St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

OXYTOCIN 30U 500ML -PER 10U D5RL

Facility

$4.23

Service Code	HCPCS J2590
Hospital Charge Code	41648037
Hospital Revenue Code	636
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$2.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2.12

OXYTOCIN 30U 500ML -PER 10U D5RL

Facility

$4.23

Service Code	HCPCS J2590
Hospital Charge Code	41658037
Hospital Revenue Code	636
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$2.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.72
Rate for Payer: Aetna Government	$0.72
Rate for Payer: Brighton Health Commercial	$2.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.43
Rate for Payer: Group Health Inc Commercial	$2.12
Rate for Payer: Group Health Inc Medicare	$1.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.75

OXYTOCIN 30U 500ML -PER 10U D5RL

Facility

$4.23

Service Code	HCPCS J2590
Hospital Charge Code	41658037
Hospital Revenue Code	636
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$2.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2.12

OXYTOCIN 30U 500ML- PER 10U RL

Facility

$3.99

Service Code	HCPCS J2590
Hospital Charge Code	41658038
Hospital Revenue Code	636
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$2.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00

OXYTOCIN 30U 500ML- PER 10U RL

Facility

$3.99

Service Code	HCPCS J2590
Hospital Charge Code	41648038
Hospital Revenue Code	636
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$2.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.72
Rate for Payer: Aetna Government	$0.72
Rate for Payer: Brighton Health Commercial	$2.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.29
Rate for Payer: Group Health Inc Commercial	$2.00
Rate for Payer: Group Health Inc Medicare	$1.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.59

OXYTOCIN 30U 500ML- PER 10U RL

Facility

$3.99

Service Code	HCPCS J2590
Hospital Charge Code	41658038
Hospital Revenue Code	636
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$2.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.72
Rate for Payer: Aetna Government	$0.72
Rate for Payer: Brighton Health Commercial	$2.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.29
Rate for Payer: Group Health Inc Commercial	$2.00
Rate for Payer: Group Health Inc Medicare	$1.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.59

OXYTOCIN 30U 500ML- PER 10U RL

Facility

$3.99

Service Code	HCPCS J2590
Hospital Charge Code	41648038
Hospital Revenue Code	636
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$2.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00

OXYTOCIN 30 UNITS/D5LR 1000 ML INFUSION

Facility

$21.50

Hospital Charge Code	41644658
Hospital Revenue Code	636
Min. Negotiated Rate	$10.75
Max. Negotiated Rate	$10.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.75
Rate for Payer: Hamaspik Choice Inc Medicare	$10.75

OXYTOCIN 30 UNITS/D5LR 1000 ML INFUSION

Facility

$21.50

Hospital Charge Code	41654658
Hospital Revenue Code	636
Min. Negotiated Rate	$10.75
Max. Negotiated Rate	$10.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.75
Rate for Payer: Hamaspik Choice Inc Medicare	$10.75

OXYTOCIN 30 UNITS/D5LR 1000 ML INFUSION

Facility

$21.50

Hospital Charge Code	41644658
Hospital Revenue Code	636
Min. Negotiated Rate	$7.52
Max. Negotiated Rate	$13.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.75
Rate for Payer: Aetna Government	$10.75
Rate for Payer: Brighton Health Commercial	$12.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.36
Rate for Payer: Group Health Inc Commercial	$10.75
Rate for Payer: Group Health Inc Medicare	$7.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.75
Rate for Payer: Hamaspik Choice Inc Medicare	$10.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.98

OXYTOCIN 30 UNITS/D5LR 1000 ML INFUSION

Facility

$21.50

Hospital Charge Code	41654658
Hospital Revenue Code	636
Min. Negotiated Rate	$7.52
Max. Negotiated Rate	$13.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.75
Rate for Payer: Aetna Government	$10.75
Rate for Payer: Brighton Health Commercial	$12.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.36
Rate for Payer: Group Health Inc Commercial	$10.75
Rate for Payer: Group Health Inc Medicare	$7.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.75
Rate for Payer: Hamaspik Choice Inc Medicare	$10.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.98

OXYTOCIN 30 UNITS/LR 1000 ML INFUSION

Facility

$21.50

Hospital Charge Code	41644657
Hospital Revenue Code	636
Min. Negotiated Rate	$7.52
Max. Negotiated Rate	$13.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.75
Rate for Payer: Aetna Government	$10.75
Rate for Payer: Brighton Health Commercial	$12.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.36
Rate for Payer: Group Health Inc Commercial	$10.75
Rate for Payer: Group Health Inc Medicare	$7.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.75
Rate for Payer: Hamaspik Choice Inc Medicare	$10.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.98

OXYTOCIN 30 UNITS/LR 1000 ML INFUSION

Facility

$21.50

Hospital Charge Code	41654657
Hospital Revenue Code	636
Min. Negotiated Rate	$7.52
Max. Negotiated Rate	$13.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.75
Rate for Payer: Aetna Government	$10.75
Rate for Payer: Brighton Health Commercial	$12.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.36
Rate for Payer: Group Health Inc Commercial	$10.75
Rate for Payer: Group Health Inc Medicare	$7.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.75
Rate for Payer: Hamaspik Choice Inc Medicare	$10.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.98

OXYTOCIN 30 UNITS/LR 1000 ML INFUSION

Facility

$21.50

Hospital Charge Code	41654657
Hospital Revenue Code	636
Min. Negotiated Rate	$10.75
Max. Negotiated Rate	$10.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.75
Rate for Payer: Hamaspik Choice Inc Medicare	$10.75

OXYTOCIN 30 UNITS/LR 1000 ML INFUSION

Facility

$21.50

Hospital Charge Code	41644657
Hospital Revenue Code	636
Min. Negotiated Rate	$10.75
Max. Negotiated Rate	$10.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.75
Rate for Payer: Hamaspik Choice Inc Medicare	$10.75

OXYTOCIN D-5W 15 UNITS/500ML LVP

Facility

$4.00

Hospital Charge Code	41647005
Hospital Revenue Code	250
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$3.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.00
Rate for Payer: Aetna Government	$2.00
Rate for Payer: Brighton Health Commercial	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.72
Rate for Payer: Group Health Inc Commercial	$2.00
Rate for Payer: Group Health Inc Medicare	$1.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.60

OXYTOCIN D5W 15 UNITS/500ML LVP

Facility

$4.00

Hospital Charge Code	41657005
Hospital Revenue Code	250
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$3.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.00
Rate for Payer: Aetna Government	$2.00
Rate for Payer: Brighton Health Commercial	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.72
Rate for Payer: Group Health Inc Commercial	$2.00
Rate for Payer: Group Health Inc Medicare	$1.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.60

OXYTOCIN-LACTATED RINGERS 30 UNIT/500ML IV SOLN [130245]

Facility

$0.07

Service Code	NDC 70092107124
Hospital Charge Code	70092107124
Hospital Revenue Code	278
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03

OXYTOCIN-LACTATED RINGERS 30 UNIT/500ML IV SOLN [130245]

Facility

$0.07

Service Code	NDC 70092107124
Hospital Charge Code	70092107124
Hospital Revenue Code	278
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.07
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	$0.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.04
Rate for Payer: EmblemHealth Commercial	$0.03
Rate for Payer: Fidelis Medicare Advantage	$0.07
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

OXYTOCIN LR 15 UNITS/500ML LVP

Facility

$4.00

Hospital Charge Code	41647007
Hospital Revenue Code	250
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$3.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.00
Rate for Payer: Aetna Government	$2.00
Rate for Payer: Brighton Health Commercial	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.72
Rate for Payer: Group Health Inc Commercial	$2.00
Rate for Payer: Group Health Inc Medicare	$1.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.60

OXYTOCIN LR 15 UNITS/500ML LVP

Facility

$4.00

Hospital Charge Code	41657007
Hospital Revenue Code	250
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$3.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.00
Rate for Payer: Aetna Government	$2.00
Rate for Payer: Brighton Health Commercial	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.72
Rate for Payer: Group Health Inc Commercial	$2.00
Rate for Payer: Group Health Inc Medicare	$1.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.60

OYSTER SHELL CALCIUM 500 MG PO TABS [5955]

Facility

$0.02

Service Code	NDC 00904188372
Hospital Charge Code	00904188372
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	$0.01
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

OYSTER SHELL CALCIUM 500 MG PO TABS [5955]

Facility

$0.11

Service Code	NDC 00904188361
Hospital Charge Code	00904188361
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	$0.05
Rate for Payer: Aetna Government	$0.05
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: Group Health Inc Commercial	$0.05
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.07

PACE BOWIE DICK TEST

Facility

$7.88

Hospital Charge Code	64904769
Hospital Revenue Code	270
Min. Negotiated Rate	$2.76
Max. Negotiated Rate	$6.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.94
Rate for Payer: Aetna Government	$3.94
Rate for Payer: Brighton Health Commercial	$5.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.36
Rate for Payer: Group Health Inc Commercial	$3.94
Rate for Payer: Group Health Inc Medicare	$2.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.94
Rate for Payer: Hamaspik Choice Inc Medicare	$3.94

PACEMAKER

Facility

$12,095.00

Service Code	HCPCS C1785
Hospital Charge Code	40202060
Hospital Revenue Code	275
Min. Negotiated Rate	$275.42
Max. Negotiated Rate	$12,699.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,652.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.42
Rate for Payer: Aetna Government	$275.42
Rate for Payer: Brighton Health Commercial	$7,257.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,047.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,954.62
Rate for Payer: EmblemHealth Commercial	$6,047.50
Rate for Payer: Fidelis Medicare Advantage	$12,699.75
Rate for Payer: Group Health Inc Commercial	$6,047.50
Rate for Payer: Group Health Inc Medicare	$4,233.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,047.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6,047.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,861.75

Know your out-of-pocket cost for care.

All Charges