.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35,238.44
Rate for Payer: SOMOS Essential	$79,286.49
Rate for Payer: United Healthcare Essential Plan 1&2	$79,286.49
Rate for Payer: United Healthcare Essential Plan 3&4	$79,286.49
Rate for Payer: United Healthcare Medicaid	$35,238.44
Rate for Payer: Wellcare CHP/FHP/Medicaid	$35,238.44

Viral illness

Facility

$40,103.39

Service Code	APR-DRG 7231
Min. Negotiated Rate	$5,296.00
Max. Negotiated Rate	$40,103.39
Rate for Payer: Affinity Essential Plan 1&2	$40,103.39
Rate for Payer: Affinity Essential Plan 3&4	$40,103.39
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,823.73
Rate for Payer: Amida Care Medicaid	$17,823.73
Rate for Payer: EmblemHealth Essential Plan 1&2	$40,103.39
Rate for Payer: EmblemHealth Essential Plan 3&4	$17,823.73
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,823.73
Rate for Payer: Fidelis Qualified Health Plan	$21,388.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,823.73
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,823.73
Rate for Payer: Healthfirst Commercial	$9,208.00
Rate for Payer: Healthfirst Essential Plan	$40,103.39
Rate for Payer: Healthfirst QHP	$5,296.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,823.73
Rate for Payer: SOMOS Essential	$40,103.39
Rate for Payer: United Healthcare Essential Plan 1&2	$40,103.39
Rate for Payer: United Healthcare Essential Plan 3&4	$40,103.39
Rate for Payer: United Healthcare Medicaid	$17,823.73
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,823.73

Viral illness

Facility

$41,784.75

Service Code	APR-DRG 7232
Min. Negotiated Rate	$6,252.00
Max. Negotiated Rate	$41,784.75
Rate for Payer: Affinity Essential Plan 1&2	$41,784.75
Rate for Payer: Affinity Essential Plan 3&4	$41,784.75
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,571.00
Rate for Payer: Amida Care Medicaid	$18,571.00
Rate for Payer: EmblemHealth Essential Plan 1&2	$41,784.75
Rate for Payer: EmblemHealth Essential Plan 3&4	$18,571.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,571.00
Rate for Payer: Fidelis Qualified Health Plan	$22,285.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,571.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,571.00
Rate for Payer: Healthfirst Commercial	$10,708.00
Rate for Payer: Healthfirst Essential Plan	$41,784.75
Rate for Payer: Healthfirst QHP	$6,252.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,571.00
Rate for Payer: SOMOS Essential	$41,784.75
Rate for Payer: United Healthcare Essential Plan 1&2	$41,784.75
Rate for Payer: United Healthcare Essential Plan 3&4	$41,784.75
Rate for Payer: United Healthcare Medicaid	$18,571.00
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,571.00

VIRAL ILLNESS

Facility

$225.90

Service Code	EAPG 00808
Min. Negotiated Rate	$164.32
Max. Negotiated Rate	$225.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$164.32
Rate for Payer: Healthfirst Commercial	$225.90

Viral meningitis

Facility

$42,871.66

Service Code	APR-DRG 0511
Min. Negotiated Rate	$6,666.00
Max. Negotiated Rate	$42,871.66
Rate for Payer: Affinity Essential Plan 1&2	$42,871.66
Rate for Payer: Affinity Essential Plan 3&4	$42,871.66
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,054.07
Rate for Payer: Amida Care Medicaid	$19,054.07
Rate for Payer: EmblemHealth Essential Plan 1&2	$42,871.66
Rate for Payer: EmblemHealth Essential Plan 3&4	$19,054.07
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,054.07
Rate for Payer: Fidelis Qualified Health Plan	$22,864.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,054.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,054.07
Rate for Payer: Healthfirst Commercial	$11,794.00
Rate for Payer: Healthfirst Essential Plan	$42,871.66
Rate for Payer: Healthfirst QHP	$6,666.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,054.07
Rate for Payer: SOMOS Essential	$42,871.66
Rate for Payer: United Healthcare Essential Plan 1&2	$42,871.66
Rate for Payer: United Healthcare Essential Plan 3&4	$42,871.66
Rate for Payer: United Healthcare Medicaid	$19,054.07
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,054.07

Viral meningitis

Facility

$45,791.17

Service Code	APR-DRG 0512
Min. Negotiated Rate	$8,569.00
Max. Negotiated Rate	$45,791.17
Rate for Payer: Affinity Essential Plan 1&2	$45,791.17
Rate for Payer: Affinity Essential Plan 3&4	$45,791.17
Rate for Payer: Affinity Medicaid/CHP/HARP	$20,351.63
Rate for Payer: Amida Care Medicaid	$20,351.63
Rate for Payer: EmblemHealth Essential Plan 1&2	$45,791.17
Rate for Payer: EmblemHealth Essential Plan 3&4	$20,351.63
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,351.63
Rate for Payer: Fidelis Qualified Health Plan	$24,421.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,351.63
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,351.63
Rate for Payer: Healthfirst Commercial	$14,421.00
Rate for Payer: Healthfirst Essential Plan	$45,791.17
Rate for Payer: Healthfirst QHP	$8,569.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,351.63
Rate for Payer: SOMOS Essential	$45,791.17
Rate for Payer: United Healthcare Essential Plan 1&2	$45,791.17
Rate for Payer: United Healthcare Essential Plan 3&4	$45,791.17
Rate for Payer: United Healthcare Medicaid	$20,351.63
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,351.63

Viral meningitis

Facility

$62,458.81

Service Code	APR-DRG 0514
Min. Negotiated Rate	$26,919.00
Max. Negotiated Rate	$62,458.81
Rate for Payer: Affinity Essential Plan 1&2	$62,458.81
Rate for Payer: Affinity Essential Plan 3&4	$62,458.81
Rate for Payer: Affinity Medicaid/CHP/HARP	$27,759.47
Rate for Payer: Amida Care Medicaid	$27,759.47
Rate for Payer: EmblemHealth Essential Plan 1&2	$62,458.81
Rate for Payer: EmblemHealth Essential Plan 3&4	$27,759.47
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27,759.47
Rate for Payer: Fidelis Qualified Health Plan	$33,311.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$27,759.47
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27,759.47
Rate for Payer: Healthfirst Commercial	$26,919.00
Rate for Payer: Healthfirst Essential Plan	$62,458.81
Rate for Payer: Healthfirst QHP	$38,705.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27,759.47
Rate for Payer: SOMOS Essential	$62,458.81
Rate for Payer: United Healthcare Essential Plan 1&2	$62,458.81
Rate for Payer: United Healthcare Essential Plan 3&4	$62,458.81
Rate for Payer: United Healthcare Medicaid	$27,759.47
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27,759.47

Viral meningitis

Facility

$58,693.32

Service Code	APR-DRG 0513
Min. Negotiated Rate	$13,185.00
Max. Negotiated Rate	$58,693.32
Rate for Payer: Affinity Essential Plan 1&2	$58,693.32
Rate for Payer: Affinity Essential Plan 3&4	$58,693.32
Rate for Payer: Affinity Medicaid/CHP/HARP	$26,085.92
Rate for Payer: Amida Care Medicaid	$26,085.92
Rate for Payer: EmblemHealth Essential Plan 1&2	$58,693.32
Rate for Payer: EmblemHealth Essential Plan 3&4	$26,085.92
Rate for Payer: Fidelis CHP/HARP/Medicaid	$26,085.92
Rate for Payer: Fidelis Qualified Health Plan	$31,303.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$26,085.92
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$26,085.92
Rate for Payer: Healthfirst Commercial	$23,767.00
Rate for Payer: Healthfirst Essential Plan	$58,693.32
Rate for Payer: Healthfirst QHP	$13,185.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$26,085.92
Rate for Payer: SOMOS Essential	$58,693.32
Rate for Payer: United Healthcare Essential Plan 1&2	$58,693.32
Rate for Payer: United Healthcare Essential Plan 3&4	$58,693.32
Rate for Payer: United Healthcare Medicaid	$26,085.92
Rate for Payer: Wellcare CHP/FHP/Medicaid	$26,085.92

VIRAL MENINGITIS

Facility

$185.14

Service Code	EAPG 00812
Min. Negotiated Rate	$185.14
Max. Negotiated Rate	$185.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$185.14

VITAMIN A 15 MG/ML IM SOLN

Facility

$431.25

Service Code	NDC 7019902611
Hospital Charge Code	7019902611
Hospital Revenue Code	250
Min. Negotiated Rate	$215.62
Max. Negotiated Rate	$215.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$215.62

VITAMIN A 15 MG/ML IM SOLN

Facility

$431.25

Service Code	NDC 7019902611
Hospital Charge Code	7019902611
Hospital Revenue Code	250
Min. Negotiated Rate	$150.94
Max. Negotiated Rate	$345.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$237.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$215.62
Rate for Payer: Aetna Government	$215.62
Rate for Payer: Brighton Health Commercial	$323.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$345.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$293.25
Rate for Payer: EmblemHealth Commercial	$215.62
Rate for Payer: Group Health Inc Commercial	$215.62
Rate for Payer: Group Health Inc Medicare	$150.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$215.62
Rate for Payer: Hamaspik Choice Inc Medicare	$215.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$280.31

VITAMIN A 3 MG (10000 UT) PO CAPS

Facility

$0.04

Service Code	NDC 4009310144
Hospital Charge Code	4009310144
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.02
Rate for Payer: EmblemHealth Commercial	$0.02
Rate for Payer: Group Health Inc Commercial	$0.02
Rate for Payer: Group Health Inc Medicare	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.02

VITAMIN A 3 MG (10000 UT) PO CAPS

Facility

$0.03

Service Code	NDC 0761043310
Hospital Charge Code	0761043310
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.02
Rate for Payer: EmblemHealth Commercial	$0.02
Rate for Payer: Group Health Inc Commercial	$0.02
Rate for Payer: Group Health Inc Medicare	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.02

VITAMIN A 3 MG (10000 UT) PO CAPS

Facility

$0.03

Service Code	NDC 0761043310
Hospital Charge Code	0761043310
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

VITAMIN A 3 MG (10000 UT) PO CAPS

Facility

$0.04

Service Code	NDC 4009310144
Hospital Charge Code	4009310144
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

VITAMIN A & D EX OINT

Facility

$0.02

Service Code	NDC 6777721507
Hospital Charge Code	6777721507
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

VITAMIN A & D EX OINT

Facility

$0.02

Service Code	NDC 6777721507
Hospital Charge Code	6777721507
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
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	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
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	$0.01

VITAMIN B-1 100 MG PO TABS

Facility

$0.23

Service Code	NDC 6809411661
Hospital Charge Code	6809411661
Hospital Revenue Code	250
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.12
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	$0.15
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

VITAMIN B-1 100 MG PO TABS

Facility

$0.07

Service Code	NDC 1093951633
Hospital Charge Code	1093951633
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.03
Rate for Payer: Aetna Government	$0.03
Rate for Payer: Brighton Health Commercial	$0.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: EmblemHealth Commercial	$0.03
Rate for Payer: Group Health Inc Commercial	$0.03
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.04

VITAMIN B-1 100 MG PO TABS

Facility

$0.07

Service Code	NDC 1093951633
Hospital Charge Code	1093951633
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03

VITAMIN B-1 100 MG PO TABS

Facility

$0.23

Service Code	NDC 6809411661
Hospital Charge Code	6809411661
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11

VITAMIN B-12 1000 MCG PO TABS

Facility

$0.21

Service Code	NDC 2055500600
Hospital Charge Code	2055500600
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11

VITAMIN B-12 1000 MCG PO TABS

Facility

$0.21

Service Code	NDC 2055500600
Hospital Charge Code	2055500600
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.11
Rate for Payer: Aetna Government	$0.11
Rate for Payer: Brighton Health Commercial	$0.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.14
Rate for Payer: EmblemHealth Commercial	$0.11
Rate for Payer: Group Health Inc Commercial	$0.11
Rate for Payer: Group Health Inc Medicare	$0.07
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	$0.14

VITAMIN B12 100 MCG PO TABS

Facility

$0.02

Service Code	NDC 8068107100
Hospital Charge Code	8068107100
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	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
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	$0.01

VITAMIN B12 100 MCG PO TABS

Facility

$0.31

Service Code	NDC 5026885211
Hospital Charge Code	5026885211
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15

Know your out-of-pocket cost for care.

All Charges