St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PACK SYSTEM KELMAN TURBOSONIC

Facility

$1,875.00

Hospital Charge Code	64903042
Hospital Revenue Code	270
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,500.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,031.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$937.50
Rate for Payer: Aetna Government	$937.50
Rate for Payer: Brighton Health Commercial	$1,406.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,500.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,275.00
Rate for Payer: Group Health Inc Commercial	$937.50
Rate for Payer: Group Health Inc Medicare	$656.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$937.50
Rate for Payer: Hamaspik Choice Inc Medicare	$937.50

PACK,TEST,STEAM,RAPID 5

Facility

$14.78

Hospital Charge Code	64901190
Hospital Revenue Code	270
Min. Negotiated Rate	$5.17
Max. Negotiated Rate	$11.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.39
Rate for Payer: Aetna Government	$7.39
Rate for Payer: Brighton Health Commercial	$11.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.05
Rate for Payer: Group Health Inc Commercial	$7.39
Rate for Payer: Group Health Inc Medicare	$5.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.39
Rate for Payer: Hamaspik Choice Inc Medicare	$7.39

PACK TEST STERIL BIO W/25 CONTR

Facility

$13.00

Hospital Charge Code	64903501
Hospital Revenue Code	270
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$10.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.50
Rate for Payer: Aetna Government	$6.50
Rate for Payer: Brighton Health Commercial	$9.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.84
Rate for Payer: Group Health Inc Commercial	$6.50
Rate for Payer: Group Health Inc Medicare	$4.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6.50

PACK TOTAL JOINT

Facility

$271.15

Hospital Charge Code	64901364
Hospital Revenue Code	270
Min. Negotiated Rate	$94.90
Max. Negotiated Rate	$216.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$149.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$135.58
Rate for Payer: Aetna Government	$135.58
Rate for Payer: Brighton Health Commercial	$203.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$216.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$184.38
Rate for Payer: Group Health Inc Commercial	$135.58
Rate for Payer: Group Health Inc Medicare	$94.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$135.58
Rate for Payer: Hamaspik Choice Inc Medicare	$135.58

PACLITAXEL 100 MG/16.7ML IV CONC [31096]

Facility

$2.03

Service Code	HCPCS J9267
Hospital Charge Code	61703034222
Hospital Revenue Code	278
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.13
Rate for Payer: Aetna Government	$0.13
Rate for Payer: Brighton Health Commercial	$1.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.16
Rate for Payer: EmblemHealth Commercial	$1.01
Rate for Payer: Fidelis Medicare Advantage	$2.13
Rate for Payer: Group Health Inc Commercial	$1.01
Rate for Payer: Group Health Inc Medicare	$0.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.01
Rate for Payer: Hamaspik Choice Inc Medicare	$1.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.32

PACLITAXEL 100 MG/16.7ML IV CONC [31096]

Facility

$2.03

Service Code	HCPCS J9267
Hospital Charge Code	61703034222
Hospital Revenue Code	278
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$1.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.01
Rate for Payer: Hamaspik Choice Inc Medicare	$1.01

PACLITAXEL 100 MG/16.7ML IV CONC [31096]

Facility

$2.84

Service Code	HCPCS J9267
Hospital Charge Code	70860020017
Hospital Revenue Code	278
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.13
Rate for Payer: Aetna Government	$0.13
Rate for Payer: Brighton Health Commercial	$1.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.63
Rate for Payer: EmblemHealth Commercial	$1.42
Rate for Payer: Fidelis Medicare Advantage	$2.98
Rate for Payer: Group Health Inc Commercial	$1.42
Rate for Payer: Group Health Inc Medicare	$0.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.42
Rate for Payer: Hamaspik Choice Inc Medicare	$1.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.84

PACLITAXEL 100 MG/16.7ML IV CONC [31096]

Facility

$2.40

Service Code	HCPCS J9267
Hospital Charge Code	00703321601
Hospital Revenue Code	278
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.20
Rate for Payer: Hamaspik Choice Inc Medicare	$1.20

PACLITAXEL 100 MG/16.7ML IV CONC [31096]

Facility

$2.84

Service Code	HCPCS J9267
Hospital Charge Code	70860020017
Hospital Revenue Code	278
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$1.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.42
Rate for Payer: Hamaspik Choice Inc Medicare	$1.42

PACLITAXEL 100 MG/16.7ML IV CONC [31096]

Facility

$3.10

Service Code	HCPCS J9267
Hospital Charge Code	63323076316
Hospital Revenue Code	278
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$3.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.13
Rate for Payer: Aetna Government	$0.13
Rate for Payer: Brighton Health Commercial	$1.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.78
Rate for Payer: EmblemHealth Commercial	$1.55
Rate for Payer: Fidelis Medicare Advantage	$3.26
Rate for Payer: Group Health Inc Commercial	$1.55
Rate for Payer: Group Health Inc Medicare	$1.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.55
Rate for Payer: Hamaspik Choice Inc Medicare	$1.55
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.02

PACLITAXEL 100 MG/16.7ML IV CONC [31096]

Facility

$2.40

Service Code	HCPCS J9267
Hospital Charge Code	00703321601
Hospital Revenue Code	278
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.13
Rate for Payer: Aetna Government	$0.13
Rate for Payer: Brighton Health Commercial	$1.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.38
Rate for Payer: EmblemHealth Commercial	$1.20
Rate for Payer: Fidelis Medicare Advantage	$2.51
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

PACLITAXEL 100 MG/16.7ML IV CONC [31096]

Facility

$3.10

Service Code	HCPCS J9267
Hospital Charge Code	63323076316
Hospital Revenue Code	278
Min. Negotiated Rate	$1.55
Max. Negotiated Rate	$1.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.55
Rate for Payer: Hamaspik Choice Inc Medicare	$1.55

PACLITAXEL 300 MG/50ML IV CONC [31097]

Facility

$2.40

Service Code	HCPCS J9267
Hospital Charge Code	00703321801
Hospital Revenue Code	278
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.20
Rate for Payer: Hamaspik Choice Inc Medicare	$1.20

PACLITAXEL 300 MG/50ML IV CONC [31097]

Facility

$2.40

Service Code	HCPCS J9267
Hospital Charge Code	72205006301
Hospital Revenue Code	278
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.20
Rate for Payer: Hamaspik Choice Inc Medicare	$1.20

PACLITAXEL 300 MG/50ML IV CONC [31097]

Facility

$3.10

Service Code	HCPCS J9267
Hospital Charge Code	63323076350
Hospital Revenue Code	278
Min. Negotiated Rate	$1.55
Max. Negotiated Rate	$1.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.55
Rate for Payer: Hamaspik Choice Inc Medicare	$1.55

PACLITAXEL 300 MG/50ML IV CONC [31097]

Facility

$2.40

Service Code	HCPCS J9267
Hospital Charge Code	00703321801
Hospital Revenue Code	278
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.13
Rate for Payer: Aetna Government	$0.13
Rate for Payer: Brighton Health Commercial	$1.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.38
Rate for Payer: EmblemHealth Commercial	$1.20
Rate for Payer: Fidelis Medicare Advantage	$2.52
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

PACLITAXEL 300 MG/50ML IV CONC [31097]

Facility

$2.40

Service Code	HCPCS J9267
Hospital Charge Code	72205006301
Hospital Revenue Code	278
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.13
Rate for Payer: Aetna Government	$0.13
Rate for Payer: Brighton Health Commercial	$1.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.38
Rate for Payer: EmblemHealth Commercial	$1.20
Rate for Payer: Fidelis Medicare Advantage	$2.52
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

PACLITAXEL 300 MG/50ML IV CONC [31097]

Facility

$3.10

Service Code	HCPCS J9267
Hospital Charge Code	63323076350
Hospital Revenue Code	278
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$3.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.13
Rate for Payer: Aetna Government	$0.13
Rate for Payer: Brighton Health Commercial	$1.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.78
Rate for Payer: EmblemHealth Commercial	$1.55
Rate for Payer: Fidelis Medicare Advantage	$3.26
Rate for Payer: Group Health Inc Commercial	$1.55
Rate for Payer: Group Health Inc Medicare	$1.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.55
Rate for Payer: Hamaspik Choice Inc Medicare	$1.55
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.02

PACLITAXEL 30 MG/5ML IV CONC [31025]

Facility

$2.23

Service Code	HCPCS J9267
Hospital Charge Code	61703034209
Hospital Revenue Code	278
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$1.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1.12

PACLITAXEL 30 MG/5ML IV CONC [31025]

Facility

$2.23

Service Code	HCPCS J9267
Hospital Charge Code	61703034209
Hospital Revenue Code	278
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.13
Rate for Payer: Aetna Government	$0.13
Rate for Payer: Brighton Health Commercial	$1.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.28
Rate for Payer: EmblemHealth Commercial	$1.12
Rate for Payer: Fidelis Medicare Advantage	$2.35
Rate for Payer: Group Health Inc Commercial	$1.12
Rate for Payer: Group Health Inc Medicare	$0.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.45

PACLITAXEL PROTEIN 100MG INJ-NF

Facility

$18.27

Service Code	HCPCS J9264
Hospital Charge Code	41646646
Hospital Revenue Code	636
Min. Negotiated Rate	$9.14
Max. Negotiated Rate	$9.14
Rate for Payer: Cash Price	$14.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.14
Rate for Payer: Hamaspik Choice Inc Medicare	$9.14

PACLITAXEL PROTEIN 100MG INJ-NF

Facility

$18.27

Service Code	HCPCS J9264
Hospital Charge Code	41656646
Hospital Revenue Code	636
Min. Negotiated Rate	$9.14
Max. Negotiated Rate	$9.14
Rate for Payer: Cash Price	$14.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.14
Rate for Payer: Hamaspik Choice Inc Medicare	$9.14

PACLITAXEL PROTEIN 100MG INJ-NF

Facility

$18.27

Service Code	HCPCS J9264
Hospital Charge Code	41646646
Hospital Revenue Code	636
Min. Negotiated Rate	$9.14
Max. Negotiated Rate	$15.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.29
Rate for Payer: Aetna Government	$14.29
Rate for Payer: Affinity Essential Plan 1&2	$10.01
Rate for Payer: Affinity Essential Plan 3&4	$10.01
Rate for Payer: Affinity Medicaid/CHP/HARP	$10.01
Rate for Payer: Brighton Health Commercial	$10.96
Rate for Payer: Cash Price	$14.29
Rate for Payer: Cash Price	$14.29
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$14.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.51
Rate for Payer: Elderplan Medicare Advantage	$14.29
Rate for Payer: EmblemHealth Commercial	$14.29
Rate for Payer: Fidelis CHP/HARP/Medicaid	$14.29
Rate for Payer: Fidelis Essential Plan Aliesa	$14.29
Rate for Payer: Fidelis Essential Plan QHP	$15.01
Rate for Payer: Fidelis Medicare Advantage	$14.29
Rate for Payer: Fidelis Qualified Health Plan	$15.01
Rate for Payer: Group Health Inc Commercial	$14.29
Rate for Payer: Group Health Inc Medicare	$14.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.14
Rate for Payer: Hamaspik Choice Inc Medicare	$9.14
Rate for Payer: Healthfirst Medicare Advantage	$12.15
Rate for Payer: Healthfirst QHP	$14.29
Rate for Payer: Humana Medicare	$14.58
Rate for Payer: Senior Whole Health Medicare Advantage	$14.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$14.54
Rate for Payer: SOMOS Essential	$14.54
Rate for Payer: United Healthcare Commercial	$11.98
Rate for Payer: United Healthcare Medicare Advantage	$14.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.88
Rate for Payer: Wellcare CHP/FHP/Medicaid	$11.44
Rate for Payer: Wellcare Medicare	$13.58

PACLITAXEL PROTEIN 100MG INJ-NF

Facility

$18.27

Service Code	HCPCS J9264
Hospital Charge Code	41656646
Hospital Revenue Code	636
Min. Negotiated Rate	$9.14
Max. Negotiated Rate	$15.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.29
Rate for Payer: Aetna Government	$14.29
Rate for Payer: Affinity Essential Plan 1&2	$10.01
Rate for Payer: Affinity Essential Plan 3&4	$10.01
Rate for Payer: Affinity Medicaid/CHP/HARP	$10.01
Rate for Payer: Brighton Health Commercial	$10.96
Rate for Payer: Cash Price	$14.29
Rate for Payer: Cash Price	$14.29
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$14.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.51
Rate for Payer: Elderplan Medicare Advantage	$14.29
Rate for Payer: EmblemHealth Commercial	$14.29
Rate for Payer: Fidelis CHP/HARP/Medicaid	$14.29
Rate for Payer: Fidelis Essential Plan Aliesa	$14.29
Rate for Payer: Fidelis Essential Plan QHP	$15.01
Rate for Payer: Fidelis Medicare Advantage	$14.29
Rate for Payer: Fidelis Qualified Health Plan	$15.01
Rate for Payer: Group Health Inc Commercial	$14.29
Rate for Payer: Group Health Inc Medicare	$14.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.14
Rate for Payer: Hamaspik Choice Inc Medicare	$9.14
Rate for Payer: Healthfirst Medicare Advantage	$12.15
Rate for Payer: Healthfirst QHP	$14.29
Rate for Payer: Humana Medicare	$14.58
Rate for Payer: Senior Whole Health Medicare Advantage	$14.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$14.54
Rate for Payer: SOMOS Essential	$14.54
Rate for Payer: United Healthcare Commercial	$11.98
Rate for Payer: United Healthcare Medicare Advantage	$14.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.88
Rate for Payer: Wellcare CHP/FHP/Medicaid	$11.44
Rate for Payer: Wellcare Medicare	$13.58

PACLITAXEL PROTEIN-BOUND PART 100 MG IV SUSR [40475]

Facility

$1,896.07

Service Code	HCPCS J9264
Hospital Charge Code	68817013450
Hospital Revenue Code	278
Min. Negotiated Rate	$948.04
Max. Negotiated Rate	$948.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$948.04
Rate for Payer: Hamaspik Choice Inc Medicare	$948.04

Know your out-of-pocket cost for care.

All Charges